Vitamin-D deficiency predicts infections in young north Indian children: A secondary data analysis

PLoS One. 2017 Mar 8;12(3):e0170509. doi: 10.1371/journal.pone.0170509. eCollection 2017.

Abstract

Background: Recent studies have demonstrated a relationship between poor vitamin D status and respiratory infections and diarrhea among young children. Acute lower respiratory infections (ALRI) and diarrhea are among the two most important causes of death in under-5 children. In this paper, we examined the extent to which vitamin-D deficiency (<10 ng/ml) predicts ALRI, clinical pneumonia and diarrhea among 6 to 30 months old children.

Methods: We used data from a randomized controlled trial (RCT) of daily folic acid and/or vitamin B12 supplementation for six months in 6 to 30 months old children conducted in Delhi, India. Generalized estimating equations (GEE) were used to examine the associations between vitamin-D deficiency and episodes of ALRI, clinical pneumonia and diarrhea.

Results: Of the 960 subjects who had vitamin-D concentrations measured, 331(34.5%) were vitamin-D deficient. We found, after controlling for relevant potential confounders (age, sex, breastfeeding status, wasting, stunting, underweight, anemia status and season), that the risk of ALRI was significantly higher among vitamin-D deficient (OR 1.26; 95% CI: 1.03 to 1.55) compared to vitamin-D-replete children in the six months follow-up period. Vitamin-D status was not associated with episodes of diarrhea or clinical pneumonia.

Conclusion: Vitamin-D deficiency is common in young children in New Delhi and is associated with a higher risk of ALRI. The role of vitamin D in Indian children needs to be elucidated in further studies.

MeSH terms

  • Child, Preschool
  • Diarrhea / complications
  • Diarrhea / diagnosis
  • Dietary Supplements
  • Female
  • Folic Acid / administration & dosage
  • Humans
  • India / epidemiology
  • Infant
  • Luminescent Measurements
  • Male
  • Odds Ratio
  • Pneumonia / complications
  • Pneumonia / diagnosis
  • Respiratory Tract Infections / complications*
  • Respiratory Tract Infections / diagnosis*
  • Seasons
  • Social Class
  • Vitamin B 12 / administration & dosage
  • Vitamin D / blood*
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / pathology

Substances

  • Vitamin D
  • Folic Acid
  • Vitamin B 12

Grants and funding

The study was supported by grants from the Centre for Intervention Science in Maternal and Child Health (CISMAC GRANTS 250216) (CISMAC; project number 223269), which is funded by the Research Council of Norway through its Centres of Excellence scheme and the University of Bergen (UiB), Norway. The implementation of the main trial was supported by grants from the South-Eastern Norway Regional Health Authority (grant no. 2012090) and Thrasher Research Fund (grant no. 9144). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.