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Abstract
Objectives: Vitamin D deficiency (VDD) is common in immigrant children with increased skin pigmentation living in higher latitudes. We assessed the pattern of and risk factors for VDD in immigrant East African children living in Melbourne (latitude 37°49′ South).
Study design: A prospective survey of 232 East African children attending a clinic in Melbourne. Data were collected by questionnaire, medical assessment and laboratory tests.
Results: Low 25-hydroxyvitamin D (25-OHD) levels (<50 nmol/l) occurred in 87% of children, and VDD (25-OHD <25 nmol/l) in 44%. Risk factors included age <5 years, female gender, increased time in Australia, decreased daylight exposure and winter/spring season. Anaemia (20%), vitamin A deficiency (20%) and iron deficiency (19%) were also identified.
Conclusions: Asymptomatic VDD is common in East African immigrant children residing at a temperate latitude. Risk factors for VDD limit endogenous vitamin D production. Screening of immigrant children with increased skin pigmentation for VDD, anaemia, iron and vitamin A deficiency is appropriate. VDD in adolescent females identifies an increased risk of future infants with VDD.
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Footnotes
The study was conducted utilising the facilities and the material support of the Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, the Centre for International Child Health, University of Melbourne Department of Paediatrics, and the Royal Children’s Hospital. No other funding was required.
Competing interests: None.
- Abbreviations:
- ALP
- alkaline phosphatase
- BMI
- body mass index
- 95% CI
- 95% confidence interval
- IQR
- interquartile range
- 25-OHD
- 25-hydroxyvitamin D
- PTH
- parathyroid hormone
- RCH
- Royal Children’s Hospital
- RR
- risk ratio
- SD
- standard deviation
- SED
- standard erythemal dose
- UVB
- ultraviolet B
- UVR
- ultraviolet radiation
- VDD
- vitamin D deficiency
- VDI
- vitamin D insufficiency