Vitamin D Deficiency among Children Aged 1-5 Years with Severe Pneumonia in comparison to Healthy Controls

Abstract

Background: Vitamin D Deficiency is on the rise and the effect of Vitamin D deficiency in various diseases like respiratory illness is being increasingly recognized. Hence this study was planned.

Objectives: To asses Dietary pattern, sun exposure, place of residence, Immunization status, anthropometry and Vitamin D levels among children-aged-1-5 years with severe pneumonia in comparison to healthy controls and find the association between Vitamin D deficiency and severe pneumonia.

Methods: Relevant parameters were assessed among 33 children with pneumonia and 33 healthy controls. Vitamin D was assessed using CLIA and was categorized into Normal (>30 ng/ml), Insufficient (20-19 ng/ml) and Deficient (<20 ng/ml) and both insufficient and deficient were included in low Vitamin D category. The data analyzed using SPSS version 24.

Results: Children belonged to Middle and Upper Lower Socio-Economic status. Mean age, gender, and Immunization status were comparable in both groups. 73% among cases and 49% controls were from rural setting. Malnutrition was more in the pneumonia group. Exclusive breastfeeding rate during first 6 months was lower than Kerala NFHS 5 data of 55%. Milk and Egg exclusion diet was noted in 12% and there was a significant association between exclusion diet and low Vitamin D status (P-0.015). Adequate sun exposure was noted in only 18% in the total children, 15% cases and 21% controls. 91% with adequate sun exposure had normal Vitamin D levels. The mean Vitamin D level was (34.13+14.01)ng/ml in cases Vs. (36.14+9.48)ng/ml in controls. Among the total children, 36% had low Vitamin D level and 6% were in the deficient category. Proportion of children with low Vitamin D were significantly more among cases than controls (51.5% vs 21.2%: P-0.011).

Conclusions: Dietary pattern, sun exposure and Vitamin D levels were suboptimum among the study children. Exclusion diets and reduced sun exposure were associated with low Vitamin D levels. Those with severe pneumonia had significantly lower Vitamin D levels compared to normal control children. Hence a closer look at this public health problem is recommended in order to optimize dietary pattern, sun exposure and Vitamin D Status among children in health and diseases.