Back
 Health  Vol.9 No.12 , November 2017
High Prevalence of Vitamin D Deficiency among Bangladeshi Children: An Emerging Public Health Problem
Abstract: Background: Recent studies suggested that vitamin D deficiency among children is widespread worldwide. Most of the Asian countries are suffering from high prevalence of vitamin D deficiency, especially in children. However, the vitamin D deficiency of Bangladeshi children has not been investigated yet. The objective of the study was to assess the prevalence of vitamin D deficiency among children in Dhaka city, Bangladesh. Methods: A cross-sectional study was designed. Children aged 0 month to 16 years attended Pediatrics’ clinics with minor illness were conveniently recruited. After obtaining informed written consent, venous blood was taken and serum 25(OH)D levels were determined by direct enzyme-linked immunosorbent assay. Descriptive statistics were performed for age, sex, biochemical parameters. Socio-economic status (SES) was estimated using a wealth index, producing a weighted score. Scores were categorized into quintiles, with category 1 representing the poorest and category 5 the richest. Serum 25(OH)D was categorized: deficient as <10 ng/ml, insufficient as 10 - 29 ng/ml and sufficient as 30 - 100 ng/ml. Results: 31.88% children of 0 - 1 year had deficient serum 25(OH)D level and 52.17% children had insufficient level. Among 2 - 5 years’ group, 38.16% were deficient and 50% were insufficient. Among the 6 - 11 years group, 41.02% were deficient and 52.56% were insufficient. Among 12 - 16 years group, 46.75% were deficient and 51.95% were insufficient. That means, serum 25-hydroxyvitamin D deficiency and insufficiency rate is found very high among Bangladeshi children. Conclusions: The prevalence of vitamin D deficiency and insufficiency among children in Bangladesh is high. The study recommended that vitamin D supplementation in Bangladeshi children should be formally launched from first day of birth up to adolescence.
Cite this paper: Zaman, S. , Hawlader, M. , Biswas, A. , Hasan, M. , Jahan, M. and Ahsan, G. (2017) High Prevalence of Vitamin D Deficiency among Bangladeshi Children: An Emerging Public Health Problem. Health, 9, 1680-1688. doi: 10.4236/health.2017.912123.
References

[1]   Webb, A.R. (2006) Who, What, Where and When-Influences on Cutaneous Vitamin D Synthesis. Progress in Biophysics and Molecular Biology, 92, 17-25.
https://doi.org/10.1016/j.pbiomolbio.2006.02.004

[2]   Holick, M.F. (2010) Vitamin D: Extra Skeletal Health. Endocrinology and Metabolism Clinics of North America, 39, 381-400.
https://doi.org/10.1016/j.ecl.2010.02.016

[3]   Holick, M.F. and Chen, T.C. (2008) Vitamin D Deficiency: A Worldwide Problem with Health Consequences. The American Journal of Clinical Nutrition, 87, 1080S-1086S.

[4]   Misra, M., Pacaud, D., Petryk, A., Collett-Solberg, P.F. and Kappy, M. (2008) Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations. Pediatrics, 122, 398-417.
https://doi.org/10.1542/peds.2007-1894

[5]   Pittas, A.G., Lau, J., Hu, F.B. and Dawson-Hughes, B. (2007) The Role of Vitamin D and Calcium in Type 2 Diabetes. A Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology and Metabolism, 92, 2017-2029.
https://doi.org/10.1210/jc.2007-0298

[6]   Svoren, B.M., Volkening, L.K., Wood, J.R. and Laffel, L.M. (2009) Significant Vitamin D Deficiency in Youth with Type 1 Diabetes Mellitus. The Journal of Pediatrics, 154, 132-134.
https://doi.org/10.1016/j.jpeds.2008.07.015

[7]   Garland, C.F., Gorham, E.D., Mohr, S.B. and Garland, F.C. (2009) Vitamin D for Cancer Prevention: Global Perspective. Annals of Epidemiology, 19, 468-483.
https://doi.org/10.1016/j.annepidem.2009.03.021

[8]   Cutolo, M. and Otsa, K. (2008) Review: Vitamin D, Immunity and Lupus. Lupus, 17, 6-10.
https://doi.org/10.1177/0961203307085879

[9]   Al Nozha, O.M. (2016) Vitamin D and Extra-Skeletal Health: Causality or Consequence. International Journal of Health Sciences (Qassim), 10, 443-452.

[10]   Cannell, J.J., Vieth, R., Umhau, J.C., Holick, M.F., Grant, W.B., et al. (2006) Epidemic Influenza and Vitamin D. Epidemiology and Infection, 134, 1129-1140.
https://doi.org/10.1017/S0950268806007175

[11]   Munger, K.L., Zhang, S.M., O’Reilly, E., Hernan, M.A., Olek, M.J., et al. (2004) Vitamin D Intake and Incidence of Multiple Sclerosis. Neurology, 62, 60-65.
https://doi.org/10.1212/01.WNL.0000101723.79681.38

[12]   Wang, T.J., Pencina, M.J., Booth, S.L., Jacques, P.F., Ingelsson, E., et al. (2008) Vitamin D Deficiency and Risk of Cardiovascular Disease. Circulation, 117, 503-511.
https://doi.org/10.1161/CIRCULATIONAHA.107.706127

[13]   Holick, M.F. (2007) Vitamin D Deficiency. The New England Journal of Medicine, 357, 266-281.
https://doi.org/10.1056/NEJMra070553

[14]   Arya, V., Bhambri, R., Godbole, M.M. and Mithal, A. (2004) Vitamin D Status and Its Relationship with Bone Mineral Density in Healthy Asian Indians. Osteoporosis International, 15, 56-61.
https://doi.org/10.1007/s00198-003-1491-3

[15]   Strand, M.A., Perry, J., Jin, M., Tracer, D.P., Fischer, P.R., Zhang, P., et al. (2007) Diagnosis of Rickets and Reassessment of Prevalence among Rural Children in Northern China. Pediatrics International, 49, 202-209.
https://doi.org/10.1111/j.1442-200X.2007.02343.x

[16]   Siddiqui, T.S. and Rai, M.I. (2005) Presentation and Predisposing Factors of Nutritional Rickets in Children of Hazara Division. Journal of Ayub Medical College, 17, 29-32.

[17]   Agarwal, K.S., Mughal, M.Z., Upadhyay, P., et al. (2002) The Impact of Atmospheric Pollution on Vitamin D Status of Infants and Toddlers in Delhi India. Archives of Disease in Childhood, 87, 111-113.
https://doi.org/10.1136/adc.87.2.111

[18]   Nakamura, K., Nashimoto, M., Okuda, Y., Ota, T. and Yamamoto, M. (2002) Fish as a Major Source of Vitamin Din the Japanese Diet. Nutrition, 18, 415-416.

[19]   Holick, M.F. (2006) High Prevalence of Vitamin D Inadequacy and Implications for Health. Mayo Clinic Proceedings, 81, 353-373.
https://doi.org/10.4065/81.3.353

[20]   Hollis, B.W. (2005) Circulating 25-Hydroxyvitamin D Levels Indicative of Vitamin D Sufficiency: Implications for Establishing a New Effective Dietary Intake Recommendation for Vitamin D. Journal of Nutrition, 135, 317-322.

[21]   Greer, F.R. (2003) Vitamin D Deficiency—It’s More than Rickets. Journal of Pediatrics, 143, 422-423.
https://doi.org/10.1067/S0022-3476(03)00465-7

[22]   Bischoff-Ferrari, H.A., Giovannucci, E., Willett, W.C., Dietrich, T. and Dawson-Hughes, B. (2006) Estimation of Optimal Serum Concentrations of 25-Hydroxyvitamin D for Multiple Health Outcomes. The American Journal of Clinical Nutrition, 84, 18-28.

[23]   Maalouf, J., Nabulsi, M., Vieth, R., Kimball, S., El-Rassi, R., Mahfoud, Z. and El-Hajj Fuleihan, G. (2008) Short-and Long-Term Safety of Weekly High-Dose Vitamin D3 Supplementation in School Children. The Journal of Clinical Endocrinology & Metabolism, 93, 2693-2701.
https://doi.org/10.1210/jc.2007-2530

[24]   Holick, M.F. (2007) Vitamin D Deficiency. The New England Journal of Medicine, 357, 266-281.
https://doi.org/10.1056/NEJMra070553

[25]   Yetley, E.A. (2008) Assessing the Vitamin D Status of the US Population. The American Journal of Clinical Nutrition, 88, 558-564.

[26]   Mansbach, J.M., Ginde, A.A. and Camargo, C.A. (2009) Serum 25-Hydroxyvitamin D Levels among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D. Pediatrics, 124, 1404-1410.
https://doi.org/10.1542/peds.2008-2041

[27]   Marwaha, R.K., Tandon, N., Reddy, D.R., Aggarwal, R., Singh, R., Sawhney, R.C., Saluja, B., Ganie, M.A. and Singh, S. (2005) Vitamin D and Bone Mineral Density Status of Healthy Schoolchildren in Northern India. The American Journal of Clinical Nutrition, 82, 477-482.

[28]   El-Hajj, F.G., Nabulsi, M., Choucair, M., Salamoun, M., Hajj Shahine, C., Kizirian, A. and Tannous, R. (2001) Hypovitaminosis D in Healthy Schoolchildren. Pediatrics, 107, 53.
https://doi.org/10.1542/peds.107.4.e53

[29]   McGrath, J.J., Kimlin, M.G., Saha, S., Eyles, D.W. and Parisi, A.V. (2001) Vitamin D Insufficiency in South-East Queensland. The Medical Journal, 174, 150-151.

[30]   Specker, B. (2004) Vitamin D Requirements during Pregnancy. The American Journal of Clinical Nutrition, 80, 1740S-1747S.

[31]   Islam, M.Z., Lamberg-Allardt, C., Karkkainen, M., Outila, T., Salamatullah, Q. and Shamim, A.A. (2002) Vitamin D Deficiency: A Concern in Premenopausal Bangladeshi Women of Two Socio-Economic Groups in Rural and Urban Region. European Journal of Clinical Nutrition, 56, 51-56.
https://doi.org/10.1038/sj.ejcn.1601284

[32]   Bhalala, U., Desai, M., Parekh, P., Mokal, R. and Chheda, B. (2007) Subclinical Hypovitaminosis D among Exclusively Breastfed Young Infants. Indian Pediatrics, 44, 897-901.

[33]   Atiq, M., Suria, A., Nizami, S.Q. and Ahmed, I. (1998) Maternal Vitamin D Deficiency in Pakistan. Acta Obstetricia et Gynecologica Scandinavica, 77, 970-973.
https://doi.org/10.1080/j.1600-0412.1998.771004.x

[34]   Dawodu, A., Agarwal, M., Hossain, M., Kochiyil, J. and Zayed, R. (2003) Hypovitaminosis D and Vitamin D Deficiency in Exclusively Breast-Feeding Infants and Their Mothers in Summer: A Justification for Vitamin D Supplementation of Breast-Feeding Infants. Journal of Pediatrics, 142, 169-173.
https://doi.org/10.1067/mpd.2003.63

[35]   Wagner, C.L. and Greer, F.R. (2008) Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Pediatrics, 122, 1142-1152.
https://doi.org/10.1542/peds.2008-1862

[36]   Ross, A.C., Manson, J.E., Abrams, S.A., Aloia, J.F., Brannon, P.M., Clinton, S.K., Durazo-Arvizu, R.A., Gallagher, J.C., Gallo, R.L., Jones, G., Kovacs, C.S., Mayne, S.T., Rosen, C.J. and Shapses, S.A. (2011) The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need Toknow. The Journal of Clinical Endocrinology & Metabolism, 96, 53-58.
https://doi.org/10.1210/jc.2010-2704

[37]   Chung, M., Balk, E.M., Brendel, M., Ip, S., Lau, J., Lee, J., Lichtenstein, A., Patel, K., Raman, G., Tatsioni, A., Terasawa, T. and Trikalinos, T.A. (2012) Vitamin D and Calcium: A Zhu et al. BMC Public Health, 12, 126.
https://doi.org/10.1186/1471-2458-12-126

 
 
Top