Vitamin D deficiency among newly diagnosed tuberculosis patients and their household contacts: a comparative cross-sectional studyReport as inadecuate




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Archives of Public Health

, 75:25

First Online: 19 June 2017Received: 26 January 2017Accepted: 13 April 2017DOI: 10.1186-s13690-017-0195-7

Cite this article as: Workineh, M., Mathewos, B., Moges, B. et al. Arch Public Health 2017 75: 25. doi:10.1186-s13690-017-0195-7

Abstract

BackgroundRecent studies suggest that the incidence and severity of tuberculosis is associated with low levels of vitamin D. Even though individuals living in Ethiopia have a high exposure to sunlight which is a source of vitamin D, tuberculosis is still one of the major causes of morbidity and mortality in the country. Therefore, this study aimed to determine the prevalence and associated factors of vitamin D deficiency in newly diagnosed tuberculosis patients, household contacts and community controls in Gondar, Ethiopia.

MethodsA comparative cross-sectional study design was conducted. Blood samples were collected from newly diagnosed smear positive pulmonary TB patients, their household contacts and community controls. Serum 25OH-vitamin D3 was determined by an Enzyme Linked Immunosorbent Assay. A serum level of 25OH-vitamin D3 below < 50 nmol-L was defined as vitamin D deficiency and <25 nmol-L as severe vitamin D deficiency.

ResultsA total of 126 newly diagnosed smear positive TB patients, 57 house hold contacts and 70 apparently community controls were included in the study. The mean ± SD age years of TB patients, house hold contacts and community controls was 29.8 ± 11.9, 24.3 ± 14.7 and 27.3 ± 7.6 respectively. Ninety out of 126 71.4% TB patients were underweight with a BMI of < 18.5 kg-m. The mean 25OH-vitamin D3 level of TB patients 30.1 ± 19.3 nmol-L was significantly lower than community controls 38.5 ± 20.9 nmol-L, P = 0.005 and household contacts 37.7 ± 12.8 nmol-L, P =0.031

The prevalence of vitamin D deficiency was higher in TB patients 83.3% than in community controls 67.1%, P = 0.009. The prevalence of vitamin D deficiency was also found higher in household contacts 80.7%. Severe vitamin D deficiency was observed in 53%67-126, 30% 21-70, 19.3%11-57 of TB patients, community controls and household contacts respectively. Low BMI AOR = 2.13; 95%CI: 1.02, 3.28 and being positive for tuberculosis AOR = 1.93; 95%CI: 1.06, 2.86 were significant predictors of severe vitamin D deficiency.

ConclusionHigh prevalence of vitamin D deficiency was found among newly diagnosed TB patients and in their household contacts. The present study warrants further studies to determine the role of vitamin D supplementation in the prevention and treatment of tuberculosis in Ethiopia.

KeywordsVitamin D deficiency Tuberculosis Ethiopia AbbreviationsANOVAAnalysis of variance

ASBMRAmerican Society for Bone and Mineral Research

BMIBody mass index

CCCommunity controls

CD4Cluster of differentiation 4

CD8Cluster of differentiation 8

DOTSDirectly observed treatment short-course program

ELISAEnzyme-linked immunosorbent assay

GHCGondar Health Center

GUHUniversity of Gondar Hospital

HHCHousehold contacts

HIVHuman immunodeficiency virus

MDR TBMultiple drug resistant tuberculosis

MtbMycobacterium tuberculosis

TBTuberculosis

VCTVoluntary counseling and testing

VDRVitamin D receptor

WHOWorld health organization





Author: Meseret Workineh - Biniam Mathewos - Beyene Moges - Adissu Gize - Sisay Getie - Olle Stendahl - Thomas Schon - Ebba Abate

Source: https://link.springer.com/







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