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Prevalence of Vitamin D Deficiency in Exclusively Breastfed Infants at the Aga Khan University Hospital, Nairobi

Thesis Info

Author

Said, Nusrat. A.

Department

Paediatrics and Child Health (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2015

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728063714

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Introduction: Vitamin D deficiency in infants is a recognized cause of rickets. In the last few years, evidence has emerged of its association with lower respiratory tract infections, food allergy, type 1 diabetes, schizophrenia and various other extra skeletal health effects. Exclusively breastfed infants are especially vulnerable to vitamin D deficiency due to their dependence on previous trans-placental transfer of vitamin D from the mother, dietary vitamin D from breast milk and cutaneous synthesis of vitamin D on exposure to sunlight. The worldwide epidemic of Vitamin D deficiency in pregnancy and the low content of vitamin D in breast milk underlie the high risk of deficiency in exclusively breastfed infants. Data regarding the magnitude of vitamin D deficiency among exclusively breastfed infants in Kenya is needed to inform policies on supplementation of at risk groups. Objectives: The aim of this study was to determine the prevalence of vitamin D deficiency in exclusively breastfed infants using 25(OH)D and to evaluate the relationship between PTH and 25(OH)D in a population of exclusively breast fed infants. Study Design: This was a cross sectional survey carried out in three to six month old exclusively breastfed infants at the Aga Khan University Hospital, Nairobi. Methods: Ninety-eight infants were enrolled in the study and all had data on their demographics and anthropometric measures recorded. Self-reported data on maternal vitamin D supplementation and sunlight exposure was also collected. A brief physical examination to assess for skeletal signs of rickets was then performed. A blood sample was collected for measurement of serum 25(OH)D, calcium, phosphate and PTH . Prevalence of vitamin D deficiency was analyzed using proportions with 25(OH)D levels below 20ng/ml. PTH, calcium and phosphate levels in the vitamin D deficient and non-deficient groups were compared using analysis of variance(ANOVA). The level of 25(OH)D beyond which there was no PTH elevation was identified by drawing a scatter plot of PTH against vitamin D levels. Tests of association using odds ratio were used to determine the correlation between infant serum vitamin D levels and maternal vitamin D supplementation and sunlight exposure. Skeletal manifestations of vitamin D deficiency in this population were described using bar charts. Results: Prevalence of vitamin D deficiency among exclusively breastfed infants at Aga Khan University Hospital was 23.5% (95% CI 14.9%-32.0%). A further 31.6% were found to have insufficient levels of vitamin D leaving only 44.9% of the population classified as having sufficient levels.
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