Assessment of risk factors associated with vitamin D status among children of an urban and a rural areas of Bangladesh
Risk factors for vitamin D status
Background: Vitamin D deficiency is one of the most common micronutrient deficiency in children worldwide, even in Bangladesh. However, to date, the prevalence of vitamin D deficiency among children of different region of Bangladesh is less reported.
Objective: This study was conducted to assess vitamin D status of urban and rural Bangladeshi children including the risk factors associated with vitamin D deficiency are also evaluated.
Methods: A multi-centre (urban and rural based), cross sectional study was done from July 2016 to June 2017, using serum 25(OH) vitamin D3 as a marker of nutritional vitamin D status. Urban and rural children were taken from Paediatric Outpatient Department, United Hospital Limited. Dhaka and Medical Outpatient Department, Upazila Health Complex, Ghatail, Tangail respectively. Children of 1-10 years age attending OPD with mild undernutrition (<–1 SD z score) and/or clinical features suggestive of vitamin D deficiency were included in the study.
Results: A total 150 children were studied with 102 (68.0%) urban and 48 (32.0%) rural children. Hypovitaminosis D (25-OHD <30ng/ml) was found in 75.0% of children. Hypovitaminosis D was found significantly more in urban children (81.0%) compared to rural (62.0%) children (OR=0.382, 95% CI: 0.177-0.822, p value <0.05). Inadequate exposure to sunlight was significantly associated with hypovitaminosis D compared to adequate sun exposure and it was about 2.5 times higher (OR=2.475, 95% CI: 1.139-5.380, p value <0.05). No significant associations of vitamin D deficiency were detected with skin color of children, covering clothes of mother, exclusive breast feeding, limb pain and anthropometric status. Children of higher educated mother (above Secondary School Certificate) (OR=0.412, 95% CI: 0.189-0.900) were more associated with vitamin D deficiency.
Conclusion: Vitamin D deficiency (VDD) is prevalent among Bangladeshi children, urban children being more vulnerable to VDD. Adoption of a screening programme for children of all age group and implementation of preventive strategies for VDD through public health policies are strongly recommended.
Bangladesh Med Res Counc Bull 2020; 46(2): 134-141
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