Vitamin D deficiency and its predictors in a country with thirteen months of sunshine: the case of school children in central Ethiopia.
PLoS One. 2015 Mar 30;10(3):e0120963. doi: 10.1371/journal.pone.0120963. eCollection 2015.
Wakayo T 1, Belachew T 1, Vatanparast H 2, Whiting SJ 2.
1Jimma University, Jimma, Ethiopia.
2University of Saskatchewan, Saskatoon, Canada.
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Studies examining vitamin D status among children living in sunny climates indicated that children did not receive adequate vitamin D, however, this has not been looked at among children living in Ethiopia. In this study, we determined vitamin D deficiency and its predictors among school children aged 11-18 years, examining circulating 25-hydroxy vitamin D [25(OH)D]. The school-based cross-sectional study was conducted in schools in Adama Town (n = 89) and in rural Adama (n = 85) for a total sample of 174. Students were randomly selected using multi-stage stratified sampling method from both settings. Socioeconomic status of parents and demographic, anthropometric, sun exposure status and blood 25(OH)D levels were obtained. Vitamin D deficiency, defined as circulating levels of 25(OH)D <50 nmol/L, was found in 42% of the entire study participants. Prevalence of deficiency was significantly higher among students in urban setting compared to rural (61.8% vs 21.2%, respectively, p<0.001). After controlling for potential confounders using multivariable logistic regression model, duration of exposure to sunlight, amount of body part exposed to sunlight, place of residence, maternal education, body fatness, having TV/computer at home and socioeconomic status were significant predictors of vitamin D deficiency. The findings suggest that Vitamin D deficiency was prevalent in healthy school children living both in urban and rural areas of a country with abundant year round sunshine providing UVB, with the prevalence of deficiency being significantly higher among urban school children who were less exposed to sunlight. Behaviour change communication to enhance exposure to ultraviolet light is critical to prevent vitamin D deficiency in tropical country like Ethiopia. Further study is required to assess the deleterious effect of its deficiency on bone mineral homeostasis of growing children in Ethiopia during their most critical period of bone development.
Table 2. Circulating 25(OH)D levels according to study variables among schoolchildren in Central Ethiopia.
Summary by VitaminDWiki
|Variable (n = 174)||Frequency||Serum 25(OH)D (nmol/L)1||P value|
|All participants(n = 174)||54.5±15.9|
|Study setting Urban lower|
|Gender Females lower|
|Age groups Older lower|
|Religion More clothes lower|
|BMI Classification Higher BMI lower|
|>85th percentile||12||42.6±10.7||p = 0.007|
|TSF Classification More skinfold thickness lower|
|>90th percentile||18||44.0±10.2||p = 0.003|
|Daily sun exposure on school days Less sun lower|
|Body part exposed to the sun on school days Less skin lower|
|Face, hands & feet||46||41.7±11.0||p<0.001|
|More than face, hands, & feet*||126||59.1±14.8|
|Daily sun exposure on weekend days Less sun lower|
|Body part exposed to the sun on weekend days Less sun lower|
|Face, hands & feet||31||41.0±11.8||p<0.001|
|More than face, hands, & feet*||143||57.4±15.1|
|Skin color Very dark skin lower|
|Dark brown||98||56.1±17.0||p = 0.211|
Higher economics: more media screens and air contitioning?