Prevalence and Factors Associated with Hypovitaminosis D among Children on Treatment with Anti-Seizure Medications at Mulago Hospital

Abstract

Introduction: Epilepsy is the most common neurological disease in childhood that often requires long term treatment with anti-seizure medications. These drugs increase the metabolism of vitamin D posing a significant risk for hypovitaminosis D. We aimed to determine the prevalence and factors associated with hypovitaminosis D among children taking antiseizure medications at Mulago Hospital. Methods: The study was a cross-sectional study conducted at Mulago Hospital between February 2023 and May 2023 involving children between 1 and18 years taking anti-seizure medications. Upon obtaining consent, we administered a structured questionnaire and performed a physical examination on the participants. Serum 25-hydroxyvitamin D (25(OH)D) was measured using the electrochemiluminescence method. Hypovitaminosis D was defined as 25(OH)D <30 ng/ml: vitamin D insufficiency (VDI) and deficiency (VDD) were 21-29 ng/ml and <20 ng/ml respectively. The prevalence of Hypovitaminosis D was obtained as a proportion of those with 25(OH)D <30 ng/ml of the total enrolled in the study. Factors associated with Hypovitaminosis D were determined using multivariable logistic regression at 5% level of significance.Results: We recruited 177 participants and analyzed 175; mean age was 7.2 ± 4.6 years, and 60.6% (106) of the participants were male. The prevalence of; hypovitaminosis D was 42.9%, VDD was 32 (18.3%) and VDI was 43 (24.6%). Compared to children being exposed to sunlight for > 60 minutes daily, children with no sunlight exposure had a 54% increase in odds of hypovitaminosis D (aOR-1.54, 95% CI 1.022-2.322). Conclusion and recommendation: The prevalence of hypovitaminosis D among children taking anti-seizure medications at Mulago hospital was high. Vitamin D supplements and increased sunlight exposure may be given to all children on Antiseizure medications who are not being exposed to sunlight. A prospective cohort study should be done to establish a temporal relationship between hypovitaminosis D and Anti-seizure medications in Uganda.