Prevalence and factors associated with vitamin D deficiency among children with sickle cell Anaemia admitted at Mulago Hospital

Abstract

Background: In Uganda, there is a high burden of sickle cell anaemia (SCA) across all regions. Children with SCA are prone to micronutrient deficiencies including vitamin D. Despite the availability of sunshine throughout the whole year, vitamin D deficiency (VDD) is still prevalent among Ugandan children. In other parts of the world, SCA has been associated with VDD. There is no documented data on vitamin D status among children with SCA in Uganda. Hence this study was aimed at determining the prevalence and factors associated with VDD among children with SCA. Objectives: The study aimed to determine the prevalence and factors associated with vitamin D deficiency among children with sickle cell anaemia admitted at Mulago hospital. Methods: A cross-sectional study design was employed to enroll 216 children with SCA between ages 6 months and 12 years over a 6 months period. They had to have had a positive sickle cell test by Hb electrophoresis and the caregivers consented to the study (assent got from older children above 8 years as appropriate). Data was collected using a semi- structured questionnaires that were administered to the parents/ caregivers. Samples of venous blood were drawn from the children and examined for hemoglobin, vitamin D levels and electrolytes. The data collected was entered into the computer using Epi data and analysed using STATA vs 13. Analysis for factors associated with VDD was done using logistic regression and both bivariate and multivariate analysis was reported. Results: The prevalence of vitamin D deficiency (25OH D less than 20ng/ml) was 71/204 [34.8% (95% CI: 28.8 - 41.7)]. Factors associated with VDD included children 5 years of age and above (aOR 2.54; 95% CI: 1.17 - 5.51) and those who were hospitalized at least once in the previous 3 months (aOR 1.45; 95% CI: 1.00 - 1.75). Conclusion: The prevalence of vitamin D deficiency in children with sickle cell anaemia is high. Children older than 5 years, and those who had been hospitalized at least once in the past 3 months were more likely to be vitamin D deficient. Vitamin D supplementation could be considered among children above 5 years of age hospitalized with sickle cell anaemia.

Key words: Vitamin D deficiency, sickle cell anaemia