Vitamin DNEW2026

A cross‑sectional analysis of vitamin D status and associated factors in children recovering from severe acute malnutrition in Zambia and Zimbabwe.

Phiri Tracy N, Dumbura Cherlynn, Mutasa Kuda, Ngosa Deophine et al. — PloS one

Summary

この研究は、ザンビアとジンバブエで重度栄養失調から回復中の幼い子どもたちのビタミンDレベルを調査しました。結果として、これらの脆弱な子どもたちのほとんどは十分なビタミンDを摂取していましたが、そのレベルは年齢、季節、居住地などの要因によって異なることが分かりました。これらの影響を理解することは、栄養失調から回復する子どもたちの健康状態を改善するのに役立ちます。

AI-generated summary — read the original

Key points

Most children recovering from severe malnutrition in this study had adequate vitamin D levels, with only a small percentage showing deficiency.
Factors such as a child's age, the season, and their geographic location were linked to their vitamin D status.
Children with cerebral palsy tended to have lower vitamin D levels compared to others.

What the study looked at

### What question the study asked Researchers wanted to understand the vitamin D status of young children recovering from severe acute malnutrition (SAM) in Zambia and Zimbabwe, and identify factors that might influence these levels. This is important because vitamin D plays a role in immune function and development, and its deficiency could potentially worsen outcomes for these vulnerable children. ### How it was studied This was a cross-sectional study, meaning data was collected at a single point in time. The team measured vitamin D levels in the blood of 442 children, aged 0 to 59 months, who were being discharged from hospitals after treatment for SAM. The children were from one hospital in Zambia and two in Zimbabwe. ### What it found The study found that vitamin D deficiency was relatively uncommon, affecting about 7.5% of the children, primarily those in Zimbabwe. Vitamin D levels were generally higher in older children (6 months and above) compared to infants under 6 months. Levels were also higher when samples were taken during the cool season, in children without cerebral palsy, and among those living in Zambia. These findings suggest that several factors, including age, season, health conditions, and location, play a role in the vitamin D status of children recovering from severe malnutrition.

Dietary takeaway

Ensuring adequate vitamin D intake is crucial for children, especially those recovering from severe malnutrition, as it supports overall health. While this study suggests widespread deficiency might not be common in this specific group, it highlights that certain factors can put children at higher risk. Parents and caregivers can support vitamin D levels through sun exposure and foods naturally rich in vitamin D like fatty fish, or fortified foods such as milk and cereals, though more research is needed to confirm specific dietary recommendations for this vulnerable population.

Abstract

Mortality following severe acute malnutrition (SAM) remains high in Africa. Some children with SAM have altered immune responses and impaired neurodevelopment; however, whether vitamin D deficiency contributes to these poor outcomes remains unclear. We conducted a cross-sectional analysis of circulating 25-hydroxyvitamin D [25(OH)D] concentrations at hospital discharge (25(OH)D) in 442 children aged 0-59 months with SAM at one hospital in Lusaka, Zambia, and two hospitals in Harare, Zimbabwe. Also, we investigated the relationship between 25(OH)D concentrations and host factors. In 442 children, plasma 25(OH)D concentrations were measured using ELISA. Vitamin D deficiency was identified in 33/442 (7.5%; 95% CI: 5.2-10.3) children, all of whom were from Zimbabwe. A multivariable regression model that included age, sex, HIV status, season, oedema, cerebral palsy, and country demonstrated significantly higher 25(OH)D levels among children aged 6-11 months (adjusted (adj) ratio; 1.3; 95% CI: 1.1, 1.6; P = 0.003), 12-23 months (adj ratio; 1.5; 95% CI: 1.3, 1.8; P < 0.001), and 24-59 months (adj ratio; 1.5; 95% CI: 1.3, 1.8; P < 0.001) compared with those <6 months. Sampling during the cool season (adj ratio; 1.2; 95% CI: 1.1, 1.3; P = 0.002), absence of cerebral palsy (adj ratio; 1.2; 95% CI: 1.1, 1.4; P = 0.002) and residence in Zambia (adj ratio; 1.2; 95% CI: 1.1, 1.2; P < 0.001) were associated with higher concentrations of 25(OH)D, even after excluding children <6 months. These findings indicate that vitamin D status among children with SAM is significantly influenced by age, seasonality, cerebral palsy, and geographical location. To facilitate management and improve clinical outcomes in these children, we recommend further investigation into whether the current vitamin D content in ready-to-use therapeutic foods is sufficient for all children and whether additional supplementation improves clinical outcomes, especially in high-risk groups. If deficiency is present, we recommend that children be managed in accordance with local guidelines and policies.

View on PubMed →DOI: 10.1371/journal.pone.0355404