Hypovitaminosis D in pediatric tuberculosis

Abstract

Background Vitamin D boosts innate immune response to mycobacteria. Hypovitaminosis D may lead to impaired clearance of tubercle bacilli and an increased risk of tuberculosis (TB). This study aimed to correlate hypovitaminosis D with clinical and microbiological profile in pediatric TB. Materials and methods A case–control study was conducted on 60 clinically diagnosed (clinical findings and radiography and/or contact history and/or Mantoux test) or microbiologically confirmed (smear and/or culture and/or cartridge-based nucleic acid amplification test positive) pediatric TB cases up to 12 years. Serum vitamin D levels were estimated using enzyme-linked immunosorbent assay in the cases and 60 healthy children. Hypovitaminosis D was categorized as insufficient at 20–29 ng/ml, deficient at less than 20 ng/ml, and sufficient at least 30 ng/ml levels. Results Hypovitaminosis D was significantly associated with pediatric TB (P=0.027). Of the cases, 33% were deficient for vitamin D, while 21.67% had insufficient levels. The levels of vitamin D inversely correlated with age (P=0.047) among the cases. There was no significant difference in the levels of vitamin D on the basis of sex, site of TB, presence of dissemination, or microbiological diagnosis. Conclusion Pediatric TB is associated with lower median serum levels of vitamin D. Diet modification to maintain optimum vitamin D levels may reduce the risk of the disease. Screening of healthy children for vitamin D levels with a strong history of close contact with an active TB case may predict the risk of developing TB disease.