Abstract
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.
Highlights
Adolescence is the most critical period in skeletal development during which peak growth velocity is concomitant with an increase in bone mass
The main supply of vitamin D comes from its production in the skin following exposure to ultraviolet B radiation (UVB) at the wave length ranging from 280–315 nm
Few Muslim students were sampled in the rural setting, while in the urban setting there were close to equal numbers
Summary
Adolescence is the most critical period in skeletal development during which peak growth velocity is concomitant with an increase in bone mass. There is need for adequate vitamin D which is important for calcium and phosphate absorption as well as bone growth and accretion [1,2,3,4,5]. The main supply of vitamin D comes from its production in the skin following exposure to ultraviolet B radiation (UVB) at the wave length ranging from 280–315 nm. Circulating 25-hydroxy cholecalciferol [25(OH)D] concentration is considered the best indicator of an individual’s vitamin D status, reflecting both cutaneous synthesis and dietary consumption of the nutrient [4,9,10]. Production of vitamin D3 in the skin depends on sunshine exposure, season, latitude, time of day, aging, skin covering clothes, the use of sun block, glass windows, and skin pigmentation [9,11,12,13]
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