ORIGINAL ARTICLE

Vitamin D deficiency: prevention or treatment?

C S Zipitis, G A Markides, I L Swann

Burnley General Hospital, Casterton Avenue, Burnley, Lancashire, BB10 2PQ, UK

Correspondence to:
Christos S Zipitis
Burnley General Hospital, Casterton Avenue, Burnley, Lancashire, BB10 2PQ, UK;czipitis{at}hotmail.com

Background: Vitamin D deficiency is a chronic condition which contributes to general ill health and seems to be re-emerging in our catchment area since funding of vitamin D supplementation by Primary Care Trusts ceased. This study aims to verify this situation and to assess the cost effectiveness of reintroducing vitamin D supplementation in the Burnley Health Care NHS Trust.

Methods: Vitamin D deficient patients presenting between January 1994 and May 2005 were identified and data retrospectively collected from their case notes. The cost of treatment and the theoretical cost of primary prevention for the Trust population were calculated using previous and current DoH guidelines.

Results: Fourteen patients were identified, of whom 86% presented in the last 5 years and 93% were of Asian origin. The incidence of vitamin D deficiency for our population is 1 in 923 children overall and 1 in 117 in children of Asian origin. The average cost of treatment for each such child is £2500, while the theoretical cost of prevention of vitamin D deficiency in the Asian population through primary prevention according to COMA guidance is £2400 per case.

Conclusions: Vitamin D deficiency is re-emerging in our Trust. The overwhelming majority of our patients are of Asian origin. The cost of primary prevention for this high risk population compares favourably both medically and financially with treatment of established disease. We suggest that Primary Care Trusts provide funds for vitamin D supplementation of Asian children for at least the first 2 years of life.

Abbreviations: ALP, alkaline phosphatase; COMA, Committee on Medical Aspects of Food and Nutritional Policy; DoH, Department of Health; 25OHC, 25-hydroxycholecalciferol; RNI, reference nutrient intake

Keywords: cost-benefit; hypocalcaemia; rickets; treatment; vitamin D deficiency; vitamin D supplementation

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