Original articles

High prevalence of asymptomatic vitamin D and iron deficiency in East African immigrant children and adolescents living in a temperate climate

George McGillivray^1,3, Susan A Skull^1,2,3,4, Gabrielle Davie^1,2, Sarah E Kofoed³, Alexis Frydenberg³, James Rice³, Regina Cooke³, Jonathan R Carapetis^1,2,3,4

¹ Murdoch Children’s Research Institute, Melbourne, Australia
² Department of Paediatrics, University of Melbourne, Melbourne, Australia
³ Royal Children’s Hospital, Melbourne, Australia
⁴ Menzies School of Health Research, Charles Darwin University, Darwin, Australia

Professor Jonathan Carapetis, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia; jonathan.carapetis{at}menzies.edu.au

Objectives: Vitamin D deficiency (VDD) is common in immigrant children with increased skin pigmentation living in higher latitudes. We assessed the pattern of and risk factors for VDD in immigrant East African children living in Melbourne (latitude 37°49' South).

Study design: A prospective survey of 232 East African children attending a clinic in Melbourne. Data were collected by questionnaire, medical assessment and laboratory tests.

Results: Low 25-hydroxyvitamin D (25-OHD) levels (<50 nmol/l) occurred in 87% of children, and VDD (25-OHD <25 nmol/l) in 44%. Risk factors included age <5 years, female gender, increased time in Australia, decreased daylight exposure and winter/spring season. Anaemia (20%), vitamin A deficiency (20%) and iron deficiency (19%) were also identified.

Conclusions: Asymptomatic VDD is common in East African immigrant children residing at a temperate latitude. Risk factors for VDD limit endogenous vitamin D production. Screening of immigrant children with increased skin pigmentation for VDD, anaemia, iron and vitamin A deficiency is appropriate. VDD in adolescent females identifies an increased risk of future infants with VDD.

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There is more to the diagnosis of iron deficiency than hypoferritinaemia or microcytosis

oscar,m jolobe

ADC Online, 13 Dec 2007 [Full text]