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High prevalence of asymptomatic vitamin D and iron deficiency in East African immigrant children and adolescents living in a temperate climate
  1. George McGillivray1,3,
  2. Susan A Skull1,2,3,4,
  3. Gabrielle Davie1,2,
  4. Sarah E Kofoed3,
  5. Alexis Frydenberg3,
  6. James Rice3,
  7. Regina Cooke3,
  8. Jonathan R Carapetis1,2,3,4
  1. 1
    Murdoch Children’s Research Institute, Melbourne, Australia
  2. 2
    Department of Paediatrics, University of Melbourne, Melbourne, Australia
  3. 3
    Royal Children’s Hospital, Melbourne, Australia
  4. 4
    Menzies School of Health Research, Charles Darwin University, Darwin, Australia
  1. Professor Jonathan Carapetis, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia; jonathan.carapetis{at}


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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  • The study was conducted utilising the facilities and the material support of the Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, the Centre for International Child Health, University of Melbourne Department of Paediatrics, and the Royal Children’s Hospital. No other funding was required.

  • Competing interests: None.

  • Abbreviations:
    alkaline phosphatase
    body mass index
    95% CI
    95% confidence interval
    interquartile range
    25-hydroxyvitamin D
    parathyroid hormone
    Royal Children’s Hospital
    risk ratio
    standard deviation
    standard erythemal dose
    ultraviolet B
    ultraviolet radiation
    vitamin D deficiency
    vitamin D insufficiency

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