Study | Year of study | Design | N§ | Location | Age (years) | Quantification methods | Prevalence/Cumulative incidence VDD‡ (50 nmol/L) (%) | Prevalence/Cumulative incidence VDD§ (30 nmol/L) (%) | Mean of serum 25(OH)D (nmol/L) | Risk factors associated with VDD |
Febriani A et al 69 | 2019 | Case-control | 40 | Indonesia | 0.5–5 | ELISA | n/a | n/a | 49.77 (control) | n/a |
Irwinda and Andardi¶57 | 2017–2019 | Cross-sectional | 30 | Indonesia | Newborn | LC-MS/MS | 52.4 | n/a | 44 | n/a |
Chuc et al¶ 22 | 2017 | Cross-sectional | 327 | Vietnam | 1–3 | ELISA | 47.7 | 0 | 81.3 | Older age |
Ariyawatkul and Lersbuasin¶46 | 2016–2017 | Cross-sectional | 94 | Thailand | Newborn | Chemiluminescent microparticle immunoassay | 89.3 | 20.2 | 37.1 | Low maternal vitamin D level |
Oktaria et al ¶††35 | 2015–2017 | Cohort | 344 (at birth) 255 (6 months) | Indonesia | Newborn and 6 months | LC-MS/MS | 90 (at birth) 13 (6 months) | 55.8 (at birth) 4.3 (6 months) | 30 (at birth) 77 (6 months) | Lower cumulative skin-sun exposure score, severe VDD at birth and exclusive breast feeding |
Loeb et al¶ 36 | 2013–2016 | RCT (baseline) | 1095 | Vietnam | 3–17 | Diasorin | 16.8 | n/a | 65.5 | n/a |
Yani et al¶ 24 | 2014–2015 | Cross-sectional | 100 | Indonesia | <5 | ELISA | 21 | 1.78 | 67.5 | n/a |
Quah et al*¶25 | 2014 | Cohort | 1016 | Malaysia | 15 | Automated direct competitive chemiluminescent immunoassay | 33 | 2.6 | 59.4 | Female sex, Malay and Indian ethnicity, and wearing long sleeves |
Smith et al¶ 51 | 2014 | Cross-sectional | 781 | Cambodia | 0.5–5 | ELISA | 13.4 | n/a | 91.1 | Urban living and older age |
Diana et al¶ 26 | 2013–2014 | Cohort | 116 | Indonesia | 6 and 12 months | Isotope-dilution LC tandem MS | 0.9 (6 months) 4.3 (12 months) | 0 (6 months and 12 months) | 89.7† (6 months) 83.2† (12 months) | n/a |
Al-Sadat et al*¶44 | 2012 | Cross-sectional | 1361 | Malaysia | 12–13 | ECLIA | 92.6 | n/a | 29.2 | Female sex, Indian ethnicity, urban living and obesity (wider waist circumference) |
Rahmadhani et al¶45 | 2012 | Cross-sectional | 678 | Malaysia | 13 | ECLIA | 70 | n/a | 42.3 | Female sex, high BMI |
Pulungan et al¶ 54 | 2012 | Cross-sectional | 120 | Indonesia | 7–12 | Diasorin | 39.2 | 1.6 | 54.6 | Less time spent outdoors |
Nguyen et al 50 | 2012–2016 | Cross-sectional | 794 | Vietnam | 6–14 | HPLC/MS | 30.6 | n/a | 67.39 | Female sex, overweight/obese |
Poh et al¶‡37 | 2010–2011 | Cross-sectional | 2016 | Indonesia, Malaysia, Thailand, Vietnam | >2 | Diasorin (Malaysia, Thailand), HPLC (Vietnam), immunoactivity detection system (Indonesia) | 42.14 | n/a | 56.1 | Female sex, older age, urban living, religion, higher BMI and region |
Senaprom et al‡39 | 2011 | Cross-sectional | 477 | Thailand | 3–13 | Diasorin | 31.9 | n/a | 60.1 | Female sex, Muslim religion, obesity, sun exposure <30 min/day in weekdays (end) |
Ernawati and Budiman et al‡40 | 2011 | Cross-sectional | 349 | Indonesia | 2–13 | EIA | 45.1 | n/a | 52.6 | Female sex, older age, less time spent outdoors |
Reesukumal et al¶‡28 | 2011–2012 | Cross-sectional | 159 | Thailand | 6–12 | ECLIA | 19.5 | 0.6 | 64 | Higher BMI, higher body fat percentage, higher parathyroid hormone |
Sandjaja et al‡33 | 2011 | Cross-sectional | 276 | Indonesia | 2–12 | Not specified | 43.6 | n/a | 52.5 | Female sex |
Rojroongwasinkul et al‡38 | 2011 | Cross-sectional | 628 | Thailand | 3–13 | Diasorin | 33.5 | n/a | n/a | Urban living |
Le Nguyen et al‡29 | 2011 | Cross-sectional | 574 | Vietnam | 6–12 | HPLC | 50.4 | n/a | n/a | n/a |
Nguyen Bao et al‡30 | 2010–2011 | Cross-sectional | 384 | Indonesia, Malaysia, Thailand, Vietnam | 1–12 | Diasorin (Malaysia, Thailand), HPLC (Vietnam), immunoactivity detection system (Indonesia) | 45.8 | 17.5 | 55.7 | Higher dairy daily consumption |
Poh et al‡27 | 2010–2011 | Cross-sectional | 2936 | Malaysia | 4–12 | Diasorin | 47.5 | n/a | 54.7 | Female sex, urban living, older age |
Laillou et al¶ 43 | 2010 | Cross-sectional | 485 | Vietnam | <5 | HPLC | 57.3 | 20.6 | 43.4 | n/a |
Poomthavorn et al¶ 31 | 2008–2009 | Cross-sectional | 179 | Thailand | <18 | HPLC | 11 (obese) 10 (non-obese) | 0 (obese and non-obese) | 70.4 (obese) 68.9 (non-obese) | Older age, lower weight circumference |
Khor et al¶ 42 | 2008 | Cross-sectional | 402 | Malaysia | 7–12 | Diasorin | 72.4 | n/a | n/a | Higher BMI in boys, female sex |
Houghton et al¶ 49 | 2002–2003 | Cross-sectional | 529 | Thailand | 6–14 | LC-MS/MS | 4 | n/a | 72.7† | Older female |
Tangngam et al¶ 47 | n/a | Cross-sectional | 28 | Thailand | 4.8–17.2 | Chemiluminescence assay | 96.4 | n/a | 66.5** | n/a |
Soesanti et al¶ 34 | n/a | Cross-sectional | 120 | Indonesia | 7–12 | Not specified | 39.2 | n/a | n/a | Female sex |
Hussain and Elnajeh¶32 | n/a | Cross-sectional | 361 | Malaysia | 13–18 | CLIA | 60.1 | 16.3 | 49 | Female sex, Malay ethnicity |
VDD was defined when serum 25(OH)D <50 nmol/L20
*Data from MyHeARTs, both studies were included because eventhough data were derived from the same study, the time point was different.
†Geometric mean.
‡Data from SEANUTS. Poh et al 37 was chosen as SEANUTS representative, as it provides most of the countries prevalence and meet our criteria to define VDD.
§Total participants that had vitamin D testing.
¶Included in the forest plot.
**Median.
††Data from IPADS, both papers present the same result, Oktaria et al 35 was chosen as it is the first one published.
BMI, body mass index; ECLIA, electrochemiluminescence immunoassay; EIA, enzyme immunoassay; HPLC, high performance liquid chromatograph; IPADS, The Indonesian Pneumonia and vitamin D Study; LC-MS/MS, liquid chromatography-mass spectrometry; MyHeARTs, Malaysian Health and Adolescents Longitudinal Research Study; n/a, not available; 25(OH)D, 25-hydroxyvitamin D; RCT, randomised controlled trial; SEA, South-East Asia; SEANUTS, South-East Asian Nutrition Survey.