ESPE Abstracts (2016) 86 P-P2-150

Prevalence of Vitamin D Deficiency in Haitian Infants and Children

Julia Elisabeth von Oettingena,b, Michele Sainvilb, Viviane Lorgeatb, Marie-Christine Mascaryb, Henry Feldmanc, Christopher Carpenterb, Ric Bonnellb, Nancy Larcod, Philippe Larcod, Diane Staffordc, Eddy Jean-Baptisted & Catherine Gordone

aMcGill University Health Center, Montreal, Quebec, Canada; bKay Mackenson Clinic, Inc., Pierre Payen, Haiti; cBoston Children’s Hospital, Boston, Massachusetts, USA; dFondation Haitienne de Diabete et de Maladies Cardiovasculaires, Port-au-Prince, Haiti; eCincinnati Children’s Hospital, Cincinnati, Ohio, USA

Background: Vitamin D deficiency in children is a common cause of rickets, and a potential risk factor for extraskeletal adverse health outcomes. Its prevalence in Haiti has not been assessed.

Objective and hypotheses: To examine the prevalence of vitamin D deficiency in dark-skinned young children in Haiti.

Method: Cross-sectional study of healthy Haitian children 9 months to 6 years across three geographical regions in Haiti (coastal (C), mountainous (M), urban (U)). We obtained anthropometrics, information on family income, 25-OH-vitamin-D levels (25OHD), and, in vitamin D deficient children, alkaline phosphatase levels. Vitamin D insufficiency, deficiency and severe deficiency were defined as 25OHD <30, <20 and <10 ng/ml, respectively.

Results: 292 subjects (mean age 3.3±1.6 years, 50.3% females, median family income USD 30/week) participated, 100 in C,94 in U, and 98 in M. Moderate-severe malnutrition was present in 16.4%, and more common in M (25.5%) vs. C (11%) and U (12.8%), P=0.01. Mean 25OHD was 30.7±9.2 ng/ml. Prevalence of vitamin D insufficiency, deficiency and severe deficiency was 43.2, 8.6 and 0%, respectively. Deficiency was highest in C (21%) vs. U and M (both 2%, P<0.0001). No subject had elevated alkaline phosphatase levels. In univariate analyses, higher weight and height z-scores, shorter breast feeding duration and less sun exposure were predictive of lower 25OHD, whereas diet, skin darkness, and income were not. In a multivariate model, region C and weight z-score remained significant predictors of lower 25OHD. In univariate and multivariate logistic models, only region was a significant predictor of vitamin D deficiency.

Conclusion: While the prevalence of vitamin D deficiency in young children in Haiti is <10%, close to half have sub-optimal vitamin D levels. Public health recommendations such as increased sun exposure, fortified food products and/or routine vitamin D supplementation should be considered. Reasons for higher deficiency rates in coastal areas need further exploration.