Vitamin D Deficiency is Associated with Increased Use of Antimicrobials among Preschool Girls in Ethiopia
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Clinical Examination and Socio-Economic Status
2.3. Sample Collection
2.4. Hemagglutination Inhibition Assay
2.5. Streptococcus FP23 Enzyme-Linked Immunosorbent Assay (ELISA)
2.6. Ex Vivo Interferon Gamma (IFNγ) Enzyme-Linked ImmunoSpot (ELISpot) Assay
2.7. Pneumoslide IgG Antibody Detection of Selected Viruses and Bacteria
2.8. Vitamin Analyses
2.9. Statistics
3. Results
3.1. High Prevalence of Antimicrobial Use during Follow-Up
3.2. High Prevalence of Influenza and Pneumococcal Exposure during Follow-Up
3.3. High Exposure to Other Airway Pathogenic Viruses and Bacteria
3.4. Vitamin D Deficiency Correlated to Illness and Antimicrobial Treatment
3.5. Body Height and Weight
3.6. Vitamins A and B12
3.7. Socio-Economic Status
4. Discussion
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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All Children | Girls | Boys | |
---|---|---|---|
All children at study start | 95 | 48 | 47 |
Age (months) 1 | 51 | 50 | 54 |
Weight (kg) 1 | 14.8 | 14.2 | 15.0 |
Height (m) 1 | 1.0 | 1.0 | 0.99 |
BMI (kg/m2) 1 | 15.1 | 14.8 | 15.2 |
Serum 25(OH)D (nmol/l) 1 | 35.2 | 35.3 | 35.0 |
Serum vitamin A (µmol/l) 1 | 0.58 | 0.60 | 0.55 |
Serum vitamin B12 (pmol/l) 1 | 472 | 430 | 502 |
Number of children providing additional samples | |||
Paired plasma samples at study start/end | 70 | 39 | 31 |
Paired PBMC samples at study start/end | 63 | 34 | 29 |
Plasma samples for measurement of 25(OH)D and vitamin A at study start | 95 | 48 | 47 |
Plasma samples for measurement of vitamin B12 at study start | 93 | 47 | 46 |
Number of children receiving vaccines | |||
BCG vaccine | 88 | 46 | 42 |
Measles vaccine | 78 | 39 | 39 |
DTP 2 vaccine × 3 | 81 | 42 | 39 |
HepB 3 and HiB 4 vaccines | 77 | 39 | 38 |
Oral polio vaccine × 3 | 86 | 44 | 42 |
Pneumococcal vaccine 1–3 doses | 3 | 2 | 1 |
All Children | Girls | Boys | |
---|---|---|---|
Treated with systemic antimicrobials | 50 | 25 | 25 |
1–2 courses of antimicrobials | 31 | 16 | 15 |
3–6 courses of antimicrobials | 19 | 9 | 10 |
4–6 visits Medical Doctor | 16 | 9 | 7 |
Any airway infection | 43 | 22 | 21 |
Pneumonia | 14 | 7 | 7 |
Pulmonary tuberculosis | 2 | 0 | 2 |
Intestinal parasites/amoebiasis | 7 | 5 | 2 |
Acute gastroenteritis | 9 | 5 | 4 |
Urinary tract infection | 2 | 2 | 0 |
Not treated with systemic antimicrobials | 45 | 23 | 22 |
No visit Medical Doctor | 34 | 17 | 17 |
Any airway infection | 3 | 1 | 2 |
Skin disorder | 8 | 5 | 3 |
Herpes simplex | 1 | 1 | 0 |
Antibodies at Start | New Antibodies | |||
---|---|---|---|---|
Pathogen | All Children | Girls/Boys | All Children | Girls/Boys |
Parainfluenza virus 1, 2, 3 | 65 (93) | 39/26 | 4 | 0/4 |
Adenovirus | 68 (97) | 37/31 | 2 | 2/0 |
Respiratory syncytial virus | 65 (93) | 37/28 | 4 | 2/2 |
Legionella pneumophila | 23 (33) | 14/9 | 12 | 8/4 |
Mycoplasma pneumoniae | 22 (32) | 11/11 | 10 | 6/4 |
Coxiella burnetii | 33 (47) | 16/17 | 5 | 5/0 |
Chlamydophila pneumoniae | 15 (21) | 9/6 | 10 | 8/2 |
Substance | Lower Limits | Children (Percent) | Girls/Boys |
---|---|---|---|
25(OH)D | 50 nmol/L | 85 (89) | 44/41 |
Vitamin A | 0.7 μmol/L | 70 (74) | 32/38 |
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Bodin, J.; Mihret, A.; Holm-Hansen, C.; Dembinski, J.L.; Trieu, M.-C.; Tessema, B.; Tarekegne, A.; Yimer, S.A.; Cox, R.; Aseffa, A.; et al. Vitamin D Deficiency is Associated with Increased Use of Antimicrobials among Preschool Girls in Ethiopia. Nutrients 2019, 11, 575. https://doi.org/10.3390/nu11030575
Bodin J, Mihret A, Holm-Hansen C, Dembinski JL, Trieu M-C, Tessema B, Tarekegne A, Yimer SA, Cox R, Aseffa A, et al. Vitamin D Deficiency is Associated with Increased Use of Antimicrobials among Preschool Girls in Ethiopia. Nutrients. 2019; 11(3):575. https://doi.org/10.3390/nu11030575
Chicago/Turabian StyleBodin, Johanna, Adane Mihret, Carol Holm-Hansen, Jennifer L. Dembinski, Mai-Chi Trieu, Bamlak Tessema, Azeb Tarekegne, Solomon A. Yimer, Rebecca Cox, Abraham Aseffa, and et al. 2019. "Vitamin D Deficiency is Associated with Increased Use of Antimicrobials among Preschool Girls in Ethiopia" Nutrients 11, no. 3: 575. https://doi.org/10.3390/nu11030575