Vitamin D status of children with recurrent lower respiratory tract infection: a comparative observational study

Authors

  • Prabhakar Patil Department of Paediatrics, Al Zahra Hospital, Dubai, UAE
  • Danny Alsalloum Department of Paediatrics, Medcare Women and Children Hospital, Dubai, UAE
  • Ravikant S. Department of Paediatrics, Bidar Institute of Medical Sciences, Bidar, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20251853

Keywords:

Vitamin D deficiency, Pediatrics, Immunity, Bronchiolitis, Respiratory tract infections

Abstract

Background: Lower respiratory tract infections (LRTIs) are one of the major causes of morbidity and mortality in children under five. Recurrent LRTIs which is defined as three or more episodes in one year or two or more in six months pose a significant health burden. Emerging evidence suggests that vitamin D deficiency in may increase susceptibility of children to such infections.

Methods: This comparative observational study was conducted over one year (January 2024 to December 2024) in the pediatric department of Bidar Institute of Medical Sciences, Karnataka, India. The study was undertaken to assess the association between vitamin D status and recurrent LRTIs in children aged 6 months to 5 years. The study included 80 children with recurrent LRTIs (group A) and 80 age matched healthy controls (group B). Detailed demographic details, clinical findings and nutritional status of cases was collected using a structured questionnaire. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured using chemiluminescent immunoassay and categorized as deficient (<20 ng/ml), insufficient (20–30 ng/ml) or sufficient (>30 ng/ml). Statistical analysis was performed using statistical package for the social sciences (SPSS) version 21.0 with significance set at p<0.05.

Results: No significant differences were noted between groups regarding age and gender distribution. Bronchiolitis and pneumonia were the most common types of LRTIs observed. The mean serum vitamin D level in group A (18.7±7.3 ng/ml) was significantly lower than in group B (26.1±8.5 ng/ml) (p<0.0001). Vitamin D deficiency was observed in 47.5% of children with recurrent LRTIs compared to 27.5% in controls (p=0.0002).

Conclusions: Children with recurrent LRTIs were found to have significantly lower serum vitamin D levels compared to healthy counterparts. These findings suggest that vitamin D deficiency may be a modifiable risk factor for recurrent respiratory infections.

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References

Grimwood K, Chang AB. Long-term effects of pneumonia in young children. Pneumonia (Nathan). 2015;6:101-14. DOI: https://doi.org/10.15172/pneu.2015.6/621

Dangor Z, Verwey C, Lala SG, Mabaso T, Mopeli K, Parris D, et al. Lower Respiratory Tract Infection in Children: When Are Further Investigations Warranted? Front Pediatr. 2021;9:708100. DOI: https://doi.org/10.3389/fped.2021.708100

Patria MF, Esposito S. Recurrent lower respiratory tract infections in children: a practical approach to diagnosis. Paediatr Respir Rev. 2013;14(1):53-60. DOI: https://doi.org/10.1016/j.prrv.2011.11.001

Laya BF, Concepcion NDP, Garcia-Peña P, Naidoo J, Kritsaneepaiboon S, Lee EY. Pediatric Lower Respiratory Tract Infections: Imaging Guidelines and Recommendations. Radiol Clin North Am. 2022;60(1):15-40. DOI: https://doi.org/10.1016/j.rcl.2021.08.003

Copley SJ. Application of computed tomography in childhood respiratory infections. Br Med Bull. 2002;61:263-79. DOI: https://doi.org/10.1093/bmb/61.1.263

Sun X, Zemel MB. Calcitriol and calcium regulate cytokine production and adipocyte-macrophage cross-talk. J Nutr Biochem. 2008;19(6):392-9. DOI: https://doi.org/10.1016/j.jnutbio.2007.05.013

Herdea A, Marie H, Ionescu A, Sandu DM, Pribeagu ST, Ulici A. Vitamin D Deficiency-A Public Health Issue in Children. Children (Basel). 2024;11(9):1061. DOI: https://doi.org/10.3390/children11091061

Marusca LM, Reddy G, Blaj M, Prathipati R, Rosca O, Bratosin F, et al. The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review. Diseases. 2023;11(3):104. DOI: https://doi.org/10.3390/diseases11030104

Zhou YF, Luo BA, Qin LL. The association between vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies. Medicine (Baltimore). 2019;98(38):e17252. DOI: https://doi.org/10.1097/MD.0000000000017252

Karatekin G, Kaya A, Salihoğlu O, Balci H, Nuhoğlu A. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr. 2009;63(4):473-7. DOI: https://doi.org/10.1038/sj.ejcn.1602960

Belderbos ME, Houben ML, Wilbrink B, Lentjes E, Bloemen EM, Kimpen JL, et al. Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis. Pediatrics. 2011;127(6):e1513-20. DOI: https://doi.org/10.1542/peds.2010-3054

Roth DE, Shah R, Black RE, Baqui AH. Vitamin D status and acute lower respiratory infection in early childhood in Sylhet, Bangladesh. Acta Paediatr. 2010;99(3):389-93. DOI: https://doi.org/10.1111/j.1651-2227.2009.01594.x

Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. DOI: https://doi.org/10.1136/bmj.i6583

Hansdottir S, Monick MM, Hinde SL, Lovan N, Look DC, Hunninghake GW. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol. 2008;181(10):7090-9. DOI: https://doi.org/10.4049/jimmunol.181.10.7090

Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science. 2006;311(5768):1770-3. DOI: https://doi.org/10.1126/science.1123933

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Published

2025-06-25

How to Cite

Patil, P., Alsalloum, D., & S., R. (2025). Vitamin D status of children with recurrent lower respiratory tract infection: a comparative observational study. International Journal of Contemporary Pediatrics, 12(7), 1049–1053. https://doi.org/10.18203/2349-3291.ijcp20251853

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Original Research Articles