Vitamin D Deficiency Among Primary School Children in Mosul City, Northern Iraq

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Elham Kh Aljammas
Nashwan M Al-Hafidh
Humam Ghanim I. Zubeer

Abstract

Introduction: Although vitamin D deficiency among young children is widespread, deficiency status may vary among regions. Data on the prevalence of vitamin D deficiency among children in Mosul city are lacking. This study aimed to determine the prevalence of vitamin D deficiency among primary school children in Mosul city, North Iraq. Methods: This cross-sectional study was conducted in the government primary schools in Mosul city over the period from February to May 2019. Multistage random sampling technique was applied; four governmental primary schools in Mosul city were selected. A representative sample size of 1072 children, aged between 6 and 12 was enrolled, serum 25OHD was analyzed in all the participants. Results: Vitamin D deficiency (25OHD < 12 ng/ml) was found in 59.7% of children, vitamin D insufficiency (25OHD 12-19 ng/ml) was evident in 33.8% of children, whereas only 6.3 % of children had vitamin D sufficiency (25OHD > 20 ng/ml). Boys had significantly higher levels of 25OHD compared to girls, (p = 0.0001). There was no significant difference in 25OHD concentrations in relation to parental education. There was a weak reverse significant correlation between body weight and 25OHD concentrations, (r = - 0.117, p = 0.000). Conclusion: Only 6.3 % of primary school children in Mosul city had sufficient vitamin D status. Vitamin D supplementation to primary school children is essential.

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Aljammas, E. K., Al-Hafidh, N. M., & I. Zubeer, H. G. (2021). Vitamin D Deficiency Among Primary School Children in Mosul City, Northern Iraq. Malaysian Journal of Medicine and Health Sciences, 17(3), 112–117. Retrieved from http://mjmhsojs.upm.edu.my/index.php/mjmhs/article/view/417
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Original Articles

References

Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016;101(2):394-415. doi: 10.1210/jc.2015-2175.

Antonucci R, Locci C, Clemente MGA-Ohoo, Chicconi E, Antonucci L. Vitamin D deficiency in childhood: old lessons and current challenges. J Pediatr Endocrinol Metab. 2018 Mar 28;31(3):247-260. doi: 10.1515/jpem-2017-0391. doi: 10.1515/ jpem-2017-0391.

Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, et al. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr. 2018;44(1):51. doi: 10.1186/s13052-018-0488-7

Bener A, Al-Ali M Fau - Hoffmann GF, Hoffmann GF. Vitamin D deficiency in healthy children in a sunny country: associated factors. International Journal of Food Sciences and Nutrition, September 2009; 60(S5): 60-70. doi: 10.1080/09637480802400487

Alyahya KO. Vitamin D levels in schoolchildren: a cross-sectional study in Kuwait. (BMC Pediatr. 2017; 17: 213. doi: 10.1186/s12887-017-0963-0.

Haq A, Wimalawansa SJ, Pludowski P, Anouti FA. Clinical practice guidelines for vitamin D in the United Arab Emirates. J Steroid Biochem Mol Biol. 2018 Jan;175:4-11. doi: 10.1016/j. jsbmb.2016.09.021

Abdulrahman R, Rahman B. Prevalence of vitamin D level in the serum of patients living in Erbil city, Iraq, referred to private clinical laboratory and effect of age and sex on it. Journal of Biological Research - Bollettino della Società Italiana di Biologia Sperimentale. 2018;91. doi:10.4081/ jbr.2018.6916

Salih S. F A-TDJ. Vitamin d status among apparently healthy population in Duhok, Kurdistan region, Iraq. Duhok Medical Journal 2016;10(1):31-9.

Fuleihan G. E.Vitamin D Deficiency in the Middle East and its Health, Clinic Rev Bone Miner Metab (2009) 7:77–93 DOI 10.1007/s12018-009-9027-9)

Abdulbari Bener, Mariam Al-Ali, Georg F Hoffmann. Vitamin D deficiency in healthy children in a sunny country: associated factors. Int J Food Sci Nutr. 2009;60 Suppl 5:60-70. doi: 10.1080/09637480802400487

Maha M H K Mansour, Khaled M Alhadidi. Vitamin D deficiency in children living in Jeddah, Saudi Arabia. Indian J Endocrinol Metab. 2012 Mar;16(2):263-9. doi: 10.4103/2230-8210.93746

Hasan Isa, Mohamed Almaliki, Aysha Alsabea, Afaf Mohamed. Vitamin D deficiency in healthy children in Bahrain: do gender and age matter? East Mediterr Health J. 2020 Mar 24;26(3):260-267. doi: 10.26719/emhj.19.084.

F. Sinem Hocaoğlu-Emre, Devrim Sarıbal, Osman Oğuz. Vitamin D Deficiency and Insufficiency According to the Current Criteria for Children: Vitamin D Status of Elementary School Children in Turkey. J Clin Res Pediatr Endocrinol. 2019 May 28;11(2):181-188. doi: 10.4274/jcrpe.galenos.2018.2018.0272.

Deena H. Elsoria, Majeda S. Hammoud. Vitamin D deficiency in mothers, neonates and children. J Steroid Biochem Mol Biol. 2018 Jan;175:195-199. doi: 10.1016/j.jsbmb.2017.01.023.

Daniel D. Bikle. Extraskeletal actions of vitamin D, Ann N Y Acad Sci. 2016 Jul; 1376(1): 29–52. doi: 10.1111/nyas.13219

Sylvia Christakos, Martin Hewison, David G Gardner, et al . Vitamin D: beyond bone. Ann N Y Acad Sci. 2013 May;1287(1):45-58. doi: 10.1111/nyas.12129.

Adnan M Al Shaikh, Bahaa Abaalkhail, Ashraf Soliman, et al. Prevalence of Vitamin D Deficiency and Calcium Homeostasis in Saudi Children. J Clin Res Pediatr Endocrinol 2016;8(4):461-467. doi: 10.4274/jcrpe.3301.

Mosul. From https://en.wikipedia.org/wiki/Mosul . Accessed in November 2020

WHO Growth reference data for 5-19 years, Indicators, BMI-for-age (5-19 years). https://www. who.int/tools/growth-reference-data-for-5to19- years/indicators/bmi-for-age. Accessed in January 2021

Canadian Paediatric Society. Vitamin D supplementation: recommendations for Canadian mothers and infants. Paediatr Child Health. 2007;12(7):583–98. PMID: 19030432 PMCID: PMC2528771

Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Drug and therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398–417. doi: 10.1542/peds.2007-1894

IOM (Institute of Medicine). Dietary reference intakes for calcium and vitamin D. Committee to review dietary reference intakes for calcium and vitamin D. Washington: National Academies Press; 2011.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30. doi: 10.1210/jc.2011-0385

Arundel P, Ahmed SF, Allgrove J, Bishop NJ, Burren CP, Jacobs B, et al. British Paediatric and adolescent bone Group's position statement on vitamin D deficiency. BMJ. 2012;345: e8182. doi: 10.1136/bmj.e8182.

Ní Chaoimh C, McCarthy EK, Hourihane JO, Kenny LC, Irvine AD, Murray DM, Kiely ME. Low vitamin D deficiency in Irish toddlers despite northerly latitude and a high prevalence of inadequate intakes. Eur J Nutr. 2018 Mar;57(2):783-794. doi: 10.1007/s00394-016-1368-9.

Al-Othman A, Al-Musharaf S, Al-Daghri NM, Krishnaswamy S, Yusuf DS, Alkharfy KM, et al. Effect of physical activity and sun exposure on vitamin D status of Saudi children and adolescents. BMC Pediatr. 2012;12(92):1471-2431. doi: 10.1186/1471-2431-12-92.

Darina Bassil, Maya Rahme, Maha Hoteit, and Ghada El-Hajj Fuleihan. Hypovitaminosis D in the Middle East and North Africa Prevalence, risk factors and impact on outcomes. Dermatoendocrinol. 2013 Apr 1; 5(2): 274–298. DOI: 10.4161/derm.25111

Lafta R, Cetorelli V, Burnham G. Living in Mosul during the time of ISIS and the military liberation: results from a 40-cluster household survey. Confl Health. 2018 Aug 1;12:31. DOI: 10.1186/s13031-018-0167-8

Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J; IOF Committee of Scientific Advisors (CSA) Nutrition Working Group .Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009 Nov;20(11):1807-20. doi: 10.1007/s00198-009- 0954-6.

Al-Horani H, Abu Dayyih W, Mallah E, Hamad M, Mima M, Awad R, et al. Nationality, Gender, Age, and Body Mass Index Influences on Vitamin D Concentration among Elderly Patients and Young Iraqi and Jordanian in Jordan. Biochem Res Int. 2016;2016:8920503. doi: 10.1155/2016/8920503.

Al-Saleh Y, Al-Daghri NM, Khan N, Alfawaz H, Al- Othman AM, Alokail MS, et al. Vitamin D status in Saudi school children based on knowledge. BMC Pediatr. 2015 May 6;15:53. doi: 10.1186/s12887-015-0369-9.

Weishaar T, Rajan S. Keller B. Probability of Vitamin D Deficiency by Body Weight and Race/Ethnicity .J Am Board Fam Med. Mar-Apr 2016;29(2):226-32. doi: 10.3122/jabfm.2016.02.150251

Narchi H, Kochiyil J, Al Hamad S, Yasin J, Laleye L, Al Dhaheri A.Hypovitaminosis D in adolescent females--an analytical cohort study in the United Arab Emirates. Paediatr Int Child Health. 2015 Feb;35(1):36-43. doi: 10.1179/2046905514Y.0000000144.