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Open Access Research article

Vitamin D deficiency among adult patients with tuberculosis: a cross sectional study from a national referral hospital in Uganda

Davis Kibirige15*, Edrisa Mutebi12, Richard Ssekitoleko13, William Worodria14 and Harriet Mayanja-Kizza1

Author Affiliations

1 Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda

2 Endocrine Unit, Mulago National Referral and Teaching Hospital, Kampala, Uganda

3 Infectious Diseases Unit, Mulago National Referral and Teaching Hospital, Kampala, Uganda

4 Pulmonology Unit, Mulago National Referral and Teaching Hospital, Kampala, Uganda

5 Department of Medicine, Makerere University College of Health Sciences, PO BOX 7062, Kampala, Uganda

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BMC Research Notes 2013, 6:293  doi:10.1186/1756-0500-6-293

Published: 25 July 2013

Abstract

Background

Vitamin D deficiency has been reported among patients with tuberculosis in Africa despite abundant sunshine. Vitamin D plays a fundamental role in improving anti tuberculosis immunity, reducing progression and severity of TB in humans.

Methods

In this descriptive cross sectional study, 260 hospitalized adults with a confirmed diagnosis of TB were enrolled into the study from the pulmonology wards of Mulago national referral and teaching hospital, Uganda. The serum concentrations of 25-hydroxyvitamin D or 25 (OH) D were determined by an electrochemilumniscence immunoassay. Vitamin D deficiency, vitamin D insufficiency, severe and very severe vitamin D deficiency were defined as serum 25(OH) D concentrations of ≤ 20 ng/ml, 21–29 ng/ml, < 10 ng/ml and <5 ng/ml respectively.

Results

Majority of the study participants were males (146, 56.2%) and < 35 years (154, 59.2%). The mean age ± SD was 34.7 ± 9.5 years. Two hundred eight (80%) patients were HIV co-infected with a median CD4 count of 68 cells/mm3 (IQR: 17–165). The prevalence of vitamin D deficiency, vitamin D insufficiency, severe and very severe vitamin D deficiency among the hospitalized adult tuberculosis patients was 44.2%, 23.5%, 13.5% and 4.2% respectively. The median (IQR) vitamin D concentration in ng/ml was 22.55 (14.59-33.31).

Vitamin D deficiency was more prevalent in patients with hypoalbuminemia (97.4%), anemia (86.1%), HIV co-infected patients with CD4 count <200cells/mm3 (83.2%) and hypocalcemia corrected for serum albumin levels (67%).

Conclusion

Vitamin D deficiency is very common among hospitalized adult tuberculosis patients in Uganda especially in patients with hypoalbuminemia, anemia, HIV co-infected patients with CD4 count <200cells/mm3 and hypocalcemia corrected for serum albumin levels.

Keywords:
Vitamin D deficiency; Tuberculosis; Uganda