Vitamin D3 in acute respiratory infections in patients under age five in a health institution in Colombia

Dilia Fontalvo-Rivera; Enrique Mazenett; Cristian Àlvarez-Zambrano; Doris Gómez-Camargo

doi:10.20883/medical.e679

Authors

Dilia Fontalvo-Rivera Pediatric Infectology Research Group, Universidad del Sinú, Cartagena, Colombia https://orcid.org/0000-0001-9793-2311
Enrique Mazenett Coosalud Cartagena de Indias, Colombia https://orcid.org/0000-0001-6934-1725
Cristian Àlvarez-Zambrano National Police of Colombia, Colombia https://orcid.org/0000-0002-5716-2858
Doris Gómez-Camargo Universidad de Cartagena, Colombia https://orcid.org/0000-0001-6172-5476

DOI:

https://doi.org/10.20883/medical.e679

Keywords:

Vitamin D3, acute respiratory infection, insufficiency, deficiency

Abstract

Aim. describe the clinical behavior in acute respiratory infections in patients under age five in a Colombian health institution after VD3 administration. Trial studies are required to determine this potential benefit.

Material and Methods. A performed series of 38 patients of both genders, aged 0-60 months to whom 50,000 units of VD3 were orrally administered per month for three months is described. The number of episodes, visits to the emergency room, and hospitalizations due to acute respiratory infections (ARI) before and after VD3 administration were described.

Results. The average age of the participants was 25.81 ± 17.50 months. The average number of ARI clinical events per month was 4.02 (95% CI 3.64-4.40) prior to VD3 administration. The number of episodes reduced at the end of the three cycles was 2.23/month (95% CI 1.81-2.65; p = 0.0230). The average number of emergency room visits during three months prior to the VD3 administration was 2.15 (95% CI 1.77-2.53). After three months of treatment, the average number of emergency room visits decreased to 0.52 (95% CI 0.32-0.72; p = 0.0180). Prior to VD3 administration, 31.58% required hospitalization. After the administration of three VD3 doses, only one patient required hospitalization (2.63%; x̄:0.026 (95% CI 0.02-0.03; p = 0.0368).

Conclusions. Vitamin D3 administration could have a benefit in reducing the number of ARI episodes, emergency room visits, and hospitalalizations in children under age five.

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References

Ministry of Health. Acute Respiratory Infections Agudas (ARI). Bogotá, Colombia: Ministry of Health; 2020.

Nair H, Simões EA, Rudan I, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381(9875):1380-1390.

García JLA, Herrera AM. Infección de vías respiratorias agudas en población pediátrica. Rev Enf Infec Pediatr. 2015;114:966-974.

Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226-2234.

You D, Hug L, Ejdemyr S, et al. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN inter-agency group for child mortality estimation. Lancet. 2015;386(10010):2275-2286.

Kamal MM, Hasan MM, Davey R. Determinants of childhood morbidity in Bangladesh: evidence from the Demographic and Health Survey 2011. BMJ Open. 2015;5(10):e007538.

Rambaud-Althaus C, Althaus F, Genton B, D'Acremont V. Clinical features for diagnosis of pneumonia in children younger than 5 years: a systematic review and meta-analysis. Lancet Infect Dis. 2015;15(4):439-450.

Qazi S, Were W. Improving diagnosis of childhood pneumonia. Lancet Infect Dis. 2015;15(4):372-373.

Ujunwa F, Ezeonu C. Risk factors for acute respiratory tract infections in under-five children in Enugu Southeast Nigeria. Ann Med Health Sci Res. 2014;4(1):95-99.

Alemayehu S, Kidanu K, Kahsay T, Kassa M. Risk factors of acute respiratory infections among under five children attending public hospitals in southern Tigray, Ethiopia, 2016/2017. BMC Pediatr. 2019;19(1):380.

Tazinya AA, Halle-Ekane GE, Mbuagbaw LT, Abanda M, Atashili J, Obama MT. Risk factors for acute respiratory infections in children under five years attending the Bamenda Regional Hospital in Cameroon. BMC Pulm Med. 2018;18(1):7.

World Health Organization, UNICEF. Ending Preventable Child Deaths from Pneumonia and Diarrhoea by 2025: The Integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD). Geneva, Switzerland: WHO; 2013.

Taylor CE, Camargo CA, Jr. Impact of micronutrients on respiratory infections. Nutr Rev. 2011;69(5):259-269.

Wang MX, Koh J, Pang J. Association between micronutrient deficiency and acute respiratory infections in healthy adults: a systematic review of observational studies. Nutr J. 2019;18(1):80.

Shenkin A. Micronutrients in health and disease. Postgrad Med J. 2006;82(971):559-567.

Looman KIM, Jansen MAE, Voortman T, et al. The role of vitamin D on circulating memory T cells in children: the Generation R study. Pediatr Allergy Immunol. 2017;28(6):579-587.

Roth DE, Shah MR, Black RE, Baqui AH. Vitamin D status of infants in northeastern rural Bangladesh: preliminary observations and a review of potential determinants. J Health Popul Nutr. 2010;28(5):458-469.

Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y. Eur J Clin Nutr. 2004;58(4):563-567.

Mulrennan S, Knuiman M, Walsh JP, et al. Vitamin D and respiratory health in the busselton healthy ageing study. Respirology. 2018;23(6):576-582.

Solomon O, Odu O, Amu E, et al. Prevalence and risk factors of acute respiratory infection among under fives in rural communities of Ekiti State, Nigeria. Glob J Med Public Health. 2018;7(1):12.

Rondanelli M, Miccono A, Lamburghini S, et al. Self-care for common colds: the pivotal role of vitamin D, vitamin C, zinc, and echinacea in three main immune interactive clusters (physical barriers, innate and adaptive immunity) involved during an episode of common colds-practical advice on dosages and on the time to take these nutrients/botanicals in order to prevent or treat common colds. Evid Based Complement Alternat Med. 2018;2018:5813095.

Gysin DV, Dao D, Gysin CM, Lytvyn L, Loeb M. Effect of vitamin D3 supplementation on respiratory tract infections in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2016;11(9):e0162996.

Hewison M. Vitamin D and the immune system: new perspectives on an old theme. Rheum Dis Clin North Am. 2012;38(1):125-139.

Esposito S, Baggi E, Bianchini S, Marchisio P, Principi N. Role of vitamin D in children with respiratory tract infection. Int J Immunopathol Pharmacol. 2013;26(1):1-13.

Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: modulator of the immune system. Curr Opin Pharmacol. 2010;10(4):482-496.

Baeke F, Korf H, Overbergh L, et al. The vitamin D analog, TX527, promotes a human CD4+CD25highCD127low regulatory T cell profile and induces a migratory signature specific for homing to sites of inflammation. J Immunol. 2011;186(1):132-142.

Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-886.

Chirumbolo S, Bjorklund G, Sboarina A, Vella A. The role of vitamin D in the immune system as a pro-survival molecule. Clin Ther. 2017;39(5):894-916.

Stelmach I, Jerzynska J, Podlecka D. Immunomodulatory effect of vitamin D in children with allergic diseases. In: Gowder S, ed. A Critical Evaluation of Vitamin D - Basic Overview. London, UK: IntechOpen; 2017:161-176.

Esposito S, Lelii M. Vitamin D and respiratory tract infections in childhood. BMC Infect Dis. 2015;15:487.

World Health Organization. Acute Respiratory Infections in Children: Case Management in Small Hospitals in Developing Countries. Geneva, Switzerland: WHO; 1990.

Luis O, Ricardo P, Felipe R. Guía de Bolsillo. Medellín, Colombia: AIEPI; 2004.

Departamento Administrativo Nacional de Estadísticas DANE. Estratificación Socioeconómica en Colombia. Bogotá, Colombia: Departamento Administrativo Nacional de Estadísticas DANE; 2020.

Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930.

Merker M, Amsler A, Pereira R, et al. Vitamin D deficiency is highly prevalent in malnourished inpatients and associated with higher mortality: a prospective cohort study. Medicine (Baltimore). 2019;98(48):e18113.

Mehta S. Vitamin D levels among children with severe acute malnutrition. World J Pharm Res. 2017. doi: 10.20959/wjpr20175-8334.

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.

Acosta B, Sánchez L, Fonseca J, Sarmiento L. Estado de la 25-hidroxivitamina D sérica en niños sanos menores de 10 años del área metropolitana de Barranquilla. Salud Pública Méx. 2017;59:657-664.

Nabeta HW, Kasolo J, Kiggundu RK, Kiragga AN, Kiguli S. Serum vitamin D status in children with protein-energy malnutrition admitted to a national referral hospital in Uganda. BMC Res Notes. 2015;8:418.

Sassi F, Tamone C, D'Amelio P. Vitamin D: nutrient, hormone, and immunomodulator. Nutrients. 2018;10(11):1656.

Battersby AJ, Kampmann B, Burl S. Vitamin D in early childhood and the effect on immunity to Mycobacterium tuberculosis. Clin Dev Immunol. 2012;2012:430972.

Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.

Aydin S, Aslan I, Yildiz I, et al. Vitamin D levels in children with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol. 2011;75(3):364-367.

Bergman P, Norlin AC, Hansen S, et al. Vitamin D3 supplementation in patients with frequent respiratory tract infections: a randomised and double-blind intervention study. BMJ Open. 2012;2(6):e001663.

Singh N, Kamble D, Mahantshetti NS. Effect of vitamin D supplementation in the prevention of recurrent pneumonia in under-five children. Indian J Pediatr. 2019;86(12):1105-1111.