Lancet Global Health – Oct 2019 https://doi.org/10.1016/S2214-109X(19)30457-7
eagan M Mogire, MSc; Agnes Mutua, BSc; Wandia Kimita, MSc; Alice Kamau, MSc; Philip Bejon, PhD; John M Pettifor, MBBCh
Background: The vitamin D status of African populations remains inadequately characterized. Our objective was to estimate the prevalence of vitamin D deficiency in children and adults living in Africa.
Methods: We searched PubMed/MEDLINE, Web of Science, Embase, African Journals Online and African Index Medicus for published vitamin D prevalence studies without language restriction. We included all studies with measured serum 25-hydroxyvitamin D (25(OH)D) concentrations from healthy participants residing in Africa. We conducted meta-analyses to derive the pooled prevalence of vitamin D deficiency using established cut-offs and mean 25(OH)D concentrations. We stratified by participant age group (adults vs. children) and area of residence (urban vs. rural). The study protocol was registered with PROSPERO (number CRD42018112030).
Findings: One hundred and thirteen studies with 19,380 participants from 21 African countries were included in the meta-analysis. The pooled prevalence of low vitamin D status was 57·6% (95% CI 48·4, 66·6), 39·3% (95% CI 30·8, 48·3) and 25·1% (95% CI 15·9, 35·6) for cut-offs of <75 nmol/L, <50 nmol/L, and <30 nmol/L respectively. The overall mean 25(OH)D concentration was 69·1 nmol/L (95% CI 65·4, 72·8). Vitamin D levels were relatively lower in populations living further from the equator, in women, children, and in urban areas.
Interpretation: The prevalence of vitamin D deficiency is high in African populations. Public health strategies should include efforts to prevent, detect and treat vitamin D deficiency, especially in vulnerable populations.
Funding: This work was funded by Wellcome (grants 110255/Z/15/Z to SHA, 202800/Z/16/Z to TNW and the DELTAS Africa Initiative (DEL-15-003).
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