Vitamin D Insufficiency as Risk Factor of Severe Pneumonia in Children
DOI:
https://doi.org/10.30574/gscarr.2021.9.2.0271Keywords:
Severe pneumonia, Vitamin D insufficiency, Risk factor, ChildrenAbstract
Severe pneumonia is an infectious disease with high morbidity and mortality in children under five. Several risk factors of severe pneumonia have been established, one of them is vitamin D insufficiency. Risk factors for severe pneumonia can help clinicians to provide better quality of life. This research aimed to prove that vitamin D insufficiency is a risk factor for severe pneumonia in children. This analytical study with case-control design performed in children aged 2 months until 59 months old. Case consisted of 42 subjects who suffered severe pneumonia, while control consisted of 42 subjects who suffered pneumonia. Both groups fulfilled the eligibilities and matched proportionally based on age. The study was conducted from June 2019 to March 2021, level of 25(OH) D was checked in both groups. Data was analyzed by Chi-square test and logistic regression with significant level set at p<0, 05. Total eighty-four subjects with median age 11, 5 month were included in this study and most of them were male (59, 5%). The risk factors of severe pneumonia was vitamin D insufficiency with adjusted odds ratio 4.71 (CI95% 1.15-19.31, p=0.031) and exposure of cigarette smoke with adjusted odds ratio 5.19 (CI95% 1.76-15.31, p=0.003). There was no association of gender, mild malnutrition, non-exclusive breastfeeding and incomplete immunization in this study. Vitamin D insufficiency is a risk factor for severe pneumonia in children.
Metrics
References
Kementrian Kesehatan RI. Profil kesehatan Indonesia 2016. Jakarta: Kemenkes RI. 2017.
Dinas Kesehatan. Profil Dinas Kesehatan Kota Denpasar 2018. Denpasar: Departemen Kesehatan Indonesia. 2019.
Davoudi A, Najafi N, Aarabi M, Tayebi A, Izadar H, Salar Z, Delavarian L, Vaseghi N, Daftarian Z, Ahangarkani F.. Lack of association between vitamin D insufficiency and clinical outcomes of patients with COVID-19 infection. BMC Inf Dis. 2021; 21: 1-7.
Pecora F, Persico F, Argentiero A, Neglia C, Esposito S. The role of micronutrients in support of the immune response against viral infections. Nutrients. 2020; 12: 1-45.
Wahed MA, Islam MA, Khondakar P, Haque MA. Effect of micronutrients on morbidity and duration of hospital stay in childhood pneumonia. Med J. 2008; 17(2): 77-83.
Marcdante KJ, Kliegman RM, Jenson HB, Behrman RE. Nelson Ilmu Kesehatan Esensial. Edisi Keenam. Singapura: Saunders Elsevier. 2014; 527-534.
Jat KR, Kaur J, Guglani V. Vitamin D and pneumonia in children: A Case control study. J RespirPulm Med. 2016; 3: 1-8.
Yun-Fang Z, Bang-An L, Lu-Lu Qin. The association between vitamin D deficiency and community-acquired pneumonia, A meta-analysis of observational studies. Medicine. 2019; 98(38): 1-7.
Banajeh SM. Nutritional rickets and vitamin D deficiency-association with the outcomes of childhood very severe pneumonia: a prospective cohort study. Pediatr Pulmonol. 2009; 44(12): 1207-15.
Subanada IB, Bakta IM, Suryawan IWB, Astawa P, Satriyasa BK. Association between vitamin D level, Vitamin D receptor gene polymorphism, and cathelicidin level to acute lower respiratory infections, and the picture of exon 2-vitamin D receptor gene polymorphisms in children under 5 years old. Maced.J.Med.Sci. 2020; 8(B): 536-541.
Li WM, Cheng X, Guo LLH, Sun C, Cui X, Zhang Q, Song G. Association between serum 25-hydroxyvitamin D concentration and pulmonary infection in children. Medicine. 2018; 97(1): 1-6.
Watts KD, Goodman DM. Wheezing in infant: bronchiolitis. In: Kliegman RM, Stanton BF, St. Game JW, Schor NF, Behram RE, editors. Nelson Textbook of Pediatrics. 19th. Es. Philadelphia: Saunders. 2011; 1456-1459.
Ahn A, Edwards KM, Grijalva KM, Grijalva CG, Self WH, Zhu Y, Chappell JD, Arnold SR, McCullrs JA, Ampofo K, Pavia AT, Bramley AM, Jain S, William DJ. Secondhand smoke exposure and illness severity among children hospitalized with pneumonia. J Pediatr. 2016; 167(4): 869-874.
Lima EJ, Mello MJG, Albuquerque MFP, Lopes MIL, Serra GHC, Lima DEP, Correia JB. Risk factors for community-acquired pneumonia in children under five years of age in the post-pneumococcal conjugate vaccine era in Brazil: a case control study. BMC Pediatr. 2016; 16(10): 1-9.
Riset Kesehatan dasar (Riskesdas). Badan penelitian dan pengembangan kesehatan kementerian RI 2018. Jakarta: Kemkes RI. 2018.
Hoang VT, Dao TL, Minodier P, Nguyen DC, Hoang NT, Dang VN, Gautret P. Risk factors for severe pneumonia according to WHO 2005 criteria definition among children <5 years of age in Thai Binh, Vietnam: A Case-Control Study.J Epidemiol Globe Hea. 2019; 9(4): 274-280.
Sunyataningkamto, Iskandar Z, Alan RT, Budiman I, Surjono A. The rolw of indoor air population and other factors in the incidens of pneumonia under five children. Pediatr Indones. 2004; 44: 25-29.
Shmuel AB, Sheiner E, Wainstock T, Landau D, Vaknin F, Walfisch A. The association between gender and pediatric respiratory morbidity. Pediatr pulmonol. 2017; 31: 1-6.
Fadl N, Ashour A, Muhammad YY. Pneumonia among under-five children in Alexandria, Egypt: a case-control study. J Egypt Public Health Assoc. 2020; 95(14): 2-7.
Misra M, Pacaud D, Petryk A, Collet-Solberg PF, Kappy M. Vitamin D Deficiency children and its management: Review of Current Knowledge and Recommendations. Pediatrics. 2008; 122: 398-417.
Chisti MJ, Tebruegge M, Vincente SL, Graham SM, Duke T. Pneumonia in severely malnourished children in developing countries-mortality risk, aetiology and validity of WHO clinical sign: a systematic review. Tropl med and int hea. 2009; 6(10): 942-950.
Kisworini P, Setyani A, Sutaryo. Mortality predictors of pneumonia in children. Pediatr Indones. 2010; 50: 149-53.
Albanna EAM, Ali YF, Ali YF, Elkashnia RAM. Vitamin D and LL-37 in children with pneumonia. Egypt J Pediatr Allergy Immunol. 2010; 8(2): 81-86.
Feldman C, Anderson R. Cigarette smoking and mechanism of suspectibility to infections of the respiratory tract and other organ system. J.Infect. 2013; 67(3): 169-184.
Zhuge Y, Qian H, Zheng X, Huang C, Zhang Y, Li B, Zhao Z, Deng Q, Yang Xu, Sun Y, Zhang X, Sundell J. Effect of parental smoking and indoor tobacco outcomes in children. Scientific Reports. 2020; 10: 1-9.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.