Prevalence of vitamin d deficiency among tb patients at a kenyan health facility

Abstract

Background: tuberculosis (tb) is a chronic illness of global importance, caused by a Bacterium known as mycobacterium tuberculosis. Vitamin d is known to play a central role as An immune regulator especially in active tb infections. Hypovitaminosis d decreases Macrophage activation and production of cathelicidin both of which are key active players in The host's immune response to tb infection. Although there are conflicting conclusions as to Whether or not vitamin d supplementation is beneficial in the treatment of tb, this study was Conducted to further provide evidence of its importance, as the need for research in new and Improved treatment strategies continue. Hypothesis: vitamin d deficiency is associated with increased risk and progression of Tuberculosis infection. Objective: to determine the prevalence of vitamin d deficiency in newly diagnosed patients With active pulmonary tuberculosis. Methodology: a comparative descriptive study was conducted by recruiting newly diagnosed Treatment naive tb patients and a control group consisting of tb negatives individuals (blood Donors) from malindi hospital in kilifi county. Their serum vitamin d level were evaluated Using a cobas platform. Their weight/bmi, hemoglobin, marital status, education level and Location of household were also collected and evaluated. The prevalence of vitamin d Deficiency was determined in the newly diagnosed tb patients and the blood donors. Serum Vitamin d levels of less than 20ng/dl was classified as severe deficiency while those less than 49ng/dl as deficient. Mean and median were used to measure central tendency while wilkinson Mann – whitney statistical test was used to measure association. Results: a total of 170 participants were recruited, 80 (tb cases) and 90 (non-tb cases). Median age was 32(23-40) years and male to female ratio was 2:1. Overall serum vitamin d Levels were significantly lower in the tb cases (p value = 0.002) compared to the non-tb Cases, with a mean of 44.6g/dl. Among the tb cases 87% recorded deficient levels of vitamin D while 11% were severely deficient. 97.5 % of the tb cases were anemic with a mean bmi Of 20.7. 18% of the tb cases were rifampicin resistant according to genexpert results. Sociodemographic characteristics demonstrated 22.5 % unemployment rate with majority (70%) of the cases residing in the urban areas. Higher levels of vitamin d (median 36.1) were Observed among tb cases who worked in the informal sector. Conclusion: vitamin d insufficiency was highly prevalent among the tb cases. Lower levels Of vitamin d were recorded among the young men who resided in the urban centers. 18 % of The newly diagnosed treatment naive tb patients were rifampicin resistance.