Prevalence of Vitamin D Insufficiency and Deficiency Among Children With Cerebral Pasly at the Kentyatta National Hospital

Abstract

Background: Deficiency of Vitamin D occurs commonly worldwide. Children with cerebral palsy (CP) are at a higher risk of vitamin D deficiency (VDD) due to the comorbidities that occur with CP. These include; feeding difficulties, inadequate language and communication skills, reduced ambulation/sun exposure and associated seizure disorders requiring the use of anti-epileptic drugs (AED). Vitamin D is a key determinant of calcium and phosphate homeostasis. Objective: This study aimed to determine the prevalence of vitamin D insufficiency and deficiency in children with CP aged 1-18 years undergoing treatment or rehabilitative therapy at the Kenyatta National Hospital (KNH). Methodology: This was a hospital based cross sectional study. Children with known diagnosis of CP were recruited. The study utilized consecutive sampling until the calculated sample size was achieved. Data on sociodemographic factors, history of use of anticonvulsant, vitamin D supplementation and sun exposure was obtained. Blood sample was taken for analysis of calcium, phosphate and Vitamin D levels. Data Analysis: Data collected was managed using Microsoft Access data base and data analysis was done using STATA version. Categorical data was summarized as frequencies & their respective percentages while continuous were presented as mean (standard deviation) or median (interquartile range). Vitamin D deficiency, insufficiency & adequate levels were reported as percentages with binomial exact 95%Cis. Univariate and multivariate logistic regression analysis was done for factors associated with Vitamin D insufficiency/deficiency. Results: The study recruited 80 children with CP with median age (IQR) 42 (21 to 72) months old. Males (50) accounted for 62% and spastic CP was the most frequent type of CP (n= 54, 67%). VDD was seen in 32% of the children, insufficiency in 29% and 32% had normal Vitamin D levels. The predictors of low vitamin D levels were age > 60months with adjusted odds ratio (aOR) increased 4.77-fold ((95%CI 1.11–20.5) (p=0.03)), duration of AED use >1year with aOR increased 4.62-fold (95%CI 1.06–20.2) (p=0.04) and sunlight exposure of duration <1hour with aOR of 0.07 ((95%CI 0.02–0.25) (p=<0.0001)). Conclusion: The prevalence of Vitamin D insufficiency/deficiency is high at 61%.