Prevalence of vitamin D deficiency in Africa: a systematic review and meta-analysis
Mogire RM, Mutua A, Kimita W, Kamau A, Bejon P, Pettifor JM, Adeyemo A, Williams TN, Atkinson SH
The Lancet. Global health · 201 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- University or hospital
- Center for Outcomes Research and Evaluation, Yale School of Medicine
- Nonprofit
- Wellcome Trust
- Government
- New Partnership for Africa's Development
- Nonprofit
- African Academy of Sciences
- Government
- National Institutes of Health
- Unclassified
- Office of the Director
- Government
- National Human Genome Research Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- University or hospital
- Center for Information Technology
- Unclassified
- Center for Global Health
- Government
- Intramural NIH HHS
- Government
- EPA
- Nonprofit
- New Partnership for Africa's Development
- Grants
- Center for Global Health (1ZIAHG200362); Wellcome Trust (DEL‐15‐003); Wellcome Trust (110255); Wellcome Trust (202800/Z/16/Z); Wellcome Trust (203077/Z/16/Z); Wellcome Trust (grant 202800/Z/16/Z); Wellcome Trust (/Z/15/Z); Wellcome Trust (202800); Wellcome Trust (110255/Z/15/Z); Wellcome Trust (107769/Z/10/Z); National Institutes of Health (1ZIAHG200362); National Institutes of Health (ZIA HG200362)
Based on 13 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2019-11-27 · Lancet Glob Health · vol. 8 · issue 1 · pp. e134–e142
- Publisher
- Elsevier BV
- Cited
- 334 citations · more than 99% of similar papers · 7.4× the field average
- Impact
- Top 10% most cited in its field
- References
- 42 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Vitamin D Research Studies · HIV-related health complications and treatments · Immune responses and vaccinations
- Keywords
- Meta-analysis, vitamin D deficiency, Medicine, Vitamin D and neurology, Systematic review, Residence, MEDLINE, Data extraction, Environmental health, Demography, Gerontology, Internal medicine, Biology
- MeSH
- humans, vitamin d deficiency, prevalence, dietary supplements, adolescent, adult, aged, aged, 80 and over, middle aged, child, child, preschool, infant, infant, newborn, africa, female, male, young adult
9 authors
From KE, GB, ZA, US
- Reagan M. MogireKenya Medical Research Institute; KEMRI-Wellcome Trust Research Programme
- Agnes M. MutuaKenya Medical Research Institute; KEMRI-Wellcome Trust Research Programme
- Wandia KimitaKenya Medical Research Institute; KEMRI-Wellcome Trust Research Programme
- Alice KamauKenya Medical Research Institute; KEMRI-Wellcome Trust Research Programme
- Philip BejonKenya Medical Research Institute; University of Oxford; KEMRI-Wellcome Trust Research Programme
- John Morley PettiforSouth African Medical Research Council; University of the Witwatersrand
Abstract
Background
Vitamin D deficiency is associated with non-communicable and infectious diseases, but the vitamin D status of African populations is not well characterised. We aimed to estimate the prevalence of vitamin D deficiency in children and adults living in Africa.
Methods
For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, African Journals Online, and African Index Medicus for studies on vitamin D prevalence, published from database inception to Aug 6, 2019, without language restrictions. We included all studies with measured serum 25-hydroxyvitamin D (25[OH]D) concentrations from healthy participants residing in Africa. We excluded case reports and case series, studies that measured 25(OH)D only after a clinical intervention, and studies with only a meeting abstract or unpublished material available. We used a standardised data extraction form to collect information from eligible studies; if the required information was not available in the published report, we requested raw data from the authors. We did a random-effects meta-analysis to obtain the pooled prevalence of vitamin D deficiency in African populations, with use of established cutoffs and mean 25(OH)D concentrations. We stratified meta-analyses by participant age group, geographical region, and residence in rural or urban areas. The study is registered with PROSPERO, number CRD42018112030.
Findings
Our search identified 1692 studies, of which 129 studies with 21 474 participants from 23 African countries were included in the systematic review and 119 studies were included in the meta-analyses. The pooled prevalence of low vitamin D status was 18·46% (95% CI 10·66-27·78) with a cutoff of serum 25(OH)D concentration less than 30 nmol/L; 34·22% (26·22-43·68) for a cutoff of less than 50 nmol/L; and 59·54% (51·32-67·50) for a cutoff of less than 75 nmol/L. The overall mean 25(OH)D concentration was 67·78 nmol/L (95% CI 64·50-71·06). There was no evidence of publication bias, although heterogeneity was high (I2 ranged from 98·26% to 99·82%). Mean serum 25(OH)D concentrations were lower in populations living in northern African countries or South Africa compared with sub-Saharan Africa, in urban areas compared with rural areas, in women compared with men, and in newborn babies compared with their mothers.
Interpretation
The prevalence of vitamin D deficiency is high in African populations. Public health strategies in Africa should include efforts to prevent, detect, and treat vitamin D deficiency, especially in newborn babies, women, and urban populations.
Funding
Wellcome Trust and the DELTAS Africa Initiative.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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