Estimation of Vitamin D Level in Severe Variant of TB against Less Severe Variant of TB in Paediatric Patients: A Comparative Study

Abstract

Background: Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis killing nearly 2 million people every year. In India, over 100,000 children die from tuberculosis every year. The best-understood function of Vitamin D is in the absorption of calcium from the small intestine, which helps to prevent diseases such as osteoporosis and osteomalacia in adults and rickets in children. The present study was done with an aim to estimate the level of Vitamin D in severe against less severe paediatric tuberculosis patients. Materials and Methods: This present prospective observational study was conducted in Department of TB and Chest of GMC, Azamgarh from February 2022 to March 2023 after approval from Ethical Committee GMC, Azamgarh. The study was done till the sample size of 96 patients was achieved in children up-to 18 years of age presenting with tuberculosis at our hospital. Results: Out of total 96 patients, 63 (53.23%) were male and 33 (46.77%) were female. Majority of patients were age group of >10 years. 33 (46.77%) of them had positive history of contact, 63 (53.23%) had no history of contact. Majority 53 (85.48%) of TB were diagnosed through CBNAAT. Most common presentation was pulmonary TB (43.75%). 53 (55.20%) patients were having deficient Vit D. 26 (27.08%) had severe variant of TB and 70 (72.91%) had less-severe TB. Mean + SD level of serum Vitamin D3 in severe variant of TB was 13.4 + 7.8 and 22.6 + 8.9 in less-severe variant TB. Hypovitaminosis D was seen in 53 (55.20%) TB patients in which majority of case were of pulmonary TB 31(60.78%). 13 (13.54%) were in the age group 0-5 years, 24 (25%) were in the age group 5-10 years and 59 (61.45%) were of age >10 years. Conclusion: The study findings support the assumption that hypovitaminosis D potentiates susceptibility to TB. This relationship should be investigated further in a large-cohort longitudinal study. We advocate for longitudinal studies across various geographical regions to accurately define the roles of Vitamin D on TB treatment and prevention.