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Acta Paediatr. 2010 Mar;99(3):389-93. doi: 10.1111/j.1651-2227.2009.01594.x. Epub 2009 Nov 7.

Vitamin D status and acute lower respiratory infection in early childhood in Sylhet, Bangladesh.

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Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.



Acute lower respiratory tract infection (ALRI) is the most important global cause of childhood death. Micronutrient deficiencies may increase the risk of ALRI. A case-control study was conducted to assess the association between vitamin D status and ALRI in rural Bangladesh.


Children aged 1-18 months hospitalized with ALRI (cases) were individually matched to controls on age, sex, and village (N = 25 pairs). The mean serum 25-hydroxyvitamin D concentration [25(OH)D] in cases and controls was compared using paired t-test. The unadjusted and adjusted odds of ALRI were assessed by multivariate conditional logistic regression.


Mean [25(OH)D] was significantly lower among ALRI cases than controls (29.1 nmol/L vs. 39.1 nmol/L; p = 0.015). The unadjusted odds of ALRI was halved for each 10 nmol/L increase in [25(OH)D] (OR 0.53, 95% CI 0.30-0.96). Adjustment for confounders increased the magnitude of the association.


Vitamin D status was associated with early childhood ALRI in a matched case-control study in rural Bangladesh. Randomized trials may establish whether interventions to improve vitamin D status can reduce the burden of ALRI in early childhood.

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