Prevalence and associations of vitamin D deficiency in foreign-born persons with tuberculosis in London

Objectives. The incidence of tuberculosis (TB) is high amongst foreign-born persons resident in developed countries. Vitamin D is important in the host D; defence against TB in vitro and deficiency may be an acquired risk factor for this disease. We aimed to determine the incidence and associations of vitamin D deficiency in TB patients diagnosed at an infectious diseases unit in London, UK. Methods. Case-note analysis of 210 unselected patients diagnosed with TB who had plasma vitamin D (25(OH)D-3) Levels routinely measured. Prevalence of 25(OH)D-3 deficiency and its relationship to ethnic origin, religion, site of TB, sex, age, duration in the UK, month of 25(OH)D-3 estimation and TB diagnosis were determined. Results. Of 210 patients 76% were 25(OH)D-3 deficient and 56% had undetectable levels. 70/82 Indian, 24/28 East African Asian, 29/34 Somali, 14/19 Pakistani and Afghani, 16/22 Sri Lankan and 2/6 other African patients were deficient (with 58, 17, 23, 9, 6 and 1 having undetectable levels, respectively). Only 0/6 white Europeans and 1/8 Chinese/South East Asians had tow plasma 25(OH)D-3 levels. Muslims, Hindus and Sikhs all had equivalent rates of deficiency though Hindus were more likely to have undetectable levels (odds ratio 1.87, 95% CI 1.27-2.76). There was no significant association between 25(OH)D-3 level. and site of TB or duration of residence in the UK. There was no apparent seasonal variation in either TB diagnosis or 25(OH)D-3 level. Conclusions. 25(OH)D-3 deficiency commonly associates with TB among all ethnic groups apart from white Europeans, and Chinese/South East Asians. Our data support a tack of sunlight exposure and potentially a vegetarian diet as contributors to this deficiency. (c) 2004 The British Infection Society. Published by Elsevier Ltd. All rights reserved.