THE PREVALENCE OF VITAMIN D DEFICIENCY IN REFUGEES

Abstract

Aim: Vitamin D deficiency is a common preventable public health problem in worldwide. The aim of the study is to determine the prevalence of vitamin D deficiency in refugees. Materials and Methods: 103 refugees, whose 25 (OH) vitamin D measurements were made in the State Hospitals in Tokat Province and Districts between January-December 2019, were included in the retrospective study. The relationship of vitamin D levels with season, age, gender and nationality was evaluated. In statistical analysis, number, percentage, mean ± standard deviation, Mann Whitney U test and Kruskal Wallis tests were used. (p <0.05) was considered statistically significant. Results: 103 individuals over the age of 18 were included the study. The mean vitamin D level in the study was found 12.59 ± 8.90 ng / ml. It was determined that 80.6% of the refugees had vitamin D deficiency (25 (OH) D <20 ng / ml). 70.9% (n = 73) of the participants in the study were female and 72.8% (n = 75) were between the ages of 19-50. 46.6% (n = 48) of the refugees were from Iraq, 44.7% (n = 46) were from Afghanistan, 8.7% (n = 9) were from Syria. In the study, no significant relationship was found between vitamin D level and season, age, gender and nationalities of refugees. Conclusion: Vitamin D deficiency prevalence was high in refugees. Health professionals should evaluate refugees who are among the disadvantaged groups in terms of vitamin D deficiency and apply appropriate treatment protocols in case of deficiency.

Keywords

• REFUGEE
• VITAMIN D DEFICIENCY
• 25(OH)D

MÜLTECİLERDE D VİTAMİNİ EKSİKLİĞİ PREVALANSI

Abstract

Amaç: D vitamini eksikliği Dünya da yaygın görülen önlenebilir bir halk sağlığı sorunudur. Çalışmanın amacı mültecilerde D vitamini eksikliği prevalansını belirlemektir. Gereç ve Yöntem: Retrospektif tipte planlanan çalışmaya Ocak-Aralık 2019 tarihleri arasında Tokat İl ve İlçelerinde bulunan Devlet Hastanelerinde 25 (OH) D vitamini ölçümü yapılmış olan 103 mülteci birey hastane otomasyon sisteminden taranarak dahil edildi. Bireylerin D vitamini düzeyinin mevsim, yaş, cinsiyet ve uyrukları ile ilişkisi değerlendirildi. İstatistiksel analizlerde sayı, yüzde, ortalama±standart sapma, Mann Whitney U testi ve Kruskal Wallis testleri kullanıldı (p<0,05) istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya 18 yaş üzeri 103 birey dahil edildi. Çalışmada D vitamini ortlaması 12,59±8,90 ng/ml olarak bulundu. Mültecilerin % 80,6’ sında D vitamini eksikliği ( 25(OH) D < 20 ng/ml) olduğu tespit edildi. Çalışmaya katılanların %70.9’ u (n=73) kadın , %72,8’i (n=75) 19-50 yaşları arasındaydı. Mültecilerin % 46,6’sı (n=48) Irak, % 44,7’si (n=46) Afganistan, % 8,7’si (n=9) Suriyeli mülteciydi. Çalışmada D vitamini düzeyi ile mevsim, yaş, cinsiyet ve mültecilerin uyrukları arasında anlamlı ilişki tespit edilmedi. Sonuç: Mültecilerde D vitamini eksikliği prevalansı yüksek bulunmuştur. Sağlık profesyonelleri dezavantajlı gruplar arasında yer alan mültecileri D vitamini eksikliği açısından değerlendirmeli ve eksiklik durumunda uygun tedavi protokollerini uygulamalıdır.

Keywords

• MÜLTECİ
• D VİTAMİNİ EKSİKLİĞİ
• 25(OH)D

References

1. 1. Renzaho AM, Nowson C, Kaur A, Halliday JA, Fong D, Desilva J. Prevalence of vitamin D insufficiency and risk factors for type 2 diabetes and cardiovascular disease among African migrant and refugee adults in Melbourne: a pilot study. Asia Pac J Clin Nutr 2011; 20 (3): 397–403.
2. 2. Kim KJ, Kim YJ, Kim SH, et al. Vitamin D status and associated metabolic risk factors among North Korean refugees in South Korea: a cross-sectional study. BMJ open 2015; 5(11): e009140.
3. 3. Eggemoen ÅR, Knutsen KV, Dalen I, Jenum AK. Vitamin D status in recently arrived immigrants from Africa and Asia: a cross-sectional study from Norway of children, adolescents and adults. BMJ open 2013; 3(10): e003293.
4. 4. Al Mheid I, Quyyumi AA. Vitamin D and cardiovascular disease controversy unresolved. J Am Coll Cardiol 2017; 70(1): 89-100.
5. 5. Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord 2017; 18(2): 153–165.
6. 6. Lips P, de Jongh RT. Vitamin D deficiency in immigrants. Bone reports 2018; 9: 37-41.
7. 7. Grant WB, Boucher BJ. Randomized controlled trials of vitamin D and cancer incidence: a modeling study. PLoS One 2017; 12(5): e0176448.
8. 8. Holick MF, Binkley NC, Bischoff-Ferrari HA et al. Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96(7): 1911–30.

9. 9. Unhcr.org [homepage on the Internet]. UNHCR Türkiye İstatistikleri. [cited 28 December 2019]. Availible from: https://www.unhcr.org/tr/unhcr-turkiye-istatistikleri.
10. 10. Afona C, Hensch NP, Kerstin K et al. Serum 25-hydroxyvitamin D levels and intramuscular vitamin D3 supplementation among Eritrean migrants recently arrived in Switzerland. Swiss Med Wkly 2017; 147: w14568.
11. 11. Benitez‐Aguirre PZ, Wood NJ, Biesheuvel C, Moreira C, Munns CF. The natural history of vitamin D deficiency in African refugees living in Sydney. MJA 2009; 190: 426–428.
12. 12. Goc.gov.tr [homepage on the Internet]. Göç İdaresi Genel Müdürlüğü İstatistikleri. [cited 28 December 2019]. Availible from: https://www.goc.gov.tr/gecici-koruma5638/.
13. 13. Grover S, Morley R. Vitamin D deficiency in veiled or dark-skinned pregnant women. Med J Aust 2001; 175: 251–2.
14. 14. Skull SA, Ngeow JYY, Biggs BA, Street A, Ebeling PR. Vitamin D deficiency is common and unrecognized among recently arrived adult immigrants from The Horn of Africa. Internal medicine journal 2003; 33(1‐2): 47-51.
15. 15. Penrose K, Adams JH, Nguyen T, Cochran J, Geltman PL. Vitamin D Deficiency Among Newly Resettled Refugees in Massachusetts. J Immigrant Minority Health 2012; 14: 941–948.
16. 16. Ruwanpathirana T, Reid CM, Owen AJ, Fong DP, Gowda U, Renzaho AM. Assessment of vitamin D and its association with cardiovascular disease risk factors in an adult migrant population: an audit of patient records at a community health centre in Kensington. BMC Cardiovascular Disorders 2014; 14: 157.
17. 17. van der Meer IM, Middelkoop BJ, Boeke AJ, Lips P. Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian, and sub-Sahara African populations in Europe and their countries of origin: an overview. Osteoporos International 2011; 22: 1009–21.
18. 18. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 1988; 67: 373–8.
19. 19. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471-8.