INTRODUCTIONTuberculosis (TB) is an important public health problem in the United Kingdom and the recent data suggest that the incidence of TB in the UK remains high compared to most other Western European countries, with 8751 cases reported in 2012, an incidence of 13.9 per 100000 population. The majority of TB cases occurred in large urban centres, amongst young adults, those from countries with high TB burdens, and those with social risk factors for TB. 73% of TB cases were born outside the UK and the rate of TB among the non UK-born population is almost 20 times the rate in the UK-born. 1 The treatment of tuberculosis has been based on antituberculosis chemotherapy for the last few decades and there has been an ongoing research in newer treatment modalities. Vitamin D has been used in the treatment of TB in pre-antibiotic times. The emergence of TB sanatoriums in the 19 th century and popularity of heliotherapy and cod liver oil as treatments strategies indicate the possible role of vitamin D in management of ABSTRACT Background: We aimed to compare the prevalence of vitamin D deficiency and insufficiency in children with active or latent tuberculosis with the control population. Methods: This was a retrospective case control study and included 34 patients with evidence of exposure to tuberculosis and 34 controls reviewed at Peterborough city hospital from October 2011 to September 2013, who were matched with regards to age, gender and ethnicity. All patients had blood investigations, chest X-ray, Quantiferon Gold and Mantoux done at the time of review along with serum 25-hydroxyvitamin D concentrations in serum. Results: 73.6% of patients with Childhood Tuberculosis and 47.1 % of controls had low Vitamin D levels (deficiency and insufficiency). The median vitamin D level in children with tuberculosis was 34.75 nmol/l and in controls was 52.8 nmol/l. Patients older than 12 years of age had significantly lower serum 25-hydroxyvitamin D concentrations than those patients younger than 5 year of age. Gender, ethnicity, BMI, BCG status, serum calcium, serum phosphate and alkaline phosphatase had no significant correlation with vitamin D concentration in patients and controls.
Conclusions:The present study demonstrated that children with evidence of exposure to Tuberculosis were more likely to be associated with lower levels of vitamin D than control population. Larger multi-centric randomized controlled trials are needed to prove the association between vitamin D and Tuberculosis. The association between low levels of vitamin D and tuberculosis suggests investigation for vitamin D deficiency in all children diagnosed with Tuberculosis and supplementation of these children with vitamin D.