This preprint is under consideration at European Journal of Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research Article
Olivia Fahrni
Universite de Geneve Faculte de Medecine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6578-1034
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This work is licensed under a CC BY 4.0 License. Read Full License
Cholecalciferol (vitamin D3) is essentially known for its part in the phospho-calcic metabolism and associated pathologies, such as rickets. In Switzerland, 40 to 50% of children are vitamin D deficient. Due to skin colour, poor nutrition, living condition and cultural practices, migrant population is particularly at risk. Our aim is to attest the vitamin D status of the children arriving in Switzerland and compare the cost-effectiveness of two supplementation strategies.
We retrospectively assessed 528 children’s vitamin D status and parathyroid hormone, phosphates and calcium levels between 2015 and 2018 by electrochemiluminescence and spectrophotometry. Cholecalciferol was considered insufficient under 50 nmol/L and severely deficient below 25 nmol/L. Supplementation strategies’ costs were based on local prices.
Seventy-three percent of children showed hypovitaminosis D and 28% had a severe deficit. Highest prevalence of deficit was found in children from Eastern Mediterranean (80%) and African regions (75%). Severe deficit was highest in the South East Asian (39%) and Eastern Mediterranean regions (33%) and higher in females than males. Deficit was predominant and more severe in winter. Hypovitaminosis increased with age. 0.4% of children presented with biological rickets. The most cost-effective supplementation strategy was to systematically supplement all children at arrival and in winter, reducing costs by 25% compared to vitamin D level-based supplementation.
Conclusion: A majority of migrant children presented with hypovitaminosis D. They must be supplemented to prevent complications. A cost-effective strategy could be to supplement all children at arrival and during wintertime without systematic vitamin D level check.
Keywords
Vitamin D, Hypovitaminosis D, Supplementation, Children, Migrant, Refugee
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This preprint is under consideration at European Journal of Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Olivia Fahrni
Universite de Geneve Faculte de Medecine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6578-1034
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 10 Mar, 2021
No community comments so far
Review #? received
Received 04 Mar, 2021
Editor assigned
On 03 Mar, 2021
Reviewers invited
Invitations sent on 03 Mar, 2021
First submitted
On 26 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Cholecalciferol (vitamin D3) is essentially known for its part in the phospho-calcic metabolism and associated pathologies, such as rickets. In Switzerland, 40 to 50% of children are vitamin D deficient. Due to skin colour, poor nutrition, living condition and cultural practices, migrant population is particularly at risk. Our aim is to attest the vitamin D status of the children arriving in Switzerland and compare the cost-effectiveness of two supplementation strategies.
We retrospectively assessed 528 children’s vitamin D status and parathyroid hormone, phosphates and calcium levels between 2015 and 2018 by electrochemiluminescence and spectrophotometry. Cholecalciferol was considered insufficient under 50 nmol/L and severely deficient below 25 nmol/L. Supplementation strategies’ costs were based on local prices.
Seventy-three percent of children showed hypovitaminosis D and 28% had a severe deficit. Highest prevalence of deficit was found in children from Eastern Mediterranean (80%) and African regions (75%). Severe deficit was highest in the South East Asian (39%) and Eastern Mediterranean regions (33%) and higher in females than males. Deficit was predominant and more severe in winter. Hypovitaminosis increased with age. 0.4% of children presented with biological rickets. The most cost-effective supplementation strategy was to systematically supplement all children at arrival and in winter, reducing costs by 25% compared to vitamin D level-based supplementation.
Conclusion: A majority of migrant children presented with hypovitaminosis D. They must be supplemented to prevent complications. A cost-effective strategy could be to supplement all children at arrival and during wintertime without systematic vitamin D level check.
Figure 1
Figure 2
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