{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:30:05Z","timestamp":1769203805405,"version":"3.49.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP 1017641"],"award-info":[{"award-number":["OPP 1017641"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Research Foundation South Africa"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1174455"],"award-info":[{"award-number":["APP1174455"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Low vitamin D levels may increase the risk of tuberculosis disease; however, previous observational cohort studies showed variable results. We investigated the relationship between vitamin D levels in infancy and subsequent development of tuberculosis disease throughout childhood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We enrolled pregnant women at 20\u201328 weeks\u2019 gestation attending antenatal care in a periurban South African setting in the Drakenstein Child Health Study. Serum 25(OH)D concentrations were measured in newborn infants aged 6\u201310 weeks. Children were followed prospectively for tuberculosis infection and disease using annual tuberculin skin testing, radiographic examinations, and microbiological diagnosis with GeneXpert, culture, and smear testing. Univariable and multivariable Cox regression was performed and HRs with 95% CIs were calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Children were followed for tuberculosis disease for a median of 7.2 years (IQR, 6.2\u20137.9). Among 744 children (&amp;lt;1% with human immunodeficiency virus (HIV), 21% HIV-exposed without HIV), those who were vitamin D deficient in early infancy were not at increased risk of developing tuberculosis disease (adjusted HR, .8; 95% CI, .4\u20131.6). Infants in the lowest vitamin D concentration tertile were at similar risk of tuberculosis as the highest tertile (adjusted HR, .7; 95% CI, .4\u20131.4). Vitamin D deficiency was associated with tuberculin conversion \u22642 years of age at a &amp;lt;30-nmol\/L (adjusted OR, 1.9; 95% CI, 1.2\u20133.2), but not &amp;lt;50-nmol\/L (adjusted OR, 1.5; 95% CI, .8\u20132.9), cutoff.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a setting with hyperendemic rates of tuberculosis, vitamin D concentrations in infancy did not predict tuberculosis disease at any point in childhood. However, very low vitamin D levels were associated with tuberculin conversion in young children.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab735","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T14:21:17Z","timestamp":1629987677000},"page":"2036-2043","source":"Crossref","is-referenced-by-count":11,"title":["Vitamin D Concentrations in Infancy and the Risk of Tuberculosis Disease in Childhood: A Prospective Birth Cohort in Cape Town, South Africa"],"prefix":"10.1093","volume":"74","author":[{"given":"Leonardo","family":"Martinez","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Boston University , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jabulani R","family":"Ncayiyana","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Faculty of Health 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Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark P","family":"Nicol","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia , Perth , Australia"},{"name":"Division of Medical Microbiology, University of Cape Town , Cape Town , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather J","family":"Zar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Red Cross War Memorial Children\u2019s Hospital, and SA-MRC Uniton Child and Adolescent Health, University of Cape Town , Cape Town , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"2022061019023212800_CIT0001","doi-asserted-by":"crossref","first-page":"e453","DOI":"10.1016\/S2214-109X(14)70245-1","article-title":"Burden of childhood tuberculosis in 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