{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:00:30Z","timestamp":1772690430011,"version":"3.50.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Vitamin D deficiency may increase the risk of childhood diarrhea. We aim to carry out a review and meta-analysis of the evidence relating vitamin D insufficiency to childhood diarrhea.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We searched PubMed, Ovid, Scopus, and Cochrane Library (from inception to August 2022), then independently reviewed the eligibility, and read full-text reviews for selected articles. Keywords used were \u2018vitamin D\u2019, \u201925-hydroxyvitamin D\u2019, \u2018vitamin D deficiency\u2019, \u2018diarrhea\u2019, \u2018gastroenteritis\u2019, \u2018children\u2019, and \u2018pediatric\u2019. The search was limited to studies only in English and with available full-text. Year limitation was not applied in our search. Unpublished trials, dissertations, preliminary reports, conference abstracts, and repositories were excluded from the study. Newcastle-Ottawa Scale was used as the risk of bias assessment tool. Meta-analysis using the random-effects model was done.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Out of 5,565 articles, 12 articles were included in our systematic review, however only 7 articles were eligible for meta-analysis. Meta-analysis showed a statistically significant association between vitamin D deficiency and diarrhea in children in developing countries (OR\u2009=\u20091.79; 95% CI\u2009=\u20091.15 to 2.80; <jats:italic>p<\/jats:italic>\u2009=\u20090.01). On the secondary outcome, the association of vitamin D deficiency and duration or recurrences of diarrhea are conflicting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>There is an association between vitamin D deficiency and the prevalence of diarrhea. Future studies should evaluate the causal association, the impact of vitamin D deficiency on the severity of diarrhea, and whether vitamin D deficiency treatments affects the prevalence of diarrhea.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12887-024-04599-0","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T06:02:41Z","timestamp":1708063361000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The relationship of vitamin D deficiency and childhood diarrhea: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"24","author":[{"given":"Glen","family":"Lazarus","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I Gusti Ngurah Sanjaya","family":"Putra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle Clarissa","family":"Junaidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica Sylvania","family":"Oswari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanifah","family":"Oswari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"issue":"25","key":"4599_CR1","doi-asserted-by":"publisher","first-page":"e11030","DOI":"10.1097\/MD.0000000000011030","volume":"97","author":"Y Guo","year":"2018","unstructured":"Guo Y, Ke HJ, Liu Y, Fu M, Ning J, Yu L, et al. Prevalence of vitamin D insufficiency among children in southern China: a cross-sectional survey. Med (Baltim). 2018;97(25):e11030.","journal-title":"Med (Baltim)"},{"key":"4599_CR2","doi-asserted-by":"publisher","first-page":"e00251","DOI":"10.1016\/j.plabm.2021.e00251","volume":"26","author":"F Trimboli","year":"2021","unstructured":"Trimboli F, Rotundo S, Armili S, Mimmi S, Lucia F, Montenegro N, et al. Serum 25-hydroxyvitamin D measurement: comparative evaluation of three automated immunoassays. Pract Lab Med. 2021;26:e00251.","journal-title":"Pract Lab Med"},{"issue":"5","key":"4599_CR3","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1542\/peds.2008-1862","volume":"122","author":"CL Wagner","year":"2008","unstructured":"Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142\u201352.","journal-title":"Pediatrics"},{"issue":"6","key":"4599_CR4","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1097\/MPG.0b013e31828f3c05","volume":"56","author":"C Braegger","year":"2013","unstructured":"Braegger C, Campoy C, Colomb V, Decsi T, Domellof M, Fewtrell M, et al. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr. 2013;56(6):692\u2013701.","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"2","key":"4599_CR5","doi-asserted-by":"publisher","first-page":"92","DOI":"10.6065\/apem.2040132.066","volume":"26","author":"A Pulungan","year":"2021","unstructured":"Pulungan A, Soesanti F, Tridjaja B, Batubara J. Vitamin D insufficiency and its contributing factors in primary school-aged children in Indonesia, a sun-rich country. Ann Pediatr Endocrinol Metab. 2021;26(2):92\u20138.","journal-title":"Ann Pediatr Endocrinol Metab"},{"key":"4599_CR6","doi-asserted-by":"publisher","first-page":"755","DOI":"10.2298\/SARH1512755R","volume":"143","author":"N Radlovic","year":"2015","unstructured":"Radlovic N, Lekovic Z, Vuleti\u0107 B, Radlovi\u0107 V, Simic D. Acute Diarrhea in Children. Srp Arh Celok Lek. 2015;143:755\u201362.","journal-title":"Srp Arh Celok Lek"},{"issue":"4","key":"4599_CR7","doi-asserted-by":"publisher","first-page":"e832","DOI":"10.1542\/peds.2012-3986","volume":"132","author":"AR Aluisio","year":"2013","unstructured":"Aluisio AR, Maroof Z, Chandramohan D, Bruce J, Mughal MZ, Bhutta Z, et al. Vitamin D3 supplementation and Childhood Diarrhea: a Randomized Controlled Trial. Pediatrics. 2013;132(4):e832\u201340.","journal-title":"Pediatrics"},{"key":"4599_CR8","doi-asserted-by":"crossref","unstructured":"Thobari JA, Sutarman, Mulyadi AWE, Watts E, Carvalho N, Debellut F et al. Direct and indirect costs of acute diarrhea in children under five years of age in Indonesia: Health facilities and community survey. Lancet Reg Health \u2013 West Pac. 2022 Feb 1 [cited 2022 Aug 13];19. Available from: https:\/\/www.thelancet.com\/journals\/lanwpc\/article\/PIIS2666-6065(21)00242-X\/fulltext.","DOI":"10.1016\/j.lanwpc.2021.100333"},{"issue":"3","key":"4599_CR9","doi-asserted-by":"publisher","first-page":"e230","DOI":"10.1016\/S2214-109X(18)30047-0","volume":"6","author":"TF Wierzba","year":"2018","unstructured":"Wierzba TF, Muhib F. Exploring the broader consequences of diarrhoeal diseases on child health. Lancet Glob Health. 2018;6(3):e230\u20131.","journal-title":"Lancet Glob Health"},{"key":"4599_CR10","doi-asserted-by":"crossref","unstructured":"Mahyar A, Ayazi P, Rad MS, Dalirani R, Javadi A, Esmaeily S. The Correlation Between Vitamin D and Bacterial Diarrhea in Children. Arch Pediatr Infect Dis. 2019 [cited 2022 Aug 13];7(2). Available from: https:\/\/brieflands.com\/articles\/apid-84382.html#abstract.","DOI":"10.5812\/pedinfect.84382"},{"issue":"1","key":"4599_CR11","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1186\/s12887-019-1614-4","volume":"19","author":"I Hassam","year":"2019","unstructured":"Hassam I, Kisenge R, Aboud S, Manji K. Association of vitamin D and diarrhoea in children aged less than five years at Muhimbili national hospital, Dar Es Salaam: an unmatched case control study. BMC Pediatr. 2019;19(1):237.","journal-title":"BMC Pediatr"},{"key":"4599_CR12","first-page":"207","volume":"29","author":"E Talachian","year":"2015","unstructured":"Talachian E, Bidari A, Noorbakhsh S, Tabatabaei A, Salari F. Serum levels of vitamins a and D, and zinc in children with acute diarrhea: a cross-sectional study. Med J Islam Repub Iran. 2015;29:207.","journal-title":"Med J Islam Repub Iran"},{"key":"4599_CR13","doi-asserted-by":"publisher","first-page":"n160","DOI":"10.1136\/bmj.n160","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160.","journal-title":"BMJ"},{"issue":"1","key":"4599_CR14","first-page":"15","volume":"61","author":"A Bener","year":"2009","unstructured":"Bener A, Al-Ali M, Hoffmann GF. High prevalence of vitamin D deficiency in young children in a highly sunny humid country: a global health problem. Minerva Pediatr. 2009;61(1):15\u201322.","journal-title":"Minerva Pediatr"},{"issue":"7","key":"4599_CR15","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1111\/jpc.12623","volume":"50","author":"MJ Binks","year":"2014","unstructured":"Binks MJ, Smith-Vaughan HC, Bar-Zeev N, Chang AB, Andrews RM. Vitamin D insufficiency among hospitalised children in the Northern Territory. J Paediatr Child Health. 2014;50(7):512\u20138.","journal-title":"J Paediatr Child Health"},{"issue":"4","key":"4599_CR16","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1111\/ped.12809","volume":"58","author":"IH Bucak","year":"2016","unstructured":"Bucak IH, Ozturk AB, Almis H, Cevik M\u00d6, Tekin M, Konca \u00c7, et al. Is there a relationship between low vitamin D and rotaviral diarrhea? Pediatr Int. 2016;58(4):270\u20133.","journal-title":"Pediatr Int"},{"key":"4599_CR17","unstructured":"Chowdhury R, Taneja S, Bhandari N, Sinha B, Upadhyay RP, Bhan MK et al. Vitamin-D deficiency predicts infections in young north Indian children: A secondary data analysis. PLoS ONE. 2017;12(3). Available from: https:\/\/www.scopus.com\/inward\/record.uri?eid=2-s2.0-85014915573&doi=10.1371%2fjournal.pone.0170509&partnerID=40&md5=285ac1b7ea39065e470441322e954e38."},{"issue":"11","key":"4599_CR18","first-page":"858","volume":"3","author":"N Abed","year":"2014","unstructured":"Abed N, Aly N, Abdel-Gawad E, Ibrahim S. Vitamin D status in children with recurrent acute diarrhea. Int J Curr Microbiol App Sci. 2014;3(11):858\u201368.","journal-title":"Int J Curr Microbiol App Sci"},{"issue":"5","key":"4599_CR19","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1038\/ejcn.2016.7","volume":"70","author":"AMS Ahmed","year":"2016","unstructured":"Ahmed AMS, Magalhaes RJS, Ahmed T, Long KZ, Hossain M, Islam MM, et al. Vitamin-D status is not a confounder of the relationship between zinc and diarrhoea: a study in 6-24-month-old underweight and normal-weight children of urban Bangladesh. Eur J Clin Nutr. 2016;70(5):620\u20138.","journal-title":"Eur J Clin Nutr"},{"issue":"3","key":"4599_CR20","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1055\/s-0042-1745836","volume":"17","author":"MK Basaran","year":"2022","unstructured":"Basaran MK, Dogan C, Sursal A, Ozdener F. Effect of Rotavirus infection on serum micronutrients and atopy in children. J Pediatr Infect Dis. 2022;17(3):137\u201342.","journal-title":"J Pediatr Infect Dis"},{"issue":"4","key":"4599_CR21","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1097\/MPG.0000000000001658","volume":"65","author":"CR Sudfeld","year":"2017","unstructured":"Sudfeld CR, Manji KP, Smith ER, Aboud S, Kisenge R, Fawzi WW, et al. Vitamin D Deficiency is not Associated with Growth or the incidence of Common Morbidities among Tanzanian infants. J Pediatr Gastroenterol Nutr. 2017;65(4):467\u201374.","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"6","key":"4599_CR22","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1097\/INF.0b013e3182868989","volume":"32","author":"KA Thornton","year":"2013","unstructured":"Thornton KA, Mar\u00edn C, Mora-Plazas M, Villamor E. Vitamin D deficiency associated with increased incidence of gastrointestinal and ear infections in school-age children. Pediatr Infect Dis J. 2013;32(6):585\u201393.","journal-title":"Pediatr Infect Dis J"},{"issue":"1","key":"4599_CR23","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1111\/nyas.13968","volume":"1430","author":"DE Roth","year":"2018","unstructured":"Roth DE, Abrams SA, Aloia J, Bergeron G, Bourassa MW, Brown KH, et al. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries. Ann N Y Acad Sci. 2018;1430(1):44\u201379.","journal-title":"Ann N Y Acad Sci"},{"issue":"4","key":"4599_CR24","doi-asserted-by":"publisher","first-page":"e03690","DOI":"10.1016\/j.heliyon.2020.e03690","volume":"6","author":"HU Ugboko","year":"2020","unstructured":"Ugboko HU, Nwinyi OC, Oranusi SU, Oyewale JO. Childhood diarrhoeal diseases in developing countries. Heliyon. 2020;6(4):e03690.","journal-title":"Heliyon"},{"issue":"3","key":"4599_CR25","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1017\/S000711451400097X","volume":"112","author":"Y Zhao","year":"2014","unstructured":"Zhao Y, Yu B, Mao X, He J, Huang Z, Zheng P, et al. Dietary vitamin D supplementation attenuates immune responses of pigs challenged with rotavirus potentially through the retinoic acid-inducible gene I signalling pathway. Br J Nutr. 2014;112(3):381\u20139.","journal-title":"Br J Nutr"},{"key":"4599_CR26","doi-asserted-by":"publisher","first-page":"3141","DOI":"10.3389\/fimmu.2019.03141","volume":"10","author":"EA Yamamoto","year":"2020","unstructured":"Yamamoto EA, J\u00f8rgensen TN. Relationships between vitamin D, gut microbiome, and systemic autoimmunity. Front Immunol. 2020;10:3141.","journal-title":"Front Immunol"},{"issue":"9","key":"4599_CR27","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1016\/j.it.2018.04.002","volume":"39","author":"JM Allaire","year":"2018","unstructured":"Allaire JM, Crowley SM, Law HT, Chang SY, Ko HJ, Vallance BA. The intestinal epithelium: central coordinator of mucosal immunity. Trends Immunol. 2018;39(9):677\u201396.","journal-title":"Trends Immunol"},{"issue":"4","key":"4599_CR28","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1053\/j.gastro.2020.11.015","volume":"160","author":"R Lu","year":"2021","unstructured":"Lu R, Zhang Y, guo, Xia Y, Zhang J, Kaser A, Blumberg R, et al. Paneth cell alertness to Pathogens maintained by Vitamin D Receptors. Gastroenterology. 2021;160(4):1269\u201383.","journal-title":"Gastroenterology"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-024-04599-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12887-024-04599-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-024-04599-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T10:11:37Z","timestamp":1708337497000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-024-04599-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,16]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4599"],"URL":"https:\/\/doi.org\/10.1186\/s12887-024-04599-0","relation":{},"ISSN":["1471-2431"],"issn-type":[{"value":"1471-2431","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,16]]},"assertion":[{"value":"30 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The exclusion of studies in which full texts are not available and non-English studies can introduce potential publication bias in this study as important research conducted in other languages with less positive or inconclusive results may have been omitted.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Risk of publication bias"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"125"}}