Vitamin D Status and Associated Factors among Children and Adolescents with Epilepsy in the Watsa Health Zone, Democratic Republic of the Congo

Abstract

Background: Vitamin D deficiency has been increasingly recognised among children and adolescents with epilepsy, particularly in low-resource settings, where disease-related factors, antiepileptic treatments, and nutritional deficiencies may contribute to reduced serum levels. This study aimed to assess vitamin D status and identify associated factors in children and adolescents with epilepsy in Watsa health zone, Democratic Republic of the Congo. Methods: A cross-sectional study was conducted among 43 children and adolescents with epilepsy. Sociodemographic, clinical, nutritional, and treatment-related data were collected. Serum 25-hydroxyvitamin D [25(OH)D] and calcium levels were measured. Associations were explored using bivariate analyses, correlation tests, and multivariable linear regression models. Results: The mean age was 11.2 ± 6.3 years, and 55.8% were male. Most participants (60.5%) had uncontrolled seizures. Vitamin D insufficiency was highly prevalent (69.8%), while 25.6% had deficiency; only 4.7% had normal levels. Mean serum 25(OH)D was 23.5 ± 4.3 ng/mL. In bivariate analysis, fish (p = 0.002), milk (p < 0.001), and egg consumption (p = 0.013) were associated with higher vitamin D levels. No associations were found with age, sex, epilepsy characteristics, treatment, or calcium levels. In multivariable analysis, fish (β = 6.51; p < 0.001), milk (β = 4.32; p = 0.001), and eggs (β = 3.62; p = 0.004) remained independent predictors of higher serum 25(OH)D. Conclusion: Vitamin D insufficiency is highly prevalent among children and adolescents with epilepsy in Watsa health zone. Dietary intake of fish, milk, and eggs appears to be the main modifiable determinant of serum 25(OH)D levels, highlighting the importance of targeted nutritional interventions in this population.