Background and Objective Suboptimal vitamin D levels and associated complications are on the rise. Vulnerable populations, like refugee children, are further at risk. Studies on the vitamin D levels in refugee children are limited. The primary objective of this cross-sectional retrospective study was to determine the level of serum 25-hydroxyvitamin D (25-(OH)D) in the paediatric refugee population residing in Sherbrooke, Quebec, Canada. The secondary objective was to determine variables predicting vitamin D levels. Methods Refugees under the age of 19 years arriving in Sherbrooke, Quebec, Canada, evaluated by the refugee clinic between March 2013 and April 2014, were included in the study. Vitamin D levels upon arrival and variables including age, sex, body mass index, season of arrival and season of test, ethnicity, previous country of residence and duration of stay in Canada from time of arrival were recorded. The protocol was approved by the scientific and ethics board of respective institutions. Results A total of 138 subjects were included in the study from the Middle East, Central Asia and South East Asia, Africa and South America. The mean 25-(OH)D serum value was 55 nmol/L (insufficient). Fourteen per cent of subjects were vitamin D deficient and 64% were vitamin D insufficient as per Canadian Paediatric Society threshold guidelines. Gender (P=0.022), age (P<0.001), latitude (P<0.001) and season of testing (P=0.022) predict vitamin D status. Conclusions This study concluded that refugee children have insufficient vitamin D levels. Gender, age, latitude and season of testing have an impact in predicting vitamin D status. © The Author 2017. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: [email protected].

Vitamin D deficiency Refugee children Predicting factors

Pakistan Afghanistan Guatemala refugee Rwanda Quebec vitamin blood level human sex difference Asia Turkey (republic) Iraq Colombia Congo Iran Bhutan season spring school child cross-sectional study ethnic difference 25 hydroxyvitamin D male preschool child South America prediction Infant female summer Central Africa prevalence Article winter age ethnicity retrospective study body mass Child latitude Cote d'Ivoire