Table 3.

Vitamin D deficiency and disease associations in South African populations, by disease, ethnicity, location, age and gender.

Category	Disease/Study Groups	Assoc 1	Study Type	Location	Population	Sample Size	Age Group	Gender	Reference
Bone	Fractures	Yes	longitudinal	Gauteng	NA	20, 20	6–29 y	M & F	[59]
Bone	Rickets	Yes	cross-sectional	KwaZulu-Natal	Black African	37	1–12 y	M & F	[60]
Bone	Bone mineral density	Yes	cross-sectional	North-West	Black African	658	>45 y	F	[32]
Bone	Growth stunting	Yes	cross-sectional	Northern Cape	NA	150	2–5 y	M & F	[57]
Bone	Rickets	No	cross-sectional	Gauteng	Black African	114	<2 y	M & F	[25]
Bone	Metabolic bone disease	No	cross-sectional	Gauteng	Black African	26	16–19 y	M	[61]
Bone	Bone mineral density	No	cross-sectional	Gauteng	Black & Asian-Indian	371, 343	18–65 y	M & F	[35]
Bone	Under weight vs. normal weight	No	case-control	Limpopo	Black African	145	3–5 y	M & F	[22]
Bone/ID	BMD in HIV uninfected vs. HIV high CD4 vs. HIV low CD4 count	No	case-control	Gauteng	Black African	98, 74, 75	≥18 y	F	[62]
ID	Schistosomiasis (PZQ vs. PZQ + vitamin D vs. vitamin D vs. placebo)	Yes 2	RCT	Mozambique border	NA	14, 16, 14, 15	14–18 y	M	[63]
ID	TB-Meningitis	Yes 3	case-control	Western Cape	Black & Coloured	42, 147	0–13 y	M & F	[64]
ID	HIV replication (Summer vs. winter vs. winter + vitamin D)	Yes	longitudinal	Western Cape	Black African	30	18–24 y	M & F	[38]
ID	TB HIV (TB vs. HIV vs. TB-HIV vs. OD)	Yes	case-control	Western Cape	Black African	93, 75, 99, 103	≥18 y	M & F	[65]
ID	HIV-Cryptococcal Meningitis vs. HIV	No 4	case-control	Western Cape	NA	150, 150	≥21 y	M & F	[66]
ID	HIV ART initiation	NA 5	cross-sectional	Gauteng/KWN	NA	270	≥18 y	M & F	[67]
ID	HIV ART initiation	NA 5	cross-sectional	Gauteng/KWN	NA	270	≥18 y	M & F	[68]
ID	Paradoxical TB-HIV IRIS vs TB-HIV no IRIS	No	case-control	KwaZulu-Natal	Black African	11, 11	24–50 y	M & F	[69]
ID	ART-associated TB vs HIV+TB-	No	case-control	KwaZulu-Natal	Black African	18, 38	23–57 y	M & F	[69]
NCD	Cardiovascular disease (blood pressure and pulse)	Yes	cross-sectional	North-West	Black African	291	>47 y	F	[34]
NCD	Metabolic syndrome	No	cross-sectional	Gauteng	Black & Asian-Indian	374, 350	18–65 y	M & F	[33]
NCD	Obesity (total body fat, fat distribution)	No	cross-sectional	Gauteng	Black & Asian-Indian	371, 343	18–65 y	M & F	[36]
Nutrition	Alzheimer’s zinc deficiency (Zn vs. Zn ± vitamin A ± vitamin D)	Yes 6	RCT	Western Cape	NA	70/group	55 y	M	[70]
Nutrition	Alcohol use disorders vs. matched controls	Yes	cross-sectional	Western Cape	Mixed ancestry	81, 81	12–16 y	M & F	[71]

Assoc., association; ART, antiretroviral therapy; BMD, bone mineral density; C:C, case vs. control; CVD, cardiovascular disease; F, female; HIV, human immunodeficiency virus; ID, infectious disease; IRIS, immune reconstitution inflammatory disease; M, male; NA, not available; NCD, Non communicable disease; OD, other diseases; PZQ, praziquantel; RCT, randomised controlled trial; TB, tuberculosis. Bold indicates significant association. y, year; ¹ Disease prevalence or disease-associated functional response negatively correlated with serum 25(OH)D levels or positively with vitamin D deficiency. ² Vitamin D supplementation improved lymphocyte and eosinophil function in schistosomiasis-infected individuals, disease association not investigated. ³ Winter sunlight hours associated with TB-meningitis. ⁴ 74% deficiency in HIV-meningitis patients, but no difference to HIV-only. ⁵ Multinational cohort (n = 30 of 270 from South Africa).HIV disease association not assessed (40%–50% deficient); initiation of Efavirenz containing ART regimes significantly decreased 25(OH)D levels. ⁶ Improved plasma zinc levels in combination Zn + vitamin A + vitamin D.