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Assessmen o he p e alence and associa ed ac o s o i amin D de iciency
among pa ien s age g ea e han o equal o 18 yea s p esen ed wi h
musculoskele al pain in selec ed public hospi als unde Addis Ababa ci y
adminis a ion heal h Bu eau, Addis Ababa, E hiopia
Libsewo k Nigussie (MD, MPH) (P ima y Au ho )
Con ibu o s:
Abdule i Ume Ali, (MD)
Dagmawi Awoke Mulu (MD)
Teshome Ayalew Feleke (MD, MPH)
Eye usalem Besu ekad Mekonnen (MD)
Blen Tes aye Demissie (MD)
Yo danos Damenu Hailu, (MD)
Gelila Zeleke Te e e, (MD)
Mulualem Dawi Bekele (MD)
Mula G/Hiwo Teklu
Hailu A ikil Ejigu(MD)
Adugna Tasewu Tebabal(MD)
Che kos Kebede(Gyneobs)
Leyu Tame a Es e anos (MD)
Engidayehu Gi ma Tessema(MD)
Ad iso : Ma ema Jebessa (PHD candida e) Addis Ababa, E hiopia
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ABSTRACT
In oduc ion: Vi amin D de iciency is a signi ican global public heal h conce n, c ucial o
heal hy bones, immuni y, and gene al well-being. A ec ing an es ima ed one billion people
wo ldwide, Vi amin D de iciency can lead o se e e bone diso de s, inc eased ac u e isk, and
ch onic diseases. O en unde diagnosed and unde ea ed, i necessi a es a ge ed public heal h
in e en ions.
Objec i e: This s udy aimed o assess he p e alence and associa ed ac o s o Vi amin D
de iciency among adul pa ien s (≥18 yea s) p esen ing wi h musculoskele al pain in public
hospi als in Addis Ababa, E hiopia, in 2025.
Me hods: An ins i u ional-based c oss-sec ional s udy was conduc ed in h ee andomly selec ed
Addis Ababa public hospi als. A o al o 385 p opo ionally alloca ed pa icipan s we e chosen
ia sys ema ic andom sampling. Desc ip i e s a is ics and mul i a iable eg ession analyses
(95% CI, p<0.05) we e employed.
Resul s: The o e all p e alence o Vi amin D de iciency among adul esponden s wi h
musculoskele al pain was 68.1% (95% CI: 63.1%–72.7%). Mul i a iable analysis iden i ied age,
u ban esidency, and ma i al s a us (single/widowed e sus di o ced) as signi ican ac o s.
Responden s aged o e six y yea s we e ou imes mo e likely o ha e Vi amin D de iciency
han hose aged 18–40 yea s (AOR = 4.412). U ban esiden s we e h ee and hal imes mo e
likely o be de icien han u al esiden s (AOR = 3.580).
Conclusion and Recommenda ions: Vi amin D de iciency is p e alen among adul pa ien s
wi h musculoskele al pain in Addis Ababa. These indings unde sco e he c i ical need o
inc eased awa eness, ou ine sc eening, and a ge ed in e en ions, pa icula ly o olde adul s
and u ban dwelle s, o imp o e musculoskele al heal h and o e all well-being.
In e na ional Jou nal o Resea ch (IJR)
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Keywo ds: Vi amin D, Musculoskele al, Public Hospi al, p e alence, Addis Ababa, c oss-
sec ional s udy.
1. INTRODUCTION
Acco ding o a 2020 sys ema ic e iew in he USA, i amin D, a a -soluble i amin, acili a es
calcium and phospho us abso p ion in he gu , suppo ing bone mine aliza ion, g ow h,
emodeling, and main aining se um calcium and phospha e le els (1). Beyond bone heal h,
i amin D egula es many cellula unc ions as mos nuclea ed cells exp ess he i amin D
ecep o (VDR). Abou 10–20% o equi emen s come om die , mainly a y ish, egg yolk, and
o i ied oods (2). Vi amin D exis s as D2 (e gocalci e ol, om molds) and D3 (cholecalci e ol,
syn hesized in skin upon sunligh exposu e) (3).
Se um 25(OH)D below 30 nmol/L, he bes ma ke o i amin D s a us, indica es insu iciency
(4). Mul iple isk ac o s a ec i amin D le els, including age, sex, obesi y, socioeconomic
s a us, ch onic illness, ac u es, die , clo hing, skin colo , e hnici y, la i ude, cul u e, limi ed
ou doo ac i i y, and season (5). Globally, abou 15.7% o adul s a e de icien (25(OH)D <30
nmol/L) (6).
A 2019 sys ema ic e iew in A ica showed p e alence anging om 30–80%, wi h pooled
p e alence a 17.3%. Causes include u baniza ion, cul u al p ac ices, and poo die (7). In
E hiopia, de iciency is also a majo conce n: a 2022 s udy in Addis Ababa ound 50–70%
p e alence, highe in u ban popula ions due o educed sunligh exposu e and indoo wo k (8).
Vi amin D de iciency con ibu es o p oximal muscle weakness, bone pain, and os eomalacia,
o en unde diagnosed in clinical p ac ice (9). Raising awa eness, ea ly sc eening, and p e en ion
can imp o e musculoskele al heal h and educe bu den (10). Howe e , mos E hiopian s udies
ocus on child en, wi h limi ed esea ch among adul s wi h musculoskele al pain (8, 11–13).
Thus, his s udy aims o assess p e alence and associa ed ac o s o i amin D de iciency among
adul s wi h musculoskele al pain in Addis Ababa.
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1.1. S a emen o p oblem
Vi amin D de iciency is a majo public heal h p oblem causing icke s in child en and
os eomalacia, os eopo osis, ac u es, in ec ions, au oimmune diseases, ca dio ascula
diso de s, dep ession, cogni i e decline, and ce ain cance s in adul s (14–16). P e en ion
h ough sunligh , o i ied oods, and supplemen a ion is possible, ye awa eness emains
low. In E hiopia, 56% o mo he s had good knowledge and 55.6% p ac iced p ope
sunligh exposu e, wi h egional a ia ions—54.4% in Amha a s. 58.3% in Sidama—
due o educa ion, cul u al, and in o ma ional di e ences (17,18). Despi e in e en ions,
de iciency a ec s 50–70% o adul s, especially in u ban a eas wi h less sun exposu e (8).
Musculoskele al pain is a common p esen a ion, wi h supplemen a ion c ucial o
managemen . One s udy epo ed de iciency in 41.9% o adul s wi h back pain, a igue,
o gene alized pain (8). Mos esea ch in E hiopia cen e s on child en (8,11–13).
The e o e, his s udy aims o assess he p e alence and associa ed ac o s o i amin D
de iciency among adul s wi h musculoskele al pain in Addis Ababa public hospi als.
1.2. Objec i e
1.2.1 Gene al objec i e
To assess he p e alence and associa ed ac o s o i amin D de iciency among adul
pa ien s p esen ed wi h musculoskele al pain in public hospi als unde Addis Ababa ci y
adminis a ion heal h bu eau in Addis Ababa, E hiopia, 2025.
1.2.2 Speci ic objec i e
To de e mine he p e alence o i amin D de iciency among adul pa ien s p esen ed wi h
musculoskele al pain in public hospi als unde Addis Ababa ci y adminis a ion heal h
bu eau in Addis Ababa, E hiopia, 2025.
To iden i y ac o s o i amin D de iciency among adul pa ien s p esen ed wi h
musculoskele al pain in public hospi als unde Addis Ababa ci y adminis a ion heal h
bu eau in Addis Ababa, E hiopia, 2025.
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1.3. Signi icance o s udy
The indings indica e ha se e e de iciency o i amin D is signi ican ly associa ed wi h he
p esence o ch onic widesp ead pain, bu i does no play a majo independen iple ole-
highligh in p edic ing egional musculoskele al pain. This highligh s he impo ance o u he
esea ch in his a ea and sugges s ha people wi h low i amin D le els a e mo e likely o
expe ience widesp ead pain ia musculoskele al sys em which can impac nega i ely on hei
quali y o li e. (17)
The ecogni ion ha i amin D de iciency is p e alen in he gene al popula ion and may
con ibu e o ch onic pain suppo s public heal h ecommenda ions including educa ion and
awa eness- aising, die a y in ake p omo ion, sa e sun exposu e as well as ood o i ica ion on
occasion o ecommenda ion o supplemen a ion aimed a aising le els o 25(OH)D wi hin
popula ions. This is e en mo e c i ical in egions wi h limi ed sunligh due o he highe
de iciency a e.(8)
E en i he e a e a lo o adul pa ien s isi ing public hospi als unde Addis Ababa ci y
adminis a ion heal h bu eau, limi ed s udies a e done o assess he p e alence and associa ed
ac o s o i amin D de iciency in adul pa ien s p esen ed wi h musculoskele al pain.(13, 16) As
a esul , his s udy is aimed o assess he p e alence and associa ed ac o s o i amin D
de iciency among adul pa ien s p esen ed wi h musculoskele al pain in selec ed public hospi als
unde Addis Ababa ci y adminis a ion heal h bu eau in Addis Ababa, E hiopia.
2. Li e a u e Re iew
2.1. Vi amin d de iciency and i s p e alence
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Vi amin D de iciency is ecognized as a widesp ead global heal h conce n, a ec ing
popula ions ac oss di e se egions. A c oss-sec ional s udy in Yemen highligh ed i s
p e alence wo ldwide, pa icula ly in Sou h Asia, he Middle Eas , No h A ica, Eu ope,
and he Uni ed S a es, whe e i is la gely unde diagnosed due o cul u al,
en i onmen al, and li es yle ac o s (19). Simila ly, a me a-analysis in he Middle Eas ,
China, Mongolia, and India con i med ha high- isk g oups such as child en, p egnan
women, olde adul s, and non-Wes e n immig an s a e disp opo iona ely a ec ed (20).
A sys ema ic e iew conduc ed by Cui e al. e ealed ha be ween 2000 and 2022,
15.7% o people had se um 25-hyd oxy i amin D le els below 30 nmol/L, indica ing ha
many indi iduals ace heal h isks associa ed wi h low i amin D (6).
In A ica, he p oblem is equally conce ning. A Sou h A ican s udy ound ha 28.5% o
heal h wo ke s we e i amin D de icien , pa icula ly black A icans and hose olde han
42 yea s, wi h s ong associa ions o obesi y, diabe es, and me abolic synd ome (9). In
Came oon, p e alence was 10.2% (21), while in Uganda, 40.2% o p egnan women
had se um i amin D le els below 20 ng/mL (22).
E idence om E hiopia shows a pa icula ly high bu den despi e abundan sunshine. A
e ospec i e c oss-sec ional s udy ound widesp ead de iciency in pa ien s wi h non-
speci ic neu omuscula pain and a igue (3). In Sodo own, 39% o p egnan women
we e a ec ed (23), while a case-con ol s udy in no hwes E hiopia epo ed 46.2%
p e alence o e all and 61.5% among ube culosis pa ien s (24). In Addis Ababa,
i amin D de iciency was ound in 96% o pa ien s wi h mul iple scle osis, wi h mean
se um le els o only 14.8 ng/mL (11), and ano he s udy con i med almos uni e sal
de iciency among pa ien s wi h neu omuscula pain (3).
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Se e al isk ac o s con ibu e o his high p e alence. Age and gende play impo an
oles, wi h s udies in Yemen and Thailand showing highe odds among women and
younge adul s who spend mo e ime indoo s (19,25). O he de e minan s include
unemploymen , low ish consump ion, and in equen sun exposu e as epo ed in Egyp
(26). Addi ional ac o s iden i ied in a sys ema ic e iew include poo die , malabso p ion
diso de s, li e and panc ea ic disease, ba ia ic su ge y, and obesi y, which educes
i amin D bioa ailabili y (27). U ban esidence and highe educa ion ha e also been
linked o de iciency due o indoo wo k pa e ns and li es yle di e ences compa ed o
u al popula ions (4).
The clinical implica ions o i amin D de iciency a e wide- anging. Low le els
comp omise b ain unc ion, leading o memo y loss, demen ia, dep ession, and poo
eco e y a e inju y (28). They a e also associa ed wi h ch onic in lamma ion and
ca dio ascula diseases (29), inc eased adiposi y and low muscle mass in women (30),
and wo sened bone densi y loss, ac u es, and os eopo osis in he elde ly (31).
An impo an a ea o esea ch is he ela ionship be ween i amin D de iciency and
musculoskele al pain. Se e al s udies ha e ound ha lowe i amin D le els a e
co ela ed wi h g ea e pain in ensi y, ch onic widesp ead pain, and wo se ou comes in
os eoa h i is, pa icula ly in weigh -bea ing join s (32–34). The p e alence o de iciency
among adul s wi h musculoskele al pain is ypically be ween 30% and 53% when using
a h eshold o <20 ng/mL, hough es ima es a y ac oss popula ions and se ings (35).
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2.5. Theo e ical and concep ual amewo k
FIGURE 1 PROPOSED CONCEPTUAL FRAMEWORK SHOWING THE FACTORS ASSOCIATED WITH
VITAMIN D DEFICIENCY AMONG PATIENTS PRESENTED WITH MUSCULOSKELETAL PAIN IN
PUBLIC HOSPITALS UNDER ADDIS ABABA CITY ADMINSTRATION HEALTH BUREAU IN ADDIS
ABABA,ETHIOPIA,2024; ADAPTED FROM REVIEW OF LITERATURES. (36–42)
En i onmen al ac o s
•sunligh
exposu e
•Geog aphical
loca ion
Sociodemo g aphic
ac o s
Age
Sex
Income
Occupa ion
Educa ion
Ma i al s a us
Place Residence
Pe sonal ac o s
•Co-mo bidi ies
like
GI
diso de (malabso
p ion)
li e diseases &
Ba ia ic su ge y
Obesi y & DM
CKD
•Medica ion like
HAART
An icon ulsan s
PPIs
•
P egnancy and
lac a ion
•Alcohol
•smoking
Li e s yle ac o s
Nu i ional
de iciency
Physical
inac i i y
Unemploymen
Vi amin D
de iciency
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3. METHOD
3.1. S udy a ea and pe iod
Addis Ababa, which se es as he poli ical capi al and he key comme cial and cul u al hub o
E hiopia, is si ua ed geog aphically in he cen e o he coun y a a la i ude o 9°2'N and a
longi ude o 38°45'E. The ci y has an a e age ele a ion o 2,400 me e s abo e sea le el, while
he highes poin , En o o Hill, loca ed o he no h, eaches an ele a ion o 3,200 me e s. I is
di ided in o 11 subci ies called ki le ke ema and 116 wo edas which a e he lowes
adminis a i e uni s.
Acco ding o he 2007 Census ca ied ou by he Cen al S a is ical Agency o E hiopia (CSA),
he popula ion o Addis Ababa ci y is 3,384,569. The ci y is si ua ed a an ele a ion o 7,546 ee
(2,300 me e s). The ci y has su ace a ea o abou 530.14 km2. Languages spoken include
Amha ic (71.0%), A aan O omo (10.7%), Gu age (8.37%), Tig igna (3.60%), Sil 'e (1.82%) and
Gamo (1.03%).(43) P ojec ed Popula ion Size o Addis Ababa in 2022 is 3,859,638).(44)
Acco ding o 2012 (EFY) Heal h and Heal h Rela ed Indica o s published by MoH, The e a e 49
hospi als,13 a e public o which 6 a e owned by Addis Ababa Ci y adminis a ion heal h bu eau,
5 NGOs, and 32 p i a e,27 public heal h cen e s, and 130 public heal h s a ions,700 di e en
le els o p i a e clinics a e ound in Addis Ababa ci y adminis a i e egion.(45)
The esea ch was conduc ed om No embe 2024 o July 2025 wi h a speci ic pe iod o da a
collec ion, analysis, and epo ing.
3.2. S udy design
Ins i u ion-based c oss sec ional s udy was conduc ed.
3.3. Popula ion
3.3.1. Ta ge popula ion
All pa ien s olde han o equal o 18 yea s wi h musculoskele al pain in Addis Ababa, E hiopia.
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bo h language and back ansla ed o English o see i s consis ency. Clinical Assessmen , was
Conduc ed by ained pe sonnel using s anda dized equipmen a ailable a he acili y. Fo he
se um le el o i amin D, seconda y da a was aken om he pa ien ca d o labo a o y
egis a ion. A eco d uni o se um i amin D was consis en ly (ng/ml o nmol/L) as pe s udy
p o ocol.(11, 22, 31, 41)
3.12. Da a collec ion me hods
Da a was collec ed by h ee ained quali ied nu ses who we e assigned a each o he h ee
selec ed hospi als and we e supe ised by one Gene al medical p ac i ione (MD) a each
espec i e hospi al. The p incipal in es iga o was esponsible o he o e all managemen o he
p ojec ; he de elopmen o he inal ques ionnai e; secu ing pa icipa ion o selec ed pa ien s;
iden i ying, aining and assignmen o da a collec o s. The pu pose o he aining was o ensu e
ha all he da a collec o s should ha e he same in o ma ion abou he s udy ins umen and
ollowed he same in e iew p ocedu es. The aining was del wi h he pu pose o he s udy,
con iden iali y and how o app oach and o wa d ques ions o clien s.
3.13. Da a quali y assu ance
Bo h he da a collec o s and supe iso s we e ained o one day in he objec i e and
me hodology o he esea ch, da a collec ion app oach. The ques ionnai e was ansla ed o
Amha ic language and back ansla ed in o English by ano he pe son o check o consis ency.
P e es was conduc ed in 5% o he samples a Zewudi u Hospi al. The da a collec ion ins umen
was assessed o comple eness, consis ency, and applicabili y and was a i ied acco dingly. The
s udy p ocedu es we e p o ec ed he pa ien 's p i acy by allowing anonymous and olun a y
pa icipa ion.
The Fas Alcohol Sc eening Tes (FAST) – (C onbach‟s alpha = 0.77; Tes – e es eliabili y =
0.8) which is a sho e sion o he Alcohol Use Diso de s Iden i ica ion Tes (AUDIT) was used
o assess mode a ion o alcohol consump ion.(83) I con ains 4 i ems and a sco e o 0 o ne e ‟,
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1 o „Less han mon hly‟, 2 o „Mon hly‟, 3 o „Weekly‟ and 4 o „Daily o almos daily‟
was gi en.
3.14. Da a p ocessing and analysis
Da a checked and cleaned a e en e ed in o KOBO ool box, hen impo ed o SPSS e sion
27.0 so wa e o analysis. Incomple e and inconsis en da a excluded om he analysis.
Desc ip i e s a is ics we e used o desc ibe he da a. The esul s o he desc ip i e s a is ics we e
exp essed as pe cen ages and equencies. Associa ions be ween independen and dependen
a iables we e analyzed i s using bi- a iable analysis o iden i y ac o s which we e associa ed
wi h he ou come a iable. Those a iables which we e ound o ha e an associa ion wi h he
ou come a iable a P<0.25.(84) We e en e ed o mul i- a iable logis ic eg ession o es o
independen associa ion. The magni ude o he associa ion be ween he di e en independen
a iables in ela ion o dependen was measu ed using odds a ios and 95% con idence in e al
(CI) and P alues below 0.05 we e conside ed o be s a is ically signi ican .
3 .15. E hical conside a ion
E hical clea ance was ob ained om Resea ch Re iew Boa d o Ka a d College. O icial le e s
o suppo was ob ained om public heal h depa men o Ka a d College and was gi en o
Addis Ababa Ci y Adminis a ion heal h Bu eau and hen he o icial le e was gi en o all he
h ee selec ed public hospi als unde Addis Ababa ci y adminis a ion heal h bu eau. On he da a
collec ing ool i sel , he i s page o he ques ionnai e was p o ide ull in o ma ion o he s udy
pa icipan s ega ding he pu pose, na u e o he esea ch, bene icence, male icen and hen
w i en Consen was ob ained om each pa icipan . Pa icipa ion o he s udy was on olun a y
basis, and pa icipan s we e in o med abou hei igh no o pa icipa e in he s udy o wi hd aw
a any ime. Mo eo e , p i acy and con iden iali y o in o ma ion was kep p ope ly and names
we e no eco ded.
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3.16. Resul dissemina ion
The indings dissemina ed o Ka a d College Public Heal h Depa men using ha d copy. The
documen will also be submi ed o go e nmen al and non-go e nmen al s akeholde s such as
Addis Ababa heal h bu eau se ing on nu i ion p og am. Finally; i will be submi ed o
publica ion.
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4. RESULT
4.1. Socio-demog aphic cha ac e is ics o pa icipan s
Ou o he o al pa ien s who we e p esen ed wi h musculoskele al pain a he 3 hospi als du ing
he s udy pe iod, 385 eligible clien s we e included in he s udy, wi h esponse a e o 100%.
Analysis was made based on he 385 comple ed ques ionnai es. The s udy consis ed o 195
(50.6%) males which was almos equal o emales. Among he emale pa icipan s only less han
hal o hem, 59(31.1%) and 38(29%) we e p egnan and lac a ing espec i ely. The majo i y o
pa icipan s we e ma ied, 240 (62.3%), he mean age o he esponden s was 40.14(25.81,
54.47) yea s and li ed in u ban a eas, 338 (87.8%) espec i ely. Addi ionally mos o hem had
a ained college o uni e si y-le el educa ion, 175 (45.5%) and go e nmen al employee 129
(33.5%) wi h mon hly income majo ly, 234 (60.8%) ea ning be ween 5,000–20,000 E hiopian
bi .
TABLE 1: DEMOGRAPHIC CHARACTERISTICS OF RESPONDENTS OLDER THAN OR EQUAL TO
18 YEARS PRESENTED WITH MUSCULOSKELETAL PAIN AT PUBLIC HOSPITALS UNDER ADDIS
ABABA CITY ADMINISTRATION HEALTH BUREAU, ADDIS ABABA,ETHIOPIA,2025(N=385)
Va iables
F equency n=385
Pe cen
Age
18-40
234*
60.8
41-60
102
26.5
>60
49
12.7
Sex
Female
190
49.4
Male
195*
50.6
Ma i al s a us
Single
83
21.6
Ma ied
240*
62.3
Di o ced
34
8.8
Widowed
28
7.3
Educa ional s a us
Can’ ead and w i e
31
8.1
Read and w i e
69
17.9
P ima y
40
10.4
Seconda y
70
18.2
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College/Uni e si y
175*
45.5
Occupa ional s a us
Unemployed
100
26
Go ’ employee
129*
33.5
P i a e employee
70
18.2
P i a e business
76
19.7
Re i ed
10
2.6
Income
<5000
121
31.4
5000-20000
234*
60.8
>20000
30
7.8
Residency
P egnancy
Lac a ion
U ban
Ru al
Yes
No
Yes
No
338*
47
59
131*
38
93*
87.8
12.3
31.1
68.9
29
71
*=Dominan numbe in he ca ego y o a iable
4.2. PREVALENCE OF VITAMIN D DEFICIENCY
Among he 385 adul esponden s (≥18 yea s) seen o musculoskele al pain a public hospi als
unde he Addis Ababa Ci y Adminis a ion Heal h Bu eau in 2025, he o e all p e alence o
i amin D de iciency was ound o be 68.1% (95% CI: 63.1%–72.7%), whe eas only 31.9%
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(95%CI: 27.3%–36.9%) o esponden s we e classi ied as su icien wi h i amin D.
FIGURE 3: PREVALENCE OF VITAMIN D DEFICIENCY AMONG RESPONDENTS OLDER THAN
OR EQUAL TO 18 YEARS PRESENTED WITH MUSCULOSKELETAL PAIN AT PUBLIC HOSPITALS
UNDER ADDIS ABABA CITY ADMINISTRATION HEALTH BUREAU, ADDIS
ABABA,ETHIOPIA,2025(N=385).
3. Pe sonal cha ac e is ics o pa icipan s
Among he 385 adul esponden s p esen ing wi h musculoskele al pain, a majo i y 279 (72.5%)
had daily sunligh exposu e o 30 minu es o mo e. The use o sunsc een was epo ed by
90(24.7%) o pa icipan s and 116(30.1%) o esponden s had como bidi ies. In e ms o
knowledge abou i amin D, 168(43.6%) had good knowledge. Conce ning die a y habi s,
234(60.8%) consumed i amin D- ich oods such as ish, milk, o eggs. And 64 (16.6%) epo ed
aking i amin D supplemen s. Only 30(7.8%) , 31(8.1%), 111(28.8%), 62(16.1%), 113(29.4%),
and 140(36.4%) o esponden s we e on HAART ,used an iepilep ic medica ions, epo ed using
p o on pump inhibi o s, smoke s, consumed alcohol and engaged in egula physical exe cise
espec i ely.
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TABLE 2: Pe sonal cha ac e is ics o esponden s olde han o equal o 18 yea s p esen ed
wi h musculoskele al pain a public hospi als unde Addis Ababa ci y adminis a ion
heal h bu eau, Addis Ababa,E hiopia,2025(n=385).
Va iables
F equency
n=385
Pe cen
Sunligh exposu e
< 30 minu es
106
27.5%
>/= 30 minu es
279*
72.5%
Use o sunsc een
Yes
90
24.7%
No
295*
75.3%
Como bidi ies
P esen
116
30.1%
Absen
269*
69.9%
Knowledge abou i amin D
Good
168
43.6%
Poo
217*
56.4%
Consump ion o ish, milk o egg
Yes
234
60.8%
Vi amin D supplemen
Use o HAART
Use o an iepilep ic
Use o p o on pump inhibi o s
Smoking
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
151
64
321*
30
355*
31
354*
111
274*
62
39.2%
16.6%
83.4%
7.8%
92.2%
8.1%
91.9%
28.8%
71.2%
16.1%
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Alcohol
Exe cise
No
Yes
No
Yes
No
323*
113
272*
140
245*
83.9%
29.4
70.6
36.4%
63.6%
4. Fac o s associa ed wi h i amin D de iciency
A e bi a ia e and mu i a ia e bina y logis ic eg ession was done o each a iables and o all
a iables wi h p< 0.25 espec i ely. Age, Residency and ma i al s a us (being single and
widowed) o esponden s we e ound o be signi ican ly associa ed (P- alue<0.05) wi h
p e alence o i amin D de iciency. Responden s aged abo e 60 yea s we e 4 imes mo e likely
o ha e i amin D de iciency compa ed o hose aged 18–40 yea s (AOR = 4.412, 95% CI:
1.745–11.154).Responden s li ing in u ban we e 3.58 imes mo e likely o be i amin D
de icien compa ed o esiden s u al a eas (AOR = 3.580, 95% CI: 1.288–9.949).Responden s
who we e single and widowed we e 70%(AOR=0.302, 95% CI: 0.111, 0.826) and 80 %(
AOR=0.190, CI: 0.053, 0.680) less likely o de elop i amin D de iciency as compa ed wi h
widowed.
TABLE 3: shows he demog aphic, pe sonal and beha io al ac o s associa ed wi h i amin
d de iciency among esponden s olde han o equal o 18 yea s p esen ed wi h
musculoskele al pain a public hospi als unde Addis Ababa ci y adminis a ion heal h
bu eau, Addis Ababa,E hiopia,2025(n=385).
Va iables
Vi amin D s a us
COR (95% CI)
AOR (95% CI)
Su icien N (%)
De icien
N (%)
Age in yea s
18-40
179(76.5)
55(23.5)
1.00
1.00
41-60
62(60.8)
40(39.2)
2.100(1.274-3.459)
1.716(0.936,3.146)
>60
21(42.9)
28(51.7)
4.339(2.285-8.241)
4.412(1.745,11.154)**
Ma i al s a us
Di o ced
17(50.0)
17(50.0)
1.00
1.00
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Ma ied
Single
Widowed
Educa ion
College-uni e si y
Illi e a e
P ima y
Read and w i e
Seconda y
Occupa ional s a us
Go e nmen al employee
P i a e business
P i a e employee
Re i ed
Unemployed
Income
<5,000
5,000-20,000
>20,000
Residency
Ru al
U ban
Sunsc een
No
Yes
Knowledge
Poo knowledge
158(65.8)
66(79.5)
21(75%)
132(75.4)
21(67.7)
25(62.5)
37(53.6)
47(67.1)
91(70.5)
55(72.4)
49(70.0)
6(60)
61(61.0)
70(57.9)
168(71.8)
24(80.0)
41(87.2)
221(65.4)
185(63.8%)
77(81.1)
7(9.8)
82(34.2)
17(20.5)
7(25%)
43(24.6)
10(32.3)
15(37.5)
32(46.4)
23(32.9)
38(29.5)
21(27.6)
21(30)
4(40)
39(39.0)
51(42.1)
66(28.2)
6(20.0)
6(12.8)
117(34.6)
105(36.2)
18(18.9)
57(16.6)
0.519.(0.52,1.070)
0.258(0.109,0.607)
0.333(.112,0.989)
1.00
1.462(0.639,3.346)
1.842(0.890,3.810)
2.655(1.479,4.766)
1.502(0.820,2.754)
1.00
0.914(0.487,1.716)
1.026(0.543,1.939)
1.596(0.426,5.980)
1.531(0.882,2.659)
1.00
0.539(0.341,0.854)
0.343(0.131,0.900)
1.00
3.618(1.492,8.770)
1.00
2.888(1.580,5.277)
1.00
0.429(0.181,1.017)
0.302(0.111,0.826)**
0.190(0.053,0.680)**
1.00
0.413(0.128,1.332)
1.345(0.567,3.192)
1.188(0.216,6.533)
1.324(0.619,2.832)
1.00
1.186(0.554,2.536)
1.816(0.851,3.877)
1.188(0.216,6.533)
1.324(0.619,2.832)
1.00
0.823(0.436,1.553)
0.432(0.128,1.455)
1.00
3.580(1.288,9.949)**
1.00
0.588(0.289,1.197)
1.00
Good knowledge
64(90.2)
286(83.4)
0.505(0.322,0.790)
0.666(0.372,1.192)
Como bidi y
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No
Yes
Smoking
No
Yes
Alcohol
No
Yes
Exe cise
No
Yes
BMI
<18.5
18.5-24.9
>24.9
188(69.9)
74(63.8)
210(65.0)
52(83.9)
175(64.3)
87(77.0)
160(65.3)
102(72.9)
109(76.2)
20(66.7)
133(62.7)
81(30.1)
42(36.2)
113(35.0)
10(16.1)
97(35.7)
26(23.0)
85(34.7)
38(27.1)
34(23.8)
10(33.3)
79(37.3)
1.00
1.317(0.832,2.086)
1.00
0.357(0.175,0.730)
1.00
0.539(0.326,.892)
1.00
0.701(0.444,1.106)
1.00
1.603(0.684,3.755)
1.904(1.184,3.062)
1.00
1.459(0.777,2.738)
1.00
0.404(0.138,1.186)
1.00
0.972(0.490,1.930)
1.00
1.544(0.816,2.922)
1.00
1.597(0.587,4.342)
1.356(0.777,2.365)
*AOR= s a is ically signi ican a p<0.05
5. DISCUSSION
This s udy assessed he p e alence and associa ed ac o s o i amin D de iciency (VDD) among
adul s wi h musculoskele al pain in selec ed public hospi als in Addis Ababa. The p e alence o
VDD was ound o be 68.1%, ma kedly highe han he global pooled es ima e o 15.7% (6) and
he A ican pooled p e alence o 17.3% (7). Al hough s udies sugges 30–80% de iciency in
pain- ela ed subg oups (35), he magni ude obse ed he e is s iking and likely e lec s bo h he
s udy popula ion and con ex ual ac o s o u ban li ing. The esul is in line wi h E hiopian
s udies, which epo adul p e alence be ween 50–70%, wi h especially high a es in u ban
a eas, such as 39% among p egnan women in Sodo (23) and 96% among mul iple scle osis
pa ien s in Addis Ababa (11). These indings ein o ce ha VDD is a c i ical public heal h
p oblem in E hiopia despi e abundan sunligh .
