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Epidemiology of tuberculosis and levels of vitamin D in Australia: person, place and time

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To the Editor: We recently reported the impact of latitude on seasonality of tuberculosis in Australia, with greater cyclic variation in southern parts of the continent.1 We hypothesise that this seasonality is partly determined by differences in ultraviolet radiation exposure and subsequent vitamin D synthesis.13

Vitamin D deficiency (serum 25-hydroxyvitamin D levels below 50 nmol/L)3 has become a significant public health concern in Australia. Australians with darker skin, including some migrants and Aboriginal and Torres Strait Islander people, are at particular risk of both vitamin D deficiency3,4 and tuberculosis.1,5

Similar to our findings regarding tuberculosis incidence,1 a recent Australian study found that vitamin D deficiency was most prevalent in spring and that risk was highest for residents in major…