Nutritional status and vitamin A and zinc levels in patients with kala-azar in Piauí, Brazil

Abstract

INTRODUCTION: Malnutrition and kala-azar (or visceral leishmaniasis) are significant public health problems in different parts of the world. Immunity and susceptibility to infectious and parasitic diseases are directly linked to the host’s nutritional state, but little is known about the interaction between nutrition and kala-azar. This study aimed to evaluate nutritional status with kala-azar and correlate these findings with the clinical and laboratory manifestations of the disease, and zinc and retinol levels. METHODS: This was a cross-sectional study of 139 patients with kala-azar. Nutritional status classification was performed according to international recommendations. Parametric or nonparametric tests were applied whenever indicated in a two-sided test with a 5% significance level. RESULTS: Weight loss and malnutrition were more frequent in adults. Body mass index-for-age, fat area of the arm, and upper arm muscle area were significantly associated with probability of death. The presence of human immunodeficiency virus, hepatomegaly, and splenomegaly was correlated with nutritional assessment. Blood leukocyte and lymphocyte, serum creatine, and vitamin A levels were significantly higher in adult men. Vitamin A levels were highly associated with the level of hemoglobin and C-reactive protein (CRP) in multivariate analysis. All patients had reduced plasma zinc levels, but this finding had no association with the outcome variables. CONCLUSIONS: Malnutrition was correlated with severe disease and was more prevalent in older people with kala-azar. Vitamin A deficiency was associated with hemoglobin and CRP. Zinc levels were reduced in patients with kala-azar.

Mucosal Leishmaniasis Involving the Nostril and Maxillary Sinus: A Case Report

“…Malnutrition is a risk factor for the development of systemic leishmaniasis [30]. Kala-azar patients reported low serum levels of vitamin A and zinc [31]. Improved clinical outcome of the disease was reported in children with kala-azar who received zinc supplementation along with amphotericin B or pentavalent antimonial treatment [32,33].…”

Global Dilemma and Needs Assessment Toward Achieving Sustainable Development Goals in Controlling Leishmaniasis

“…Lack of vitamin A, iron, zinc, and protein-energy malnutrition execrable the infection resulting in a full-scale disease condition [ 27 ]. The severity of leishmaniasis can be intensified due to malnutrition [ 28 ].…”

From Infection to Death: An Overview of the Pathogenesis of Visceral Leishmaniasis

“…Weight loss is also a common manifestation of VL, resulting from severe malnutrition [ 84 , 85 ]. Patients with VL-driven malnutrition are at higher risk of death [ 86 , 87 , 88 , 89 , 90 ].…”

“…However, a deficiency in albumin reduces its important function as a carrier for the transport of micronutrients, like zinc. Likewise, other negative APR, such as transthyretin and retinol-binding protein, may reduce the availability of vitamin A for its essential function in the immune system, rendering patients with VL more susceptible to bacterial infections [ 70 , 85 ]. Due to the relevant role of malnutrition in immunity, its potential impact on chemotherapy is worthy of investigation.…”