Nutritional Status and Cutaneous Leishmaniasis in Rural Ecuadorian Children

Abstract

The relationship between nutritional status and cutaneous leishmaniasis (CL) was evaluated in 230 children living in a rural subtropical rainforest in Northwest Ecuador. One-third of the subjects had evidence of either current (13 per cent) or past CL infection (21 per cent). Subjects with current (4.71 +/- 0.44 mg) or previous disease (4.29 +/- 0.35 mg) had lower mean daily dietary iron intakes than non-infected children (5.45 +/- 0.2 mg; chi 2 = 0.048), but not energy, protein, or other micronutrients. The low dietary iron intake data was corroborated by the reduced mean haemoglobin values observed in children with current (11.7 +/- 0.3 mg/dL) or past infection (11.3 +/- 0.2 mg/dL) compared to non-infected subjects (12.7 +/- 0.15 mg/dL; F-ratio = 17.0, P < 0.0001). Mean hematocrit values were also lower in the two infected groups (37.4 +/- 0.9 per cent and 37.4 +/- 0.6 per cent v. 39.5 +/- 0.5 per cent; F-ratio = 4.23, P = 0.0175). Furthermore, they were more likely to suffer from iron-deficiency anaemia than their non-infected counterparts (chi 2 = 4.64, P = 0.03). However, the children with active disease accounted for most of the excess risk for anemia (Fisher's exact test P = 0.009; OR = 10.0, exact 95 per cent CI = 1.37-111.8). Finally, growth stunting (< -2SD height-for-age) was more common in subjects with current (54 per cent) or past infection (51 per cent) compared to those without CL history (31 per cent; chi 2 = 8.03, P = 0.004).(ABSTRACT TRUNCATED AT 250 WORDS)

Risk factors for therapeutic failure to meglumine antimoniate and miltefosine in adults and children with cutaneous leishmaniasis in Colombia: A cohort study

“…Low height/age z-scores can be used to identify children at risk of stunting [37, 38], and is a robust measure for population nutritional studies [39, 40]. Few studies have confirmed the relationship between malnutrition and risk of Leishmania infection [41, 42] and a small study in adults did not find a relationship between weight and time-to-cure in tegumentary leishmaniasis [43]. However, using this indicator, we provide evidence of the influence of nutrition on treatment response in children with CL, as has been described in other infectious diseases [44, 45], murine models of leishmaniasis [46], and in a small descriptive study conducted in children treated with miltefosine [47].…”

Risk Factors for Anthroponotic Cutaneous Leishmaniasis at the Household Level in Kabul, Afghanistan

“…Infection is also known to be dependent on host nutritional status and acquired immunosupression (e.g. HIV) [21],[22]. Risk factors of disease commonly include sex (e.g.…”

Epidemiology of leishmaniasis in Ecuador: current status of knowledge - A review

“…In the lowlands are children under the age of ten in tropical and five years in subtropical Pacific region , Armijos et al 1997. The increased disease prevalence in children could be associated with no previous exposure to the parasite, the role of cellular immune status and/or with malnutrition (Weigel et al 1995). Nevertheless, for the Amazon region in a passive hospital-based report the mean age of leishmaniasis diagnosis was 33.4 and 19.7 years for MCL and CL respectively (Amunarriz 1991), suggesting unknown reasons for delays in the diagnosis in this wide and disperse region.…”