Prevalence of malnutrition and associated risk factors among adult visceral leishmaniasis patients in Northwest Ethiopia: a cross sectional study

BMC Research Notes

Ermias Diro²  Amsalu Feleke⁴  Takele Tadesse⁴  Kalehiwot Mekonnen³  Yegnasew Takele³  Mengistu Endris¹  Bewketu Mengesha⁴ 

[1] Department of Medical Microbiology, University of Gondar, Gondar, Ethiopia;Institute of Tropical Medicine, Antwerp, Belgium;Leishmaniasis Research and Treatment Center, University of Gondar, Gondar, Ethiopia;Institute of Public Health, University of Gondar, Gondar, Ethiopia

关键词: Visceral leishmaniasis;    Malnutrition;    Intestinal parasites;    HIV;    Anemia;   

Others  :  1134605
DOI  :  10.1186/1756-0500-7-75

 received in 2013-09-04, accepted in 2014-01-30,  发布年份 2014

【 摘 要 】

Background

Visceral leishmaniasis (VL) causes considerable morbidity and mortality in Ethiopia. Data on the prevalence and associated risk factors on malnutrition among VL patients in Ethiopia are scarce. This study aimed to assess the prevalence of malnutrition and its associated risk factor among VL patients in Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted from June to September 2012 at four leishmaniasis treatment sites in Northwest Ethiopia. Four hundred and three adult VL patients were enrolled in the study. Malnutrition was defined as a body mass index (BMI) ≤ 18.5 kg/m2. The data collected from the VL patients included sex, age, residence, occupation, weight, height, laboratory results (HIV, hemoglobin, intestinal parasites). Multivariate logistic regression model was used to determine the strength of association between malnutrition and associated risk factors.

Results

Among 403 adult VL patients 385 (95.5%) were malnourished. Twenty eight percent (n = 113), 30.3% (n = 122), and 37.2% (n = 150) were mildly, moderately and severely malnourished, respectively. The prevalence of intestinal parasitic infection was 47.6% (n = 192) and it was associated with malnutrition (P = 0.01). The prevalence of VL-HIV co-infection was 10.4% (n = 42). Hook worm, Giardia intestinalis and Ascaris lumbircoides were the leading prevalent intestinal parasites. Factors such as age, sex, residence, occupation, HIV status and anemia were not associated with severe malnutrition.

Conclusions

The prevalence of malnutrition in VL patients was very high and it was associated with intestinal parasitic infections. Therefore, screening of severely malnourished VL patients for intestinal parasitic infections during admission is recommended.

【 授权许可】

   
2014 Mengesha et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]van Griensven J, Diro E: Visceral leishmaniasis. Infect Dis Clin North Am 2012, 26(2):309-322.
• [2]WHO: Control Of The Leishmaniasis: Report Of A Meeting Of The Who Expert Committee On The Control Of Leishmaniasis. Volume 949. 1st edition. Geneva: WHO; 2010.
• [3]Collin S, Davidson R, Ritmeijer K, Keus K, Melaku Y, Kipngetich S, Davies C: Conflict and kala-azar: determinants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis 2004, 38(5):612-619.
• [4]Deribe K, Meribo K, Gebre T, Hailu A, Ali A, Aseffa A, Davey G: The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination. Parasit Vectors 2012, 5:240. BioMed Central Full Text
• [5]Alvar J, Bashaye S, Argaw D, Cruz I, Aparicio P, Kassa A, Orfanos G, Parreno F, Babaniyi O, Gudeta N, et al.: Kala-azar outbreak in Libo Kemkem, Ethiopia: epidemiologic and parasitologic assessment. Am J Trop Med Hyg 2007, 77(2):275-282.
• [6]Malafaia G: Protein-energy malnutrition as a risk factor for visceral leishmaniasis: a review. Parasite Immunol 2009, 31(10):587-596.
• [7]Anstead GM, Chandrasekar B, Zhao W, Yang J, Perez LE, Melby PC: Malnutrition alters the innate immune response and increases early visceralization following Leishmania donovani infection. IinfectT Immun 2001, 69(8):4709-4718.
• [8]Werneck GL, Hasselmann MH, Gouvea TG: An overview of studies on nutrition and neglected diseases in Brazil. NFECT Immun 2011, 16(1):39-62.
• [9]WHO: Report Of The 5th Consultative Meeting On Leishmania/Hiv Co-Infection. In Report of the Fifth Consultative Meeting on Leishmania/HIV Co-infection. Addis Ababa, Ethiopia: WHO; 2007.
• [10]Jardim-Botelho A, Brooker S, Geiger SM, Fleming F, Souza Lopes AC, Diemert DJ, Correa-Oliveira R, Bethony JM: Age patterns in undernutrition and helminth infection in a rural area of Brazil: associations with ascariasis and hookworm. Trop Med Int Health 2008, 13(4):458-467.
• [11]Pearson RD, Sousa AQ: Clinical spectrum of Leishmaniasis. Clin Infect Dis 1996, 22(1):1-13.
• [12]Central Statistical Agency: Ethiopia Demographic and Health Survey 2011. In Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and ICF International Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012:182-183.
• [13]WHO: Physical Status: The Use And Interpretation Of Anthropometry. In Report of a WHO Expert Committee. vol. 854 edition. Edited by Series WTR. Geneva Switzerland: World Health Organization; 2004.
• [14]WHO: Bench Aids For The Diagnosis Of Intestinal Parasites. Geneva: WHO; 1994.
• [15]Federal Democratic Republic of Ethiopia Ministry of Health: National Training Package for Provider-Initiated HIV Testing and Counseling. In National training package provider-initiated HIV testing and counseling: Trainer’s Manual. vol. 1 edition. Addis Ababa: The Federal Democratic Republic of Ethiopia Ministry of Health; 2010.
• [16]Ministry of Health: Visceral Leishmaniasis Diagnosis and Treatmnt Guideline for Health Workers in Ethiopia. In Guideline for diagnosis, treatment and prevention of Leishmaniasis in Ethiopia. 2nd edition. Edited by Disease prevention and control department. Addis Ababa: The Federal Democratic Republic of Ethiopia Ministry of Health; 2013.
• [17]WHO: Worldwide Prevalence Of Anaemia 1993–2005 Who Global Database On Anaemia. vol. 2 edition. Edited by de Benoist B, McLean E, Egli I, Cogswell M. Geneva switzerland: WHO; 2008.
• [18]Hurissa Z, Gebre-Silassie S, Hailu W, Tefera T, Lalloo DG, Cuevas LE, Hailu A: Clinical characteristics and treatment outcome of patients with visceral leishmaniasis and HIV co-infection in northwest Ethiopia. Trop Med Int Health 2010, 15(7):848-855.
• [19]Bashaye S, Nombela N, Argaw D, Mulugeta A, Herrero M, Nieto J, Chicharro C, Cañavate C, Aparicio P, Darío Vélez I: Risk factors for visceral leishmaniasis in a New epidemic site in amhara region, Ethiopia. Am J Trop Med Hyg 2009, 81(1):34-39.
• [20]Mueller Y, Mbulamberi DB, Odermatt P, Hoffmann A, Loutan L, Chappuis F: Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda. Trop Med Int Health 2009, 14(8):910-917.
• [21]Cerf BJ, Jones TC, Badaro R, Sampaio D, Teixeira R, Johnson WD: Malnutrition as a risk factor for visceral leishmaniasis. J Infect Dis 1987, 156(6):1030-1033.