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

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Mísia Joyner de Sousa Dias Monteiro, Maria Nauside Pessoa da Silva, Adriana de Azevedo Paiva, Dilina do Nascimento Marreiro, Liania Alves Luzia, Gilberto Simeone Henriques, Patrícia Helen de Carvalho Rondó, Ingridi de Souza Sene, Ana Tárcila Alves de Almeida, Carlos Henrique Nery Costa, Dorcas Lamounier Costa
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2021
• Subjects: Leishmaniasis; Visceral; Kala-azar; Malnutrition; Vitamin A; Zinc; Arctic medicine. Tropical medicine; RC955-962; Arctic; Azar
• Online Access: https://doi.org/10.1590/0037-8682-0800-2020; https://doaj.org/article/c1a24d7485574e9f9b75b98c55423413

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.