TITLE:
Association of Nutritional Supplements with Nutritional Status and Treatment Outcomes of Visceral Leishmaniasis among Children Aged 5 - 12 Years in Baringo and West Pokot Counties, Kenya
AUTHORS:
Ann Iruata Namulen, John Gachohi, Anselimo Makokha, Joseph Mutai
KEYWORDS:
Visceral Leishmaniasis, Micronutrients, Minerals, Vitamins, Implications
JOURNAL NAME:
Open Journal of Epidemiology,
Vol.14 No.4,
September
5,
2024
ABSTRACT: Introduction: Visceral leishmaniasis is a severe form of leishmaniasis that affects about 90,000 people annually worldwide. It is mainly transmitted by Leishmania donovani and infantum, which can cause damage to internal organs, such as the spleen, liver, and bone marrow. If left untreated, severe cases can be fatal, as the disease can lead to severe secondary diseases, mycological and bacterial infections, and hemorrhages. Nutritional deficiencies and concurrent infections increase the incidence of visceral leishmaniasis and the likelihood of lethality. There is limited information about the relationship between the disease and nutrition in endemic areas in Kenya. Objective: The study was to analyze the association of nutritional supplements with the nutritional status and treatment outcomes of visceral leishmaniasis among children aged 5 - 12 years in Baringo and West Counties in Kenya. Methods: A quasi-experimental study design adopting quantitative data collection method was used in this study. A total of 204 children aged 5 - 12 years were included in the study. Data on nutritional status and treatment outcomes for VL was collected using a questionnaire and consent form. Pre- and post-intervention assessments were conducted to compare BMI, fever, spleen size, splenic aspirate after treatment, and the presence of PKDL in a 3-month follow-up. The data was analyzed using R statistical software with descriptive and inferential statistics, including chi-square tests and t-tests. The impact of treatment was estimated using the difference-in-difference method to compare changes in outcomes over time between the intervention and comparison groups. Results: The baseline characteristics assessed in this study were socio-demographics (age, gender, marital status, education and religion), vitamins (A, B, C, D) and minerals (zinc, Iron and Iodine). The results showed that the mean age was 8.72, children aged 5 - 9 years were 64.7%, and those aged 10 - 12 years were 35.3% in the intervention and comparison groups. There were more males than females in the study (53.9% in the intervention and 52.9% in the comparison group respectively). All the children in the study were from a Christian background, were underweight, had enlarged spleen, and were positive for VL by Splenic Aspirate. Those who presented with fever were 88.2% (88% in both intervention and comparison groups). Most children had lower levels of zinc, iron, vitamins A, B12, and D at baseline (54.9%, 91.2%, 54.4%, 57.8%, and 58.8% respectively). The majority (93.1%) were deficient in vitamin C (90.2% in the intervention and 96.1% in the comparison group). Conclusion: According to the study findings, the effect of administering micronutrients is significant at 5% significance level with the intervention having a positive effect. The administration of the nutritional supplement led on average to an increase of the minerals, vitamins and BMI levels in the body.