Vitamin D Status and its Association with Cutaneous Leishmaniasis in Northwest of Amhara Region, Ethiopia

Abstract

AbstractBackground:Cutaneous Leishmaniasis (CL) can have varying outcomes in individuals due to differences in vulnerability and severity, which can be influenced by malnutrition. Vitamin D is known to play a role in the immune system, but its specific impact on cutaneous leishmaniasis is not well understood and previous researches have provided contradictory results. This study aimed to investigate the levels of serum Vitamin D in patients with cutaneous leishmaniasis and assess its relationship with the disease pattern.Method: The study was conducted at Nefas Mewcha Hospital in the Amhara Regional State of Ethiopia from April to July 2022. Dermatology specialists evaluated outpatients aged 18 and above presenting with skin issues for CL. Patients suspected of CL underwent a skin slit test for parasite diagnosis. Those diagnosed with CL were purposively selected to participate in the study. A structured questionnaire was used to collect demographic information. Anthropometric measurements were taken to calculate body mass index (BMI) [weight (kg)/height (m2)]. Blood samples (5 ml) were collected and centrifuged. The serum samples were stored at -80°C until analysis was carried out. Serum samples were analyzed for vitamin D using MAGLIMI 800 analyzer.Results: The study found that 11/48(23%) of CL patients were underweight (BMI: <18.5). Additionally, 24/33 (72.7%) of CL patients had low serum vitamin D levels (?30ng/ml). Interestingly, obese patients had lower mean serum vitamin D levels compared to those with a normal BMI (26.3 Vs 22.5ng/ml) respectively. Severe vitamin D deficiency was associated with the chronicity and severity of CL, with patients experiencing symptoms for over 6 months showing higher deficiency levels of vitamin D compared to those with a shorter duration of CL symptoms (p<0.05). Furthermore, patients with larger CL lesion sizes and female patients, as well as those with mucocutaneous CL type, were found to have higher vitamin D deficiency compared to their counterparts.Conclusion:Vitamin D deficiency is a significant issue among cutaneous leishmaniasis patients in Amhara region, with the severe form of the disease often exhibiting low levels of this vitamin. This deficiency might contribute to the progression of the disease. Therefore, it is important for treatment plans for cutaneous leishmaniasis patients to consider supplementing with vitamin D in addition to anti-leishmaniasis medications. More research is needed to explore this relationship further, including measuring vitamin D levels at different time points and studying a larger sample size. Case-control studies can help to determine the generalizability of these findings in the broader context of cutaneous leishmaniasis treatment. [Ethiop. J. Health Dev. 2024; 38(1): 00-00]Keywords: Cutaneous Leishmaniasis, Nutrition, Vitamin D, Pathology of Leishmaniasis