Updates on Cutaneous Leishmaniasis and its Association with Serum Vitamin D Status in Northwest Amhara, Ethiopia

Abstract

Abstract Background: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 research 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: A cross-sectional study at Nefas Mewcha Hospital, conducted from April to July 2022. Patients suspected of CL, aged 18 and above evaluated by dermatologists and eligible for the criteria underwent skin slit tests. Consented, diagnosed and positive, all were included for the study. Completing a structured questionnaire for demographic data. Anthropometric measurements calculated body mass index (BMI). Serum samples (5 ml) were collected, stored at -80°C until processing, and analyzed for vitamin D using a MAGLIMI 800 analyzer. Statistical analysis declared when p<0.05. Results: The study showed 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).  While notable differences were observed between normal BMI and obese groups (27.4&22.5ng/ml) respectively.  Severe vitamin D deficiency was associated with the chronicity of CL, with patients experiencing symptoms for less than 6 months showing higher deficiency levels of vitamin D compared to those with a longer duration of CL illness (p<0.05). Furthermore, patients with larger CL lesion sizes and female patients were found to have higher vitamin D deficiency compared to their counterparts. The proportion of Vitamin D measurement was lower in mucosal CL type compared to localized CL type but in the mean value, no difference was seen between the two forms. Conclusion: Vitamin D deficiency is prevalent among CL patients. This deficiency may play a role in the disease's onset and progression, highlighting the need to incorporate in treatment plans alongside anti-leishmaniasis medications. Further research, including larger case-control studies, is essential to better understand this relationship. [Ethiop. J. Health Dev. 2024; 38(1)] Keywords: Cutaneous Leishmaniasis, Nutrition, Vitamin D, Pathology of Leishmaniasis