Effect of Nutritional Supplementation on Nutritional Status and Treatment Outcomes of Visceral Leishmaniasis among Children Aged 5-12 Years in Kenya

Abstract

Visceral Leishmaniasis (VL) is a parasitic disease that significantly affects children in endemic regions, including parts of Kenya such as Baringo and West Pokot counties. Malnutrition is a common comorbidity in VL patients, and nutritional supplementation may play a role in improving treatment outcomes and overall health status. However, limited data exists regarding the association of nutritional supplements with the nutritional status and treatment outcomes of VL among children. This study aimed to assess the impact of selected nutritional supplements on the nutritional status and treatment outcomes of children aged 5-12 years diagnosed with Visceral Leishmaniasis in Baringo and West Pokot counties. A quasi-experimental study design was conducted among 204 VL infected participants aged 5-12 who were enrolled into the study through consecutive sampling and equally distributed in the two study sites in Baringo and West Pokot Counties. A questionnaire and an abstraction form were used to collect data after obtaining consent from the caregivers of the study participants and assent from the study participants. Baseline information included anthropometric measurement of the weight, height, serum levels of zinc, Iron and urinary Iodine and vitamins A, B,C and D to determine the participant’s nutritional status and the clinical and parasitiological characteristics which included splenic aspirate, spleen size and body temperature.The study participants were subjected to pre- and post-nutritional intervention assessments. After screening, the children were divided into two groups where the intervention group received the nutritional supplement given in addition to the usual anti-leishmanial treatment while the comparison group received a placebo and the usual anti- leishmania treatment. Data was analyzed using R statistical software and it involved descriptive statistics for the frequencies, means and standard deviations, and inferential statistics included Wilcoxon Rank sum Test, chi square tests, and paired t- tests among the quantitative variables. Children receiving nutritional supplements demonstrated significantly better nutritional outcomes, including increased weight for age compared to those not receiving supplements. Furthermore, treatment outcomes were more favorable in the intervention group, with a higher rate of parasite clearance (p < 0.05), higher recovery rates (p < 0.01), and lower concurrence and re-infection. A Difference-in-Difference regression revealed that nutritional supplementation was independently associated with improved treatment outcomes and better overall nutritional status. This study concludes that nutritional supplementation plays a significant role in improving both the nutritional status and treatment outcomes of children with Visceral Leishmaniasis. These findings suggest that the integration of nutritional interventions into VL management could be an effective strategy to enhance recovery and reduce mortality in endemic regions.