NUTRITIONAL-STATUS AND CUTANEOUS LEISHMANIASIS IN RURAL ECUADORIAN CHILDREN

The relationship between nutritional status and cutaneous leishmaniasi s (CL) was evaluated in 230 children living in a rural subtropical rai nforest in Northwest Ecuador. One-third of the subjects had evidence o f either current (13 per cent) or past CL infection (21 per cent). Sub jects with current (4.71+/-0.44 mg) or previous disease (4.29+/-0.35 m g) had lower mean daily dietary iron intakes than noninfected children (5.45+/-0.2 mg; chi(2)=0.048), but not energy, protein, or other micr onutrients. The low dietary iron intake data was corroborated by the r educed mean haemoglobin values observed in children with current (11.7 +/-0.3 mg/dL) or past infection (11.3+/-0.2 mg/dL) compared to non-inf ected subjects (12.7+/-0.15 mg/dL; F-ratio=17.0, P<0.0001). Mean hemat ocrit values were also lower in the two infected groups (37.4+/-0.9 pe r cent and 37.4+/-0.6 per cent v. 39.5+/-0.5 per cent; F-ratio=4.23, P =0.0175). Furthermore, they were more likely to suffer from iron-defic iency anaemia than their noninfected counterparts (chi(2) = 4.64, P = 0.03). now ever, the children with active disease accounted for most o f the excess risk for anemia (Fisher's exact test P=0.009; OR=10.0, ex act 95 per cent CI= 1.37-111.8). Finally, growth stunting (< - 2 . SD height-for-age) was more common in subjects with current (54 per cent) or past infection (51 per cent) compared to those without CL history (31 per cent; chi(2)=8.03, P=0.004). It is hypothesized that chronic u ndernutrition increased subject susceptibility for infection with CL. Alternatively, host nutritional status may have been affected by the p arasitic infection.