The Implications of Incorporating Nutritional Supplements into the Treatment Regimen for Children Aged 5-12 Years with Visceral Leishmaniasis in Baringo and West Pokot Counties in Kenya

Abstract

Purpose: The purpose of this article is to inform the Ministry of Health Management and all stakeholders in Kenya, the importance of the intervention, fills gaps, and provides guidance on future research direction to accelerate control and eventually eliminate Leishmaniasis. This will also shed new light on the importance of micronutrients and trace elements and their role in immunology, patient outcomes, and the physiology of Visceral Leishmaniasis (VL). The results of this study will also pave way to explore possibilities to fill the research gaps and address challenges like the resistance and relapse of the infection, in patients with VL. Furthermore, this study may help in developing evidence-based strategies related to malnutrition and trace elements, which may be implemented in the eradication program of VL.

Materials and Methods: A quasi-experimental study design was conducted in Kenya from January 2022 to March 2022 in 204 VL-infected children aged 5-12 years. Demographic and clinical data were abstracted from questionnaires and lab forms. Descriptive and inferential analyses were conducted to determine the effect of the intervention on VL outcomes among the study children. Variables with a P-value < 0.05 were considered statistically significant. A total of 204 VL study participants, 102 in each intervention and comparison group were included in this study. Baseline characteristics of the study participants were taken and recorded. The treatment and intervention were started and the trend of BMI, body temperature, vitamins A, B12, C, and D together with minerals Zinc, iron, and iodine levels were monitored weekly for four weeks to determine their effect on the treatment outcomes.

Findings: The results showed that the outcome of administering the micronutrients is significant at 5% level, indicating that the intervention has a favorable effect. The micronutrients increased their levels in the body by increasing BMI, reducing spleen size, and controlling the body temperature of the study participants. In conclusion, the intervention accelerated the recovery from VL.

Implications to Theory, Practice and Policy: This study was informed by the previous researchers' outputs (Mashayekhi Goyonlo V, 2020) indicating that administering the anti-leishmaniasis treatment alone will not yield a favorable treatment outcome in Visceral Leishmaniasis patients and also a study by Nweze JA, Nweze EI (2019) which indicated that malnourished patients with VL had an unfavorable outcome, which was recurrence in 21.4% and also that serum micronutrients levels favor good treatment outcome in Visceral Leishmaniasis. It is therefore important to note that Baringo and West-Pokot Counties, where the present study was conducted, are the Counties in Kenya with the highest percentage of VL patients. The study’s outcomes highlight the potential benefits of micronutrients to improve treatment outcomes in this regard, we recommend that the MOH should encourage the integration of micronutrients with the VL treatment in Baringo and West Pokot Counties. This research provides this new insight indicating that micronutrients affect the nutritional status and the treatment outcomes of VL by controlling body temperature, improving BMI, decreasing spleen size, negative VL tests, and therefore there is need to incorporate micronutrients to the treatment of children with VL. This study also raises several questions that warrant further investigation, such as the research on all the other micronutrients that were not analyzed in this study.