Dietary diversity and the lack of household food stocks are diet-related risk factors for leprosy in North-west Bangladesh: a case-control study
Although the prevalence of leprosy is decreasing, the elimination target is still not reached in all countries. Leprosy is assumed to be closely associated with poverty, but there is doubt on which aspects of poverty are associated with leprosy susceptibility and progression. Recent food shortage and food shortage ever in life were reported as risk factors for leprosy. The goal of this study is to identify the difference between the food patterns of recently diagnosed leprosy patients and controls in North-west Bangladesh, during the food shortage period from the end of September until the end of November.
A case-control study was performed in the leprosy endemic districts Nilphamari and Rangpur in North-west Bangladesh. Data was collected using a structured questionnaire during home visits. The questions covered demographics, socio-economics, health and diet. Besides, anthropometric measures were taken and a 9-scaled dietary diversity score (DDS) was calculated based on a 24-hour recall. The results were analysed using logistic regression.
Fifty-two leprosy cases and 100 controls were interviewed. The most important health and diet-related factors were the body mass index (BMI), the DDS and the presence of household food stocks. Other significant factors were household food expenditure and square meters of land owned (p < 0.10). Combining all factors above in the final model, only food expenditure remained a significant risk factor for leprosy in North-west Bangladesh (p = 0.000). A deeper analysis on dietary diversity showed that a lack of ‘meat and fish’ and ‘other fruits and vegetables’ in the diet are risk factors for leprosy in North-west Bangladesh (p = 0.006 and p = 0.019 respectively).
In conclusion, this study shows that BMI, DDS and household food stocks are the major health and diet-related risk factors for leprosy. A DDS below 4, a low intake of ‘other fruits and vegetables’ and a low intake of ‘meat and fish’ are good predictors for leprosy. Nutritional education can be a potential high-impact approach.