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The impact of diabetes on cutaneous leishmaniasis: a case–control field assessment

  • Protozoology - Original Paper
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Abstract

This study aimed to assess the associated-risk determinants for cutaneous leishmaniasis (CL) in patients with diabetes mellitus (DM) compared to patients without DM. This case–control study was performed between 2017 and 2019 in southeastern Iran. Overall, 206 participants were selected from patients with DM without CL (11.2%), patients with CL without DM (6.2%), and DM patients concomitance with CL (27.6%) as case groups and healthy individuals as a control group 64 (76%). These cases were compared for parasitological, immunological, biochemical, and hematological parameters. The findings demonstrated that parasitological factors regarding the number, duration, and size of the lesion in CL patients showed a significant difference among patients with and without DM (p < 0.05). Data analysis showed that six major risk factors, including female (odds ratio (OR) = 3.47, confidence interval (CI) = 1.84–6.53, p < 0.001), total protein in CL group (OR = 4.9, CI = 2.3–10.44, p < 0.001), alanine aminotransferase (ALT) concentration in CL group (OR = 0.87, CI = 0.81–0.93, p < 0.001) and DM co-infected with CL group (OR = 0.8, CI = 0.72–0.88, p < 0.001) than healthy group, aspartate aminotransferase (AST) concentration in DM group (OR = 0.86, CI = 0.76–0.98, p = 0.02), transforming growth factor beta)TGF-β( level in the CL group (OR = 1.03, CI = 1.003–1.05, p = 0.02), and presence of diabetes disease (OR = 2.07, CI = 1.16–3.7, p < 0.05), were significantly linked with the induction of CL lesion. The findings demonstrated a significant relationship between DM and CL in distinct risk determinants. Also, the study revealed that DM enhanced the severity of active CL.

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Fig. 1

taken from diabetics (A–D) and non-diabetic patients (E–H) in endemic areas with CL in southeastern Iran

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

Abbreviations

L:

Leishmania

DM:

Diabetes mellitus

CL:

Cutaneous leishmaniasis

OR:

Odds ratio

CI:

Confidence interval

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

ALP:

Alkaline phosphatase

WBC:

White blood cell

RBC:

Red blood cell

TGF-β:

Transforming growth factor-beta

IL:

Interleukin

INF:

Interferon

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Acknowledgements

We would like to express our heartfelt thanks to the health personnel of the Bam Health Center. Special thanks to Dr. Dabiri and Mr.Karimi and Kerman University of Medical Sciences that helped carry out this study.

Funding

This work was financially supported by grant No. 95/230 from Kerman University of Medical Sciences.

Author information

Authors and Affiliations

  1. Leishmaniasis Research Center, Kerman University of Medical Sciences, Area Code 76169-14115, Kerman, Iran

    Mahshid Mostafavi, Iraj Sharifi, Mehdi Bamorovat & Razieh Tavakoli Oliaee

  2. Department of Clinical Biochemistry, Kerman University of Medical Sciences, Kerman, Iran

    Gholamreza Asadikaram

  3. Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran

    Nozar Nakhaee

  4. Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran

    Sina Kakooei

  5. Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran

    Mohammad Reza Aflatoonian

  6. Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

    Ali Karamoozian

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  1. Mahshid Mostafavi
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Contributions

ISh administered and supervised the work. GhA, ISh, and MM conceived and designed the experiments. SK and MM performed the experiments. NN, MM, and MRA analyzed and interpreted the patient data. MM and SK wrote the first draft of the paper. ISh, MB, and RTO reviewed and corrected the paper. All authors reviewed and approved the manuscript.

Corresponding author

Correspondence to Iraj Sharifi.

Ethics declarations

Ethics approval

The survey protocol was reviewed and approved by the joint Ethics Committees of the Leishmaniasis Research Center and Vice-Chancellor for Research, Kerman University of Medical Sciences, under protocol number 95/230.

Consent to participate

The participants signed a consent sheet. Informed consent was obtained from a parent or guardian for participants under 16 years old.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Mostafavi, M., Sharifi, I., Asadikaram, G. et al. The impact of diabetes on cutaneous leishmaniasis: a case–control field assessment. Parasitol Res 120, 3865–3874 (2021). https://doi.org/10.1007/s00436-021-07255-z

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