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Association between helminth infections and diabetes mellitus in adults from the Lao People's Democratic Republic : a cross-sectional study

Htun, Nan Shwe Nwe and Odermatt, Peter and Paboriboune, Phimpha and Sayasone, Somphou and Vongsakid, Malisa and Phimolsarn-Nusith, Vilayouth and Tran, Xuan Duong and Ounnavong, Phoum-Savath and Andriama-Hefasoa, Navalone and Senvanpan, Nilun-Done and Homsana, Anousine and Lianosay, Baocher and Xayavong, Dalouny and Robinson, Dimbitsoa Rakotomalala and Bounsavath, Phaivanh and Prasayasith, Phoy-Phaylinh and Syphan, Seng-Davanh and Lu, Yi-Xiao and Thilakoun, Kanchana and Xaiyaphet, Xaipa-Song and Vongngakesone, Phout-Tasin and Eze, Ikenna C. and Imboden, Medea and Sripa, Banchob and Reinharz, Daniel and Probst-Hensch, Nicole. (2018) Association between helminth infections and diabetes mellitus in adults from the Lao People's Democratic Republic : a cross-sectional study. Infectious Diseases of Poverty, 7. p. 105.

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Abstract

As a result of epidemiological transition, the health systems of low- and middle-income countries are increasingly faced with a dual disease burden of infectious diseases and emerging non-communicable diseases. Little is known about the mutual influence of these two disease groups. The aim of this study was to investigate the co-occurrence of helminth infections and diabetes mellitus in adults in Lao People's Democratic Republic (Lao PDR).; We conducted a cross-sectional study among 1600 randomly selected adults aged 35 and older from four different socio-economical and ecological provinces. Information on socio-demographics, risk factors and health conditions was obtained from personal interviews. Clinical assessments including anthropometry (height, weight, waist and hip circumference) and blood pressure measurements were also conducted. Diabetes was classified based on self-reported diagnoses and a point-of-care glycated haemoglobin (HbA1c) test from finger prick blood samples. Stool samples for helminth diagnosis were examined with formalin-ether concentration technique for intestinal parasitic infections. The independent associations of helminth infections with diabetic status and HbA1c were assessed using multiple regression analyses.; The prevalence of pre-diabetes and diabetes was 37.3% and 22.8%, respectively. Fifty-six percent of diabetic cases were undiagnosed and 85% of diagnosed diabetic cases had poor glycemic control. Participants from rural areas and from southern parts of the country had higher infection rates, with Opisthorchis viverrini, being the most common helminth infection (30.5%). We found a positive association between Taenia spp. infections and HbA1c (β = 0.117; 95% CI: 0.042-0.200) and diabetes mellitus risk (OR = 2.98; 95% CI: 1.10-8.05). No other helminth species was associated with glycated hemoglobin.; Hyperglycaemia and diabetic rates in Lao PDR are alarmingly high, but consistent with other high rates in the region. Given the high rates of under-diagnosis and poorly-controlled glycaemia in diabetes mellitus patients, routine diabetes screening and treatment is essential for the local healthcare system. Large longitudinal cohorts integrating biomarkers are warranted in the search of causal diabetes mellitus risk factors in the region. Common intestinal helminth infections, including O. viverrini, are unlikely to explain the high diabetes mellitus rates observed.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Chronic Disease Epidemiology > Genetic Epidemiology of Non-Communicable Diseases (Probst-Hensch)
03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Genetic Epidemiology of Non-Communicable Diseases (Probst-Hensch)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Eco System Health Sciences > Helminths and Health (Odermatt)
UniBasel Contributors:Htun, Nan Shwe Nwe and Odermatt, Peter and Imboden, Medea and Probst Hensch, Nicole and Sayasone, Somphou and Eze, Ikenna C.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Biomed Central
e-ISSN:2049-9957
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:22 Nov 2018 13:42
Deposited On:22 Nov 2018 13:42

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