Dual burden of diseases in resource poor countries : diabetes mellitus and neglected tropical diseases

Htun, Nan Shwe Nwe. Dual burden of diseases in resource poor countries : diabetes mellitus and neglected tropical diseases. 2017, Doctoral Thesis, University of Basel, Faculty of Science.


Official URL: http://edoc.unibas.ch/diss/DissB_13015

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Background: The prevalence of diabetes mellitus and neglected tropical diseases are nowadays escalating, especially in endemic resource poor countries and their impact on social and economic development are negatively huge. Recent studies indicate that diabetes mellitus
problem is now truly global epidemic and a number of risk factors are contributed to diabetes. Dengue viral infections have been one of the most reemerging diseases worldwide in recent years and case fatalities are usually high among dengue infected individuals having any
underlying co-morbid disease condition. Helminth or parasite infections mainly contribute to global burden of diseases and cause adverse events on health. Therefore, it is very important to understand the interaction between diabetes mellitus and neglected tropical diseases in clinical management for curative, as well as disease epidemiology for preventive purposes.
Methods: Firstly, we conducted a systematic review and meta-analysis to summarize and update the current knowledge of diabetes mellitus and dengue viral infections as well as helminth or parasite infections. To follow up the findings between diabetes and parasite
infections and to explore their association in epidemiological settings, we conducted two field
studies. A cross-sectional community based study was carried out among adults in 4 provinces of Lao People’s Democratic Republic. We also investigated a longitudinal study among schoolchildren in poor neighborhoods of South Africa to figure out the comorbid association and effect of helminth infections on blood sugar concentration determined by HbA1c measurements after deworming.
Results: In this PhD work, we found a positive relationship between diabetes mellitus and neglected tropical diseases we studied. Firstly, our systematic review and meta-analysis summarized that diabetic patients are more likely to have a severe form of dengue if they were infected with a dengue viral infection. In the context of relationship between diabetes mellitus and another neglected tropical disease, our findings showed that the prevalence and species of helminth infections were different in different country settings. In Laos PDR, food born trematodes were more prevalent and the prevalence of diabetes was also higher than estimated figures. We observed a positive relationship between diabetes mellitus and teania infection in Lao PDR setting. In South Africa, we found soil transmitted helminth infections and H. pylori infections were quite common among schoolchildren and the high numbers of
prediabetic prevalence. A positive relationship between diabetes mellitus and H. pylori infections has been revealed in the study. No association has been found between diabetes and other infections. We also disclosed that HbA1c levels are more likely to increase after
Conclusion: Our research work provides valuable insights of co-morbid association. It can be concluded that diabetes mellitus and dengue or taenia or H. Pylori infections have influenced each other not in a good way, either dengue infection or teania or H. Pylori infections
exacerbate diabetes mellitus or vise visa. The patho-physiological mechanism behind these associations should be further explored. As diabetes is a multi-faceted disease, many other factors could also top up these interactions. Diabetes, dengue, parasitic infections remain of major public health concerns in both Laos PDR and South Africa. Hence, our findings call for
action to establish a proper public health policy with an integrated approach addressing both diseases condition to reduce mortality and/or morbidity and to ameliorate clinical outcomes and preventive measures among affected population. Additional studies in other endemic
countries are also greatly recommended to reflect our current findings to be able to apply for the implementation as a global perspective.
Advisors:Probst-Hensch, Nicole and Battegay, Manuel
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)
Item Type:Thesis
Thesis Subtype:Doctoral Thesis
Thesis no:13015
Thesis status:Complete
Number of Pages:1 Online-Ressource (vii, 179 Seiten)
Identification Number:
edoc DOI:
Last Modified:03 May 2019 08:25
Deposited On:03 May 2019 08:24

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