Toxoplasma gondii as a possible causative pathogen of type-1 diabetes mellitus: Evidence from case-control and experimental studies.

Local assessment of the magnitude of intestinal parasitic infections and associated factors among diabetic patients helps for good prognosis of diabetes. Hospital based cross-sectional study was conducted by recruiting 215 diabetic patients. A structured questionnaire was used to capture data about socio-demographic characteristics, clinical history and factors associated with intestinal parasitosis. Stool samples were collected and processed by direct wet mount, formol-ether concentration and modified ziehl-Neelson staining techniques. All data were analyzed using Statistical Package for Social Sciences software version 20. The rate of intestinal parasitic infection among diabetic patients was 19.5%. Cryptosporidium parvum accounts the highest frequency (18, 8.4%) followed by Ascaris lumbricoides (8, 3.7%). Presence of domestic animals in the house (AOR = 2.857, 95% CI 1.290–6.330, p = 0.010), manifestation of abdominal pain (AOR = 3.716, 95% CI 1.632–8.459, p = 0.002) and farmer and labor occupation (AOR = 3.695, 95% CI 1.082–12.618, p = 0.037) were significantly associated with intestinal parasitosis. The magnitude of intestinal parasitosis among diabetic patients attending Arba Minch Hospital was considerable. Hence, we recommend routine screening and prompt treatment for intestinal parasitosis in order to improve the health of diabetic patients.

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Intestinal parasitosis and associated factors among diabetic patients attending Arba Minch Hospital, Southern Ethiopia

Globally, urogenital and intestinal parasitosis remain significant health challenges. They are associated with rising morbidity, death, and many harmful outcomes. A little is known concerning parasitosis and type 2 diabetes mellitus. Our study planned to investigate the urogenital and intestinal parasitic infections among type 2 diabetes patients compare to non-diabetic (Control) individuals and examine the intensity of helminthiasis in both groups. At Kosti Teaching Hospital (Sudan), 300 Urine and 300 stool samples have collected from 150 type 2 diabetes and 150 control individuals, along with the socio-demographic data using a structured questionnaire. The parasitic infections were examined by direct sedimentation technique for urine specimens. Whereas, for fecal samples, simple-direct saline, formal-ether concentration, Kato-Katz, and modified Ziehl–Neelsen techniques were used. Out of 150 type 2 diabetes patients studied, 31 (20.6%) and 14 (9.3%) had intestinal parasitosis and urogenital schistosomiasis, respectively. Whereas, 16 (10.6%) and 8 (5.3%) of the control group were infected, respectively. Compared to the control group, the odds of testing positive for either urogenital schistosomiasis (AOR: 2.548, 95% CI: 0.836–7.761, P = 0.100) or intestinal parasitic diseases (AOR: 2.099, 95% CI: 0.973–4.531, P = 0.059) were greater in diabetic individuals. Likewise, the intensities of helminthiasis were much higher in the diabetic patients and positively correlated with the duration of illness. The rate of urogenital schistosomiasis was also significantly different among the disease duration subcategories. Our study has highlighted the relationship of type 2 diabetes with urogenital and intestinal parasitic infections and enhanced our knowledge about the frequency of particular urogenital and intestinal parasites as well as the intensity of helminths infection in type 2 diabetes compared to non-diabetic individuals, which are important for further studies.

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Association of urogenital and intestinal parasitic infections with type 2 diabetes individuals: a comparative study

Background Worldwide, more than one-sixth of the population is infected by intestinal parasites, of which the majority live in developing countries. On the other hand, the prevalence of diabetes mellitus has been increasing over recent decades in developing countries. Patients with diabetes mellitus encountered impaired immunity and suffer from the consequences of infection particularly intestinal parasitic infection. Objective This study is aimed at assessing the prevalence of intestinal parasites and associated factors among diabetes mellitus patients at the University of Gondar Referral Hospital, Northwest Ethiopia. Methods and materials An institutional-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Referral Hospital from February 15 to March 30, 2018. A total of 234 diabetes mellitus patients were enrolled. A systematic random sampling technique was used to select study participants. Sociodemographic and clinical data were collected using a semistructured questionnaire. A 5-gram stool sample was collected to identify parasitic infection using a direct wet mount and formal-ether concentration technique. Data was entered and analyzed by using SPSS version 20. A p value of ≤0.05 was considered as statistically significant. Result In the current study, the overall prevalence of intestinal parasite infection among diabetics was 45 (19.2%). The parasites identified in this study were Ascaris lumbricoides 15 (6.41%), Entamoeba histolytica/dispar 9 (3.85%), Hookworm 9 (3.85%), Schistosoma mansoni 7 (3%), Enterobius vermicularis 3 (1.3%), and Giardia lamblia 2 (0.9%). Poor educational background (AOR = 3.62; 95% CI (1.038, 12.65); p = 0.043), poor hygiene and sanitation (AOR = 4.67; 95% CI (1.82, 12.07); p = 0.001), and inappropriate latrine usage (AOR = 5.41; 95% CI (1.43, 20.56); p = 0.013) were significantly associated with the prevalence of intestinal parasitic infection among diabetes mellitus patients. Conclusion The overall prevalence of intestinal parasitic infection among diabetes mellitus patients was relatively high. There should be continued prevention, control, and management of intestinal parasitic infection in such a study population.

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The Prevalence of Intestinal Parasites and Their Associated Factors among Diabetes Mellitus Patients at the University of Gondar Referral Hospital, Northwest Ethiopia.

The present work aims to investigate the antiparasitic and the immunomodulating effects of nitazoxanide (NTZ) and ivermectin (IVC) alone or combined together or combined with selenium (Se), on Cryptosporidium infection in diabetic mice. The results revealed that the combined NTZ and IVC therapy achieved the highest reduction of fecal oocysts (92%), whereas single NTZ showed the lowest reduction (63%). Also, adding Se to either NTZ or IVC resulted in elevation of oocyst reduction from 63% to 71% and from 82% to 84% respectively. All treatment regimens, with the exception of NTZ monotherapy, showed a significant improvement in the intestinal histopathology, the highest score was in combined NTZ and IVC therapy. The unique results of immunohistochemistry in this study showed reversal of the normal CD4/CD8 T cell ratio in the infected untreated mice, however, following therapy it reverts back to a normal balanced ratio. The combined (NTZ+ IVC) treatment demonstrated the highest level of CD4 T cell expression. Taken together, NTZ and IVC combined therapy showed remarkable anti-parasitic and immunostimulatory effects, specifically towards the CD4 population that seem to be promising in controlling cryptosporidiosis in diabetic individuals. Further research is required to explore other effective treatment strategies for those comorbid patients.

Antiparasitic and immunomodulating effects of nitazoxanide, ivermectin and selenium on Cryptosporidium infection in diabetic mice.

Background: Intestinal parasites are an important cause of morbidity and mortality and a public health problem especially in tropical developing countries including Cameroon. The two main types of intestinal parasites are helminths and protozoa which are important causes of infections in immunocompromised individuals. Diabetes Mellitus (DM) is a metabolic non-communicable disease in which a person has high blood glucose. DM is an increasing problem in our community today and diabetics have been reported to be immunocompromised. The purpose of this study was to determine the prevalence and type of intestinal parasites in DM patients living in Buea and Limbe municipalities. Methods: This hospital based cross sectional study involved a total 150 diabetic patients and 85 non-diabetic individuals which served as control group. Questionnaires were administered to the Diabetic patients only. Fresh stool specimens were collected and processed using Direct Microscopy, Formalin-Ether Concentration, Stoll’s technique and Modified Ziehl Nielsen staining techniques. Data was analyzed using Microsoft Office Excel 2013 and Statistical Package for Social Sciences (SPSS) version 20. Results: The overall prevalence of intestinal parasites among diabetics was 10%. The parasites detected in diabetics included Entamoebahistolytica 10(6.7%), Blastocystishominis 4(2.7%) Ascarislumbricoides 1(0.67%), Hookworm 1(0.67%) and Cryptosporidium parvum 1(0.67%). An overall prevalence of 23.5% of intestinal parasites was observed in the control group with detected parasites Entamoebahistolytica 18(21.2%), Ascarislumbricoides 2(2.4%), and Blastocystishominis 1(1.2%). The prevalence in both groups (10% vs. 23.5%, p=0.0052) were statistically significantly different. DM status was significantly associated with the prevalence of intestinal parasites or acquiring intestinal parasitic infection (OR: 0.36 Confidence Interval (CI) =0.17-0.75; p=0.0051)). Conclusion: The prevalence of intestinal parasites in diabetics is 10%. The most prevalent type of intestinal parasite in diabetics is Entamoebahistolytica which is same with non-diabetics. The more types of intestinal parasites in diabetics and along with the detection of C. parvum indicates a weakened immune system in diabetics. A protective association exists between Diabetes mellitus and Intestinal Parasitic Infections (IPIs). Diabetic patients should be screened routinely for intestinal parasites especially protozoans and treated for their overall well-being.

https://openventio.org/Volume2-Issue1/Intestinal-Parasites-in-Diabetes-Mellitus-Patients-in-the-Limbe-and-Buea-Municipalities-Cameroon-DROJ-2-123.pdf

Fominyam Boris Tangi

Papers

Intestinal Parasites in Diabetes Mellitus Patients in the Limbe and Buea Municipalities, Cameroon