Association between gastrointestinal tract infections and glycated hemoglobin in school children of poor neighborhoods in Port Elizabeth, South Africa
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 4424350
Author(s) Htun, Nan Shwe Nwe; Odermatt, Peter; Müller, Ivan; Yap, Peiling; Steinmann, Peter; Schindler, Christian; Gerber, Markus; Du Randt, Rosa; Walter, Cheryl; Pühse, Uwe; Utzinger, Jürg; Probst-Hensch, Nicole
Author(s) at UniBasel Htun, Nan Shwe Nwe
Odermatt, Peter
Müller, Pie
Yap, Peiling
Steinmann, Peter
Schindler, Christian
Utzinger, Jürg
Probst Hensch, Nicole
Pühse, Uwe
Gerber, Markus
Müller, Iwan Martin
Year 2018
Title Association between gastrointestinal tract infections and glycated hemoglobin in school children of poor neighborhoods in Port Elizabeth, South Africa
Journal PLoS Neglected Tropical Diseases
Volume 12
Number 3
Pages / Article-Number e0006332
Mesh terms Adolescent; Albendazole, therapeutic use; Animals; Anthelmintics, therapeutic use; Child; Cross-Sectional Studies; Feces, parasitology; Female; Gastrointestinal Tract, parasitology; Glycated Hemoglobin A, analysis; Helicobacter Infections, complications; Helicobacter pylori; Helminthiasis, epidemiology; Helminths, drug effects; Humans; Intestinal Diseases, Parasitic, epidemiology; Male; Multivariate Analysis; Regression Analysis; Schools; South Africa, epidemiology
Abstract BACKGROUND: Low- and middle-income countries are facing a dual disease burden with infectious diseases (e.g., gastrointestinal tract infections) and non-communicable diseases (e.g., diabetes) being common. For instance, chronic parasite infections lead to altered immune regulatory networks, anemia, malnutrition, and diarrhea with an associated shift in the gut microbiome. These can all be pathways of potential relevance for insulin resistance and diabetes. The aim of this study was to investigate the association between common gastrointestinal tract infections and glycemia in children from non-fee paying schools in South Africa. METHODOLOGY: We conducted a cross-sectional survey among 9- to 14-year-old school children in Port Elizabeth. Stool and urine samples were collected to assess infection status with parasitic worms (e.g., Ascaris lumbricoides, Enterobius vermicularis, and Trichuris trichiura), intestinal protozoa (e.g., Cryptosporidium parvum and Giardia intestinalis), and the bacterium Helicobacter pylori. Glycated hemoglobin (HbA1c) was measured in finger prick derived capillary blood. All children at schools with a high prevalence of helminth infections and only infected children at the schools with low infection rates were treated with albendazole. The association of anthelmintic treatment with changes in HbA1c 6 months after the drug intervention was also investigated. FINDINGS: A high prevalence of 71.8% of prediabetes was measured in this group of children, with only 27.8% having HbA1c in the normal range. H. pylori was the predominant infectious agent and showed an independent positive association with HbA1c in a multivariable regression analysis (β = 0.040, 95% confidence interval (CI) 0.006-0.073, p<0.05). No association of HbA1c with either any other infectious agent or albendazole administration was found. CONCLUSION: The role of H. pylori in diabetes needs confirmation in the context of longitudinal treatment interventions. The specific effect of other gastrointestinal tract infections on glycemia remains unclear. Future studies should integrate the measurement of biomarkers, including immunological parameters, to shed light on the potential mediating mechanisms between parasite infections and diabetes.
Publisher Public Library of Science
ISSN/ISBN 1935-2727 ; 1935-2735
Full Text on edoc Available
Digital Object Identifier DOI 10.1371/journal.pntd.0006332
PubMed ID
ISI-Number WOS:000431268900056
Document type (ISI) Journal Article

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