Association between gastrointestinal tract infections and glycated hemoglobin in school children of poor neighborhoods in Port Elizabeth, South Africa

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...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2018-03, Vol.12 (3), p.e0006332-e0006332
Main Authors: 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
Format: Article
Language:English
Subjects:
Albendazole
Anaemia
Anemia
Anthelmintic agents
Bioindicators
Biology and life sciences
Biomarkers
Blood glucose
Care and treatment
Children
Confidence intervals
Cryptosporidium
Cryptosporidium parvum
Diabetes
Diabetes mellitus
Diarrhea
Diseases
Dosage and administration
Elementary school students
Epidemiology
Gastroenterology
Gastrointestinal system
Gastrointestinal tract
Giardia
Giardia intestinalis
Glucose
Health aspects
Helicobacter pylori
Hemoglobin
Hyperglycemia
Immunology
Infections
Infectious diseases
Insulin
Insulin resistance
Intestinal microflora
Intestine
Investigations
Low income groups
Malnutrition
Medicine and Health Sciences
Microbiomes
Neighborhoods
Parasites
Parasitic diseases
Protozoa
Public health
Regression analysis
Schools
Social Sciences
Statistical analysis
Supervision
Surveying
Tropical diseases
Urine
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Summary: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. 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. 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
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0006332