Association between helminth infections and diabetes mellitus in adults from the Lao People’s Democratic Republic:a crosssectional study  

作　　者：Nan Shwe Nwe Htun Peter Odermatt Phimpha Paboriboune Somphou Sayasone Malisa Vongsakid Vilayouth Phimolsarn-Nusith Xuan Duong Tran Phoum-Savath Ounnavong Navalone Andriama-Hefasoa Nilun-Done Senvanpan Anousine Homsana Baocher Lianosay Dalouny Xayavong Dimbitsoa Rakotomalala Robinson Phaivanh Bounsavath Phoy-Phaylinh Prasayasith Seng-Davanh Syphan Yi-Xiao Lu Kanchana Thilakoun Xaipa-Song Xaiyaphet Phout-Tasin Vongngakesone Ikenna C Eze Medea Imboden Banchob Sripa Daniel Reinharz Nicole Probst-Hensch 

机构地区：[1]Department of Epidemiology and Public Health,Swiss Tropical and Public Health Institute,PO Box,4002,4051 Basel,Switzerland [2]University of Basel,Basel,Switzerland [3]The Francophone Institute for Tropical Medicine(International Program for Health in the Tropics),Vientiane,Lao PDR [4]Lao Tropical and Public Health Institute,Ministry of Health,Vientiane,Lao People’s Democratic Republic [5]Tropical Disease Research Laboratory,Faculty of Medicine,Khon Kaen University,Khon Kaen,Thailand [6]Universite Laval,Quebec City,Canada

出　　处：《Infectious Diseases of Poverty》2018年第1期1110-1120,共11页贫困所致传染病（英文）

基　　金：We are grateful to the financial support of the Agence Universitaire de la Francophonie and the Rudolf Geigy Foundation,Basel,Switzerland。

摘　　要：Background: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 cooccurrence of helminth infections and diabetes mellitus in adults in Lao People’s Democratic Republic(Lao PDR).Methods: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 selfreported 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.Results: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.Conclusions: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 i

关 键 词：Dual burden of disease Opisthorchis viverrini TAENIA Diabetes mellitus CROSS-SECTIONAL EPIDEMIOLOGY ADULTS Lao PDR 

分 类 号：R58[医药卫生—内分泌]