Intestinal parasite infections in diabetes mellitus patients; A cross-sectional study of the Bolgatanga municipality, Ghana

Abstract

Diabetes mellitus (DM) is a chronic disease which predisposes affected people to the acquisition of intestinal parasites. This study was conducted to detect the prevalence of intestinal parasites (ITPs) infection among DM patients and to identify their socio-demographic and clinical characteristics. The cross-sectional study was conducted among 152 diabetes mellitus patients selected from three hospitals in the Bolgatanga municipality. Stool samples were collected from the participants and examined using direct wet mount, formol-ether concentration, and modified Ziehl-Neelsen (ZN) staining methods. Questionnaires were designed to elicit socio-demographic information from participants and medical history was obtained from hospital folders. A prevalence of 12.5% ITP infections was recorded. Ascaris lumbricoides (5.3%), Cryptosporidium parvum (15%), Entamoeba hystolytica (21.1%), Entamoeba coli (15.8%), Giardia lamblia (47. 4%) and Hookworm (5.1%) were detected. Fasting blood glucose (FBG) (p<0.0001), duration of diabetes mellitus (p = 0.017), duration of therapy (p = 0.029) and type of therapy (metformin) (p = 0.0101) significantly affected the prevalence of ITPs infections. Diabetic mellitus complications (nephropathy, OR=25.20; CI=2.46–257.87; p<0.0001), no history of visit to dietician (OR=11.56; CI=3.95–33.82; p<0.0001) and level of education (informal education, OR=10.60; CI=1.22–92.27; p = 0.032) were significant risk factors of ITP infections. The Widowed (OR=0.13; CI=0.02–0.92; p = 0.040), married participants (OR=0.09; CI=0.02–0.35; p = 0.001), people that defecated twice a day (p<0.0001) and participants reported to have GI symptoms (p<0.0001) were also significantly associated with ITP infection. DM patients might be at an increased risk of infection with intestinal parasites especially G. lamblia, Entamoeba hystolytica and Cryptosporidium parvum and it is therefore necessary to carry out routine stool examination for them