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

Abstract

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.