Intestinal parasitic infections and associated risk factors in diabetic patients: a case-control study

Diabetes mellitus (DM) is a metabolic disease that puts the individual at immune-suppression state. The present study aims to detect the burden of intestinal parasites and associated risk factors among diabetic patients in a case-control study. Stool samples from 100 diabetic patients, and 100 non-diabetic controls attending Beni-Suef University Hospital were collected and processed by direct smear examination, concentration technique, permanent staining by modified Ziehl-Neelsen and modified trichrome stains, and culture on nutrient agar plates. The overall prevalence of intestinal parasites was 38%; higher in diabetic patients (44%) than control group (32%) with non-statistical significance. The most predominant intestinal parasites detected among diabetics were Blastocystis hominis (29%), followed by Cryptosporidium sp. (12%), Giardia lamblia (7%), Microsporidia sp. (5%), Entamoeba histolytica/dispar, Hymenolepis nana, and Capillaria philippinensis (each representing 2%). No statistical difference was detected between both groups in all parasites except for Microsporidia sp. (P = 0.008). In diabetic patients; age ≥ 41 years, living in rural areas, and patients having uncontrolled and complicated DM were significantly associated with intestinal parasitosis by univariate analysis (P = 0.016, 0.035, 0.014, 0.043) respectively. By multivariate analysis, age and rural residence were the only statistically significant risk factors (OR = 6.192, and 2.614) respectively. Intestinal parasites were highly associated with diarrhea (P < 0.001), and flatulence (P = 0.042) in the diabetic patients. Diabetic patients should be screened routinely for intestinal parasites, especially the opportunistic ones, and treated for their overall well-being.