The Effect of Helminth Infections and Their Treatment on Metabolic Outcomes: Results of a Cluster-Randomized Trial

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dc.contributor.authorSanya, Richard E.
dc.contributor.authorWebb, Emily L.
dc.contributor.authorZziwa, Christopher
dc.contributor.authorKizindo, Robert
dc.contributor.authorSewankambo, Moses
dc.contributor.authorTumusiime, Josephine
dc.contributor.authorNakazibwe, Esther
dc.contributor.authorOduru, Gloria
dc.contributor.authorNiwagaba, Emmanuel
dc.contributor.authorNakawungu, Prossy Kabuubi
dc.contributor.authorKabagenyi, Joyce
dc.contributor.authorNassuuna, Jacent
dc.contributor.authorWalusimbi, Bridgious
dc.contributor.authorAndia-Biraro, Irene
dc.contributor.authorElliot, Alison M.
dc.date.accessioned2023-03-27T09:31:24Z
dc.date.available2023-03-27T09:31:24Z
dc.date.issued2020
dc.description.abstractHelminths may protect against cardiometabolic risk through effects on inflammation and metabolism; their treatment may be detrimental to metabolic outcomes. In a cluster-randomized trial in 26 Ugandan fishing communities we investigated effects of community-wide intensive (quarterly single-dose praziquantel, triple-dose albendazole) vs standard (annual single-dose praziquantel, biannual single-dose albendazole) anthelminthic treatment on metabolic outcomes, and observational associations between helminths and metabolic outcomes. The primary outcome, homeostatic model assessment of insulin resistance (HOMA-IR), and secondary outcomes (including blood pressure, fasting blood glucose, lipids) were assessed after 4 years' intervention among individuals aged ≥10 years. We analyzed 1898 participants. Intensive treatment had no effect on HOMA-IR (adjusted geometric mean ratio, 0.96 [95% confidence interval {CI}, .86–1.07]; P = .42) but resulted in higher mean low-density lipoprotein cholesterol (LDL-c) (2.86 vs 2.60 mmol/L; adjusted mean difference, 0.26 [95% CI, −.03 to .56]; P = .08). Lower LDL-c levels were associated with Schistosoma mansoni (2.37 vs 2.80 mmol/L; −0.25 [95% CI, −.49 to −.02]; P = .04) or Strongyloides (2.34 vs 2.69 mmol/L; −0.32 [95% CI, −.53 to −.12]; P = .003) infection. Schistosoma mansoni was associated with lower total cholesterol (4.24 vs 4.64 mmol/L; −0.25 [95% CI, −.44 to −.07]; P = .01) and moderate to heavy S. mansoni infection with lower triglycerides, LDL-c, and diastolic blood pressure. Helminth infections improve lipid profiles and may lower blood pressure. Studies to confirm causality and investigate mechanisms may contribute to understanding the epidemiological transition and suggest new approaches to prevent cardiometabolic disease.en_US
dc.identifier.citationSanya, R. E., Webb, E. L., Zziwa, C., Kizindo, R., Sewankambo, M., Tumusiime, J., ... & Elliott, A. M. (2020). The effect of helminth infections and their treatment on metabolic outcomes: results of a cluster-randomized trial. Clinical infectious diseases, 71(3), 601-613.https://doi.org/10.1093/cid/ciz859en_US
dc.identifier.issn1537-6591
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/8304
dc.language.isoenen_US
dc.publisherClinical infectious diseasesen_US
dc.subjectHelminthsen_US
dc.subjectSchistosoma mansonien_US
dc.subjectDiabetesen_US
dc.subjectCardiovascular diseaseen_US
dc.titleThe Effect of Helminth Infections and Their Treatment on Metabolic Outcomes: Results of a Cluster-Randomized Trialen_US
dc.typeArticleen_US
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