Abstract
Background: The concurrent presence of intestinal parasitic infections (IPIs) and diabetes mellitus (DM) creates a compounding clinical and haematological burden that remains inadequately characterised in Nigeria. This study determined the distribution of intestinal parasite species and their relationship with anaemic status, body mass index (BMI), and glycaemic control among DM patients in Ondo State.
Methods: A cross-sectional study enrolled 284 confirmed DM patients across the three senatorial districts of Ondo State. Stool specimens were examined using formol-ether concentration and modified Ziehl-Neelsen methods; full blood count were obtained by automated haematology analyser; and glycated haemoglobin (HbA1c) was measured by fluorescence immunoassay. Glycaemic control was stratified as well-controlled (HbA1c ≤ 6.0%), moderately controlled (> 6.0–< 8.0%), and poorly controlled (≥ 8.0%). Chi-square tests were performed at p < 0.05.
Results: IPI overall prevalence was 27.5% (78/284): helminthic infections accounted for 58 cases (20.4%) and protozoan infections for 20 cases (7.1%). Ascaris lumbricoides was the most prevalent species (11.9%), followed by Entamoeba histolytica (7.1%), Schistosoma mansoni (4.2%), hookworm (2.5%), Trichuris trichiura (1.1%), and Enterobius vermicularis (0.7%). Anaemic subjects had a significantly higher IPI prevalence (51.9%) than non-anaemic participants (22.0%; p < 0.001). Mean haemoglobin concentration was significantly lower in IPI-positive patients (532.64 ± 40.82 g/L) than IPI-negative patients (697.23 ± 24.81 g/L; p = 0.0001). Overweight individuals (BMI 25–29.9 kg/m²) had a significantly higher infection rate (50.0%) compared with normal-weight counterparts (26.0%; p = 0.04). All 43 participants with HbA1c ≥ 8.0% were parasitologically positive (100.0%), compared with 16.5% and 14.2% among well- and moderately controlled patients respectively (p < 0.001). Diarrhoea and lipid profile parameters showed no statistically significant associations with IPI prevalence.
Conclusion: IPIs are strongly associated with both anaemia and poor glycaemic control in DM patients in Ondo State, underscoring the need for routine parasitological screening, integrated haematological monitoring, and context-sensitive anthelmintic therapy within comprehensive diabetes management protocols in endemic areas of Nigeria.