Helminth infection does not reduce risk for chronic inflammatory disease in a population-based cohort study

Gastroenterology. 2012 Jan;142(1):55-62. doi: 10.1053/j.gastro.2011.09.046. Epub 2011 Oct 6.

Abstract

Background & aims: Parasitic helminth infections can suppress symptoms of allergy, type 1 diabetes, arthritis, and inflammatory bowel disease in animal models. We analyzed data from a large, population-based cohort study to determine whether common childhood enterobiasis protects against these diseases.

Methods: We collected information on individual prescriptions filled for the drug mebendazole against Enterobius vermicularis for all children born in Denmark 1995-2008 from the National Register of Medicinal Product Statistics (n = 924,749; age 0-14 years); 132,383 of these children (14%) filled a prescription for mebendazole, 102,482 of the children (11%) had a household peer who was registered with a filled mebendazole prescription, and the remaining 689,884 children (75%) comprised the reference group. Children diagnosed with asthma, type 1 diabetes, juvenile arthritis, ulcerative colitis, or Crohn's disease were identified from the National Patient Registry. We used Poisson regression to estimate confounder-adjusted incidence rate ratios for first in- or outpatient hospital diagnosis of chronic inflammatory disease according to history of mebendazole treatment prescribed to children in the study.

Results: Chronic inflammatory disease was diagnosed in 10,352 children during 6.4 million person-years of follow-up. The incidence rate ratios was 1.07 for asthma (95% confidence interval [CI]: 1.00-1.13), 1.05 for type 1 diabetes (95% CI: 0.79-1.12), 1.13 for juvenile arthritis (95% CI: 0.94-1.37), 0.77 for ulcerative colitis (95% CI: 0.41-1.46), and 1.44 for Crohn's disease (95% CI: 0.82-2.53). Results were not modified by number of treatments or age at treatment.

Conclusions: Based on a population-based analysis, enterobiasis does not reduce risk for asthma, type 1 diabetes, arthritis, or inflammatory bowel disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Antinematodal Agents / therapeutic use
  • Arthritis, Juvenile / diagnosis
  • Arthritis, Juvenile / epidemiology*
  • Arthritis, Juvenile / prevention & control
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / prevention & control
  • Child
  • Child, Preschool
  • Cohort Studies
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / epidemiology*
  • Colitis, Ulcerative / prevention & control
  • Crohn Disease / diagnosis
  • Crohn Disease / epidemiology*
  • Crohn Disease / prevention & control
  • Denmark / epidemiology
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / prevention & control
  • Drug Prescriptions / statistics & numerical data
  • Enterobiasis / drug therapy
  • Enterobiasis / epidemiology*
  • Enterobiasis / parasitology
  • Enterobius / pathogenicity
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Linear Models
  • Mebendazole / therapeutic use
  • Registries
  • Risk Assessment
  • Risk Factors
  • Time Factors

Substances

  • Antinematodal Agents
  • Mebendazole