{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T18:48:11Z","timestamp":1769280491758,"version":"3.49.0"},"reference-count":46,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T00:00:00Z","timestamp":1634774400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010586","name":"Haukeland University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010586","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_sjpain-2021-0122_s_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To investigate whether acute infection with\n                      <jats:italic>Giardia lamblia<\/jats:italic>\n                      is associated with fibromyalgia 10 years after infection and whether fibromyalgia is associated with irritable bowel syndrome (IBS) and chronic fatigue (CF) in this setting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2021-0122_s_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cohort study was established after an outbreak of\n                      <jats:italic>G.\u00a0lamblia<\/jats:italic>\n                      in Bergen, Norway, 2004. Laboratory-confirmed cases and a matched control group were followed for 10 years. The main outcome was fibromyalgia 10 years after giardiasis, defined by the 2016 revisions of the fibromyalgia diagnostic criteria using the Fibromyalgia Survey Questionnaire (FSQ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2021-0122_s_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of fibromyalgia was 8.6% (49\/572) among\n                      <jats:italic>Giardia<\/jats:italic>\n                      exposed compared to 3.1% (21\/673) in controls (p&lt;0.001). Unadjusted odds for having fibromyalgia was higher for\n                      <jats:italic>Giardia<\/jats:italic>\n                      exposed compared to controls (odds ratio (OR): 2.91, 95% confidence interval (CI): 1.72, 4.91), but adjusted for IBS and CF it was not (OR: 1.05, 95% CI: 0.57, 1.95). Among participants without CF the odds for fibromyalgia was 6.27 times higher for participants with IBS than those without (95% CI: 3.31, 11.91) regardless of\u00a0exposure. Among participants without IBS the odds for fibromyalgia was 4.80 times higher for those with CF than those without (95% CI: 2.75, 8.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2021-0122_s_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      We found a higher prevalence of fibromyalgia among\n                      <jats:italic>Giardia<\/jats:italic>\n                      exposed compared to controls 10 years after the acute infection. Fibromyalgia was strongly associated with IBS and CF, and the difference between the exposed and controls can be attributed to the high prevalence of IBS and CF among the\n                      <jats:italic>Giardia<\/jats:italic>\n                      exposed. Notably, this study was not designed to establish causality between\n                      <jats:italic>Giardia<\/jats:italic>\n                      exposure and the outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/sjpain-2021-0122","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T16:39:25Z","timestamp":1634920765000},"page":"348-355","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence of fibromyalgia 10 years after infection with\n                    <i>Giardia lamblia<\/i>\n                    : a controlled prospective cohort study"],"prefix":"10.1515","volume":"22","author":[{"given":"Gunnhild S.","family":"Hunskar","sequence":"first","affiliation":[{"name":"Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway"},{"name":"Department of Dermatology , Haukeland University Hospital , Bergen , Norway"},{"name":"Research Unit for General Practice , NORCE Norwegian Research Centre , Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guri","family":"Rortveit","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway"},{"name":"Research Unit for General Practice , NORCE Norwegian Research Centre , Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sverre","family":"Litleskare","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice , NORCE Norwegian Research Centre , Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geir Egil","family":"Eide","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway"},{"name":"Centre for Clinical Research , Haukeland University Hospital , Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurt","family":"Hanevik","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit for Tropical Infectious Diseases , Haukeland University Hospital , Bergen , Norway"},{"name":"Department of Clinical Science , University of Bergen , Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Langeland","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit for Tropical Infectious Diseases , Haukeland University Hospital , Bergen , Norway"},{"name":"Department of Clinical Science , University of Bergen , Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut-Arne","family":"Wensaas","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice , NORCE Norwegian Research Centre , Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,10,21]]},"reference":[{"key":"2025120910041618914_j_sjpain-2021-0122_ref_001","unstructured":"Burton, C. 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