4.6 Article Proceedings Paper

Lack of an adverse effect of Giardia intestinalis infection on the health of Peruvian children

Journal

AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 168, Issue 6, Pages 647-655

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwn177

Keywords

developing countries; diarrhea; Giardia lamblia; growth; natural history; Peru

Funding

  1. NICHD NIH HHS [F31 HD008488, F31-HD08488] Funding Source: Medline
  2. PHS HHS [U01-A135894] Funding Source: Medline

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Giardia intestinalis is a common gastrointestinal protozoan worldwide, but its effects on childhood growth in developing countries are not clearly understood. The authors aimed to describe its effects on child growth. They followed 220 Peruvian children daily for diarrhea, weekly for stool samples, and monthly for anthropometry. The authors modeled the effect of nutritional status on the risk of Giardia infection and the risk of diarrhea attributable to Giardia using negative binomial regression. They modeled the effects of Giardia infection on growth using linear regression, with 85% of children becoming infected with Giardia and 87% of these becoming reinfected. In multivariable analysis, the risk of Giardia infection did not vary with weight for age (relative risk = 1.00, 95% confidence interval: 0.89, 1.12) or height for age (relative risk = 0.92, 95% confidence interval: 0.82, 1.04). Giardiasis did not affect growth at 1 or 2 months following the first infection at any age interval. The longitudinal prevalence of Giardia between 6 and 24 months of age was not associated with height gain in that interval (p = 0.981). Giardia was not associated with an increased risk of diarrhea at any age interval. Study results question the importance of Giardia as a childhood pathogen in developing countries where giardiasis is hyperendemic.

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