Article

Asymptomatic giardiasis and growth in young children; a longitudinal study in Salvador, Brazil

Institute of Public Health, Universidade Federal da Bahia, Salvador, BA, Brazil.
Parasitology (Impact Factor: 2.35). 08/2005; 131(Pt 1):51-6. DOI: 10.1017/S0031182005007353
Source: PubMed

ABSTRACT This study sought to assess the effect of giardiasis on growth of young children. In Salvador, northeast Brazil, 597 children initially aged 6 to 45 months were followed for a year in 1998/9, measured anthropometrically thrice, every 6 months, and monitored for diarrhoea prevalence twice weekly. Stool samples were collected and examined during the second round of anthropometry, and infected children were treated 39 days later, on average (S.D. 20 days). For each 6-month interval, the gains in z-scores of infected and uninfected children were compared, after adjustment for potential confounding factors, including longitudinal prevalence of diarrhoea. No significant difference was found for the first interval but in the second, the gain in adjusted height-for-age z-score was 0.09 less in infected than uninfected children, equivalent to a difference in height gain of 0.5 cm. The shortfall in growth was greater in children who remained free of diarrhoea, and was significantly correlated with the proportion of the second interval during which the child had remained untreated. We conclude that Giardia can impede child growth even when asymptomatic, presumably through malabsorption. This finding challenges the view that young children found to have asymptomatic giardiasis in developing countries should not be treated.

Download full-text

Full-text

Available from: Mauricio L. Barreto, Dec 14, 2014
0 Followers
 · 
119 Views
  • Source
    • "Awareness is growing of the public health importance and economic consequences of malnutrition in early childhood attributable to poor environmental sanitation (Acharya and Paunio 2008), whether it is occasioned by repeated episodes of diarrhea or by parasite infection. Indeed, Giardia duodenalis infection in this setting is associated with diminished growth, even in children suffering no diarrhea at all (Prado et al. 2005). The long-term consequences of parasite infection in one's early years go beyond diminished growth and include impaired cognitive performance (Berkman et al. 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Sanitation affects health, especially that of young children. Residents of Salvador, in Northeast Brazil, have had a high prevalence of intestinal parasites. A citywide sanitation intervention started in 1996 aimed to raise the level of sewer coverage from 26% to 80% of households. We evaluated the impact of this intervention on the prevalence of Ascaris lumbricoides, Trichuris trichuria, and Giardia duodenalis infections in preschool children. The evaluation was composed of two cross-sectional studies (1998 and 2003-2004), each of a sample of 681 and 976 children 1-4 years of age, respectively. Children were sampled from 24 sentinel areas chosen to represent the range of environmental conditions in the study site. Data were collected using an individual/household questionnaire, and an environmental survey was conducted in each area before and after the intervention to assess basic household and neighborhood sanitation conditions. Stool samples were examined for the presence of intestinal parasites. The effect of the intervention was estimated by hierarchical modeling, fitting a sequence of multivariate regression models. The prevalence ofA. lumbricoides infection was reduced from 24.4% to 12.0%, T. trichuria from 18.0% to 5.0%, and G. duodenalis from 14.1% to 5.3%. Most of this reduction appeared to be explained by the increased coverage in each neighborhood by the sewage system constructed during the intervention. The key explanatory variable was thus an ecological measure of exposure and not household-based, suggesting that the parasite transmission prevented by the program was mainly in the public (vs. the domestic) domain. This study, using advanced statistical modeling to control for individual and ecological potential confounders, demonstrates the impact on intestinal parasites of sanitation improvements implemented at the scale of a large population.
    Environmental Health Perspectives 11/2010; 118(11):1637-42. DOI:10.1289/ehp.1002058 · 7.03 Impact Factor
  • Côlon & Rectum 05/2010; 4(2).
  • Source
Show more