Lack of an Adverse Effect of Giardia intestinalis Infection on the Health of Peruvian Children

Département de Médecine Sociale et Préventive, Université de Montréal, Montréal, Québec, Canada.
American journal of epidemiology (Impact Factor: 5.23). 10/2008; 168(6):647-55. DOI: 10.1093/aje/kwn177
Source: PubMed


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.


Available from: Maria-Graciela Hollm-Delgado, Mar 28, 2015
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    • "Carvalho-Costa et al. (2007) found an interaction between G. lamblia infection and weight, height, and UAC, suggesting that this species affected the nutritional status in Brazilian children. In contrast, other studies found no effects of giardiasis on child growth (Campbell et al., 2004; Hollm-Delgado et al., 2008), whereas Muniz- Junqueira and Queiroz (2002) "
    [Show abstract] [Hide abstract] ABSTRACT: The Program for the Control of Intestinal Parasites and Nutrition was designed to intervene in small communities to prevent and control the effects of parasitic infections on children's health. Objectives: To analyze the association between nutritional status and parasitic infection in suburban and rural children from Buenos Aires, Argentina. Methods: Nutritional status was assessed by anthropometric (weight, height, BMI, skinfolds, upper arm circumference, muscle, and fat upper arm areas) and biochemical (Hb, Ca, Mg, Zn, and Cu) indicators. Parasitological analysis were made on both serial stool and perianal swab samples. A total of 708 children aged 3-11 were measured. The biochemical analysis included 217 blood samples and the parasitological study included 284 samples. Results: Anthropometric status was similar in both settings with low rates of underweight and stunting (<6%), and high rates of overweight (∼17%) and obesity (∼12%). Ca deficiency was significantly higher in suburban children where 80% of them were hypocalcemic. Around 70% of fecal samples contained parasites. Among infected children, the most prevalent species were Blastocystis hominis and Enterobius vermicularis (∼43%) followed by Giardia lamblia (∼17%). Differences in parasitological status between districts were not significant. In the suburban district parasitized children were lighter, shorter, and had a lower upper arm circumference than their non-infected peers. No differences in anthropometric status were seen among infected and uninfected rural children. Conclusions: The results suggest an association between intestinal parasites and physical growth in suburban children. Rural children seem to be protected against the effects of parasitic infection. Am. J. Hum. Biol., 2013. © 2013 Wiley Periodicals, Inc.
    Full-text · Article · Jan 2014 · American Journal of Human Biology
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    • "However, the impact of Giardia infection in children development is not clear. Some studies showed detrimental effects on nutritional status and poorer cognitive function on children with giardiasis [5] [6] [7] [8], while others showed that giardiasis did not affect childhood growth [9]. Host factors, such as immune status, nutritional status, and age, are recognized as important determinants for the severity of infection [10]. "
    [Show abstract] [Hide abstract] ABSTRACT: Giardia duodenalis is the most prevalent intestinal protozoan infection especially in children. In Portugal scarce data are available relative to this infection in preschoolers. The present study was conducted from April to July 2009 in public preschools in Lisbon enrolling 316 children. Stool examination was performed through microscopy. Molecular analysis was conducted in all positive samples for G. duodenalis in order to determine the assemblage and subassemblage of this parasite. Eight of the preschoolers studied children (2.5%, 8/316) were infected with G. duodenalis. Additionally the brother of one of the infected children was also infected. Genotyping analysis targeting ssu-rRNA and β-giardin loci revealed six infections with assemblage A and 3 with assemblage B. Sub-assemblage determination was possible in four of the samples, with three A2 and one A3. The limited number of cases precluded an association of a determined symptom with an assemblage. The data presented here show the relevance of considering G. duodenalis analysis in children with intestinal complaints even in developed countries.
    Full-text · Article · Sep 2013 · Journal of Parasitology Research
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    • "It is well understood that food intake is necessary for proper physiological and metabolic activity particularly in young children. In giardiasis the altered gut morphology impairs the metabolism that leads to malnutrition, diarrhoea or steatorrhoea (Delgado et al. 2008; Herems et al. 2008). In the present study, we found increased body mass in all renourished-probiotic-Giardia infected mice compared with Giardiainfected mice and is in accordance with our earlier studies (Shukla and Sidhu 2011a, b). "
    [Show abstract] [Hide abstract] ABSTRACT: The present study describes the in vivo ameliorating effect of Lactobacillus casei supplementation in renourished Giardia intestinalis infected BALB/c mice. It was observed that daily administration of probiotic 7 days prior to Giardia-infection to renourished mice, efficiently reduced the excretion of Giardia cysts and trophozoite counts, along with significant increased fecal lactobacilli counts compared with Giardia-infected mice. It was also observed that oral feeding of probiotic to renourished-Giardia-infected mice abrogated all the anthropometric and biochemical anomalies. Histologically, morphological and cellular alteration of microvillus membrane integrity revealed that probiotic administration further ameliorated the mucosal damage in renourished-probiotic-Giardia-infected mice compared to severe microvillus atrophy, oedematous, vacuolated epithelial cells and ileitis in renourished-Giardia and Giardia-infected mice. Thus, it is suggested that probiotic used as the functional food helps in restoration of anthropometric, biochemical alterations and atrophied gut by enhancing the goblet cells and reducing the giardiasis.
    Full-text · Article · Mar 2012 · Antonie van Leeuwenhoek
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