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Clin Infect Dis. 2016 Sep 15;63(6):792-7. doi: 10.1093/cid/ciw391. Epub 2016 Jun 16.

A Prospective Longitudinal Cohort to Investigate the Effects of Early Life Giardiasis on Growth and All Cause Diarrhea.

Author information

1
Division of Pediatric Infectious Diseases, Children's Hospital of Richmond at Virginia Commonwealth University.
2
Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
3
Department of Public Health Sciences, University of Virginia, Charlottesville.
4
Department of Medicine and Vaccine Testing Center, The University of Vermont College of Medicine, Burlington.
5
Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
6
Division of Infectious Diseases, University of North Carolina-Chapel Hill.

Abstract

BACKGROUND:

Growth stunting in children under 2 years of age in low-income countries is common. Giardia is a ubiquitous pathogen in this age group but studies investigating Giardia's effect on both growth and diarrhea have produced conflicting results.

METHODS:

We conducted a prospective longitudinal birth cohort study in Dhaka, Bangladesh, with monthly Giardia and continuous diarrheal surveillance.

RESULTS:

629 children were enrolled within the first 72 hours of life, and 445 completed 2 years of the study. 12% of children were stunted at birth with 57% stunted by 2 years. 7% of children had a Giardia positive surveillance stool in the first 6 months of life, whereas 74% had a positive stool by 2 years. The median time to first Giardia positive surveillance stool was 17 months. Presence of Giardia in a monthly surveillance stool within the first 6 months of life decreased length-for-age Z score at 2 years by 0.4 (95% confidence interval, -.80 to -.001; P value .05) whereas total number of Giardia positive months over the 2-year period of observation did not. Neither variable was associated with weight-for-age Z score at 2 years. In our model to examine predictors of diarrhea only exclusive breastfeeding was significantly associated with decreased diarrhea (P value <.001). Concomitant giardiasis was neither a risk factor nor protective.

CONCLUSIONS:

Early life Giardia was a risk factor for stunting at age 2 but not poor weight gain. Presence of Giardia neither increased nor decreased odds of acute all cause diarrhea.

KEYWORDS:

Giardia; diarrhea; growth; low-income countries; stunting

PMID:
27313261
PMCID:
PMC4996141
DOI:
10.1093/cid/ciw391
[Indexed for MEDLINE]
Free PMC Article

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