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

Published online by Cambridge University Press:  08 March 2005

M. S. PRADO ,
S. CAIRNCROSS ,
A. STRINA ,
M. L. BARRETO ,
A. M. OLIVEIRA-ASSIS  and
S. REGO
M. S. PRADO
Affiliation:
Institute of Public Health, Universidade Federal da Bahia, Rua Padre Feijó 29, 4° andar, 40110-170 Salvador – BA, Brazil
S. CAIRNCROSS
Affiliation:
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
A. STRINA
Affiliation:
Institute of Public Health, Universidade Federal da Bahia, Rua Padre Feijó 29, 4° andar, 40110-170 Salvador – BA, Brazil
M. L. BARRETO
Affiliation:
Institute of Public Health, Universidade Federal da Bahia, Rua Padre Feijó 29, 4° andar, 40110-170 Salvador – BA, Brazil
A. M. OLIVEIRA-ASSIS
Affiliation:
School of Nutrition, Universidade Federal da Bahia, Rua Araújo Pinho 32, 40110-150 Salvador – BA, Brazil
S. REGO
Affiliation:
Institute of Public Health, Universidade Federal da Bahia, Rua Padre Feijó 29, 4° andar, 40110-170 Salvador – BA, Brazil
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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.

Keywords

BrazildiarrhoeaGiardia duodenalisgrowthlongitudinal studymalabsorptionnutritional status
Type
Research Article
Information
Parasitology , Volume 131 , Issue 1 , July 2005 , pp. 51 - 56
Copyright
© 2005 Cambridge University Press

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References

REFERENCES

CHECKLEY, W., EPSTEIN, L. D., GILMAN, R. H., BLACK, R. E., CABRERA, L. & STERLING, C. R. ( 1998). Effects of Cryptosporidium parvum infection in Peruvian children; growth faltering and subsequent catch-up growth. American Journal of Epidemiology 148, 497–506.CrossRefGoogle Scholar
CHECKLEY, W., GILMAN, R. H., EPSTEIN, L. D., SUAREZ, M., DIAZ, J. F., CABRERA, L., BLACK, R. E. & STERLING, C. R. ( 1997). Asymptomatic and symptomatic cryptosporidiosis: their acute effect on weight gain in Peruvian children. American Journal of Epidemiology 145, 156–163.CrossRefGoogle Scholar
CROMPTON, D. W. T. ( 1984). Influence of parasitic infection on food intake. Federation Proceedings 43, 239–245.Google Scholar
FIBGE ( 1991). Censo demográfico – Bahia. Fundação Instituto Brasileiro de Geografia e Estatística, Rio de Janeiro.
GILMAN, R. H., MARQUIS, G. S., MIRANDA, E., VESTEGUI, M. & MARTINEZ, H. ( 1988). Rapid reinfection by Giardia lamblia after treatment in a hyperendemic Third World community. Lancet 8581, 343–345.CrossRefGoogle Scholar
GUPTA, M. C. & URRUTIA, J. J. ( 1982). Effect of periodic antiascaris and antigiardia treatment on nutritional status of preschool children. American Journal of Clinical Nutrition 36, 79–86.CrossRefGoogle Scholar
ISLAM, A. ( 1990). Giardiasis in developing countries. In Giardiasis (ed. Meyer, E. A.), pp. 235–265. Elsevier, Amsterdam.
LOHMAN, T. G., ROCHE, A. F. & MARTORELL, R. ( 1988). Anthropometric Standardization Reference Manual. Ilinois, Human Kinetics Books.
MORRIS, S. S., COUSENS, S. N., KIRKWOOD, B. R., ARTHUR, P. & ROSS, D. A. ( 1996). Is prevalence of diarrhea a better predictor of subsequent mortality and weight gain than diarrhea incidence? American Journal of Epidemiology 144, 582–588.Google Scholar
MUNIZ, P. T., FERREIRA, M. U., FERREIRA, C. S., CONDE, W. L. & MONTEIRO, C. A. ( 2002). Intestinal parasitic infections in young children in São Paulo, Brazil: prevalences, temporal trends and associations with physical growth. Annals of Tropical Medicine and Parasitology 95, 503–512.CrossRefGoogle Scholar
NEVA, F. A. & BROWN, H. W. ( 1994). Basic Clinical Parasitology, 6th Edn. Appleton and Lange. Norwalk, USA.
NEWMAN, R. D., MOORE, S. R., LIMA, A. A. M., NATARO, J. P., GUERRANT, R. L. & SEARS, C. L. ( 2001). A longitudinal study of Giardia lamblia infection in north-east Brazilian children. Tropical Medicine and International Health 6, 624–634.CrossRefGoogle Scholar
PRADO, M. S., BARRETO, M. L., OLIVEIRA-ASSIS, A. M., PAZ, L. M. & CAIRNCROSS, S. ( 2003). Risk factors for infection with Giardia duodenalis in pre-school children in the city of Salvador, Brazil. Epidemiology and Infection 131, 899–906.CrossRefGoogle Scholar
ROSENBERG, I. H. & BOWMAN, A. B. B. ( 1984). Impact of intestinal parasites on digestive function in humans. Federation Proceedings 43, 246–250.Google Scholar
SHETTY, N., NARASIMHA, M., RAGHUVEER, T. S., ELLIOTT, E., FARTHING, M. J. & MACADEN, R. ( 1990). Intestinal amoebiasis and giardiasis in Southern Indian infants and children. Transactions of the Royal Society of Tropical Medicine and Hygiene 84, 382–384.CrossRefGoogle Scholar
STRINA, A., CAIRNCROSS, S., BARRETO, M. L., LARREA, C. & PRADO, M. S. ( 2003). Childhood diarrhea and observed hygiene behavior in Salvador, Brazil. American Journal of Epidemiology 157, 1032–1038.CrossRefGoogle Scholar
SULLIVAN, P. B., MARSH, M. N., PHILLIPS, M. B., DEWIT, O., NEALE, G., CEVALLOS, A. M., YAMSON, P. & FARTHING, M. J. ( 1991). Prevalence and treatment of giardiasis in chronic diarrhoea and malnutrition. Archives of Disease in Childhood 66, 304–306.CrossRefGoogle Scholar
TEIXEIRA, M. G. L. C., BARRETO, M. L., COSTA, M. C. N., STRINA, A., MARTINS, D. F. J. & PRADO, M. S. ( 2002). Sentinel areas: a monitoring strategy in public health. Cadernos de Saúde Pública 18, 1189–1195.CrossRefGoogle Scholar
WALTERSPIEL, J. N. & PICKERING, L. K. ( 1994). Giardia and giardiasis. Progress in Clinical Parasitology 4, 1–26.Google Scholar
WORLD HEALTH ORGANIZATION ( 1981). Intestinal protozoal and helminth infections. Technical Report Series No. 666. World Health Organization, Geneva, pp. 49–55.
WORLD HEALTH ORGANIZATION ( 1995). Physical status; the use and interpretation of anthropometry. Technical Report Series No. 854. World Health Organization, Geneva.