2016/06/16 by Jeffrey R. Donowitz, Masud Alam, Mamun Kabir +6 · 1 citation
Immunology and Microbiology · Nursing · Environmental Science · Medicine · #Parasitic Infections and Diagnostics #Child Nutrition and Water Access #Fecal contamination and water quality #Giardia #Medicine #Diarrhea #Prospective cohort study #Odds ratio #Breastfeeding #Cohort study #Cohort #Risk factor #Giardia lamblia #Internal medicine #Confidence interval #Pediatrics #Veterinary medicine #Pathology
paper · pdf · doi:10.1093/cid/ciw391
openalex publication_date 2016/06/16 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
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.