Burden of Giardia duodenalis Infection and Its Adverse Effects on Growth of Schoolchildren in Rural Malaysia

Abstract

Background Giardia duodenalis infection and malnutrition are still considered as public health problems in many developing countries especially among children in rural communities. This study was carried out among Aboriginal (Orang Asli) primary schoolchildren in rural peninsular Malaysia to investigate the burden and the effects of Giardia infection on growth (weight and height) of the children.Methods/FindingsWeight and height of 374 children aged 7–12 years were assessed before and after treatment of Giardia infection. The children were screened for Giardia parasite using trichrome staining technique. Demographic and socioeconomic data were collected via face-to-face interviews using a pre-tested questionnaire. Overall, 22.2% (83/374) of the children were found to be infected with Giardia. Nutritional status of children was assessed and the results showed that the mean weight and height were 23.9 kg (95% CI = 23.3, 24.5) and 126.6 cm (95% CI = 125.6, 127.5), respectively. Overall, the prevalence of severe underweight, stunting and wasting were 28.3%, 23.8% and 21.0%, respectively. Multiple linear regression analyses showed sex, Giardia infection and household monthly income as the significant determinants of weight while sex and level of mother's education were the significant determinants of height. Weight and height were assessed at 3 and 6 months after treatment of Giardia infection. It was found that Giardia infection has a significant association with the weight of children but not with height.Conclusions/SignificanceThis study reveals high prevalence of Giardia infection and malnutrition among Aboriginal children in rural Malaysia and clearly highlights an urgent need to identify integrated measures to control these health problems in the rural communities. Essentially, proper attention should be given to the control of Giardia infection in Aboriginal communities as this constitutes one of the strategies to improve the nutritional status of Aboriginal children.

Age-dependent decline and association with stunting of Giardia duodenalis infection among schoolchildren in rural Huye district, Rwanda

“…This small and non-representative study is not suited to add to the discussion whether asymptomatic infections in highly endemic settings should be treated (Gilman et al, 1988;Sullivan et al, 1988;Prado et al, 2005;Veenemans et al, 2011). However, in accordance with recent data from Malaysia (Al-Mekhlafi et al, 2013) our results point to the problem of Giardia-associated growth impairment persisting into school age.…”

Prevalence and Risk Factors of Giardia lamblia and Blastocystis hominis Infections in Children Under Ten Years Old, Hamadan, Iran

“…Clinical picture in newborns and children varies from an asymptomatic infection to an acute infection or a chronic disease with sudden attack of watery diarrhea, abdominal cramps, malabsorption and weight loss. The prevalence is as high as 10% -50% in the developing countries (5). Blastocystis hominis, a common protozoan of large intestine, has two forms of cyst and trophozoite in its life cycle.…”

Giardia Alters Commensal Microbial Diversity throughout the Murine Gut

“…iardia lamblia is a microaerophilic protozoan parasite of humans and animals that causes significant morbidity and diarrheal disease worldwide (1,2). Giardiasis is a zoonotic disease with diverse animal reservoirs.…”

“…Over 200 million people are estimated to have acute or chronic giardiasis, and rates of giardiasis approach 90% in areas where it is endemic (3,4). When prevalent, giardiasis has been implicated as a primary cause of growth restriction for children, resulting in long-term consequences, such as stunting, failure to thrive, malnutrition, and cognitive disabilities (1,2,5). In addition, Giardia has been associated with substantial postclearance irritable bowel symptoms in both children and adults (1,(6)(7)(8).…”