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Asymptomatic giardiasis in children
M Ish-Horowicz1, S H Korman, M Shapiro
1Department of Pediatrics, Hadassah University Hospital, Jerusalem, Israel.
Insights
Asymptomatic Giardia lamblia infections in young children attending daycare were common. These children showed no nutritional disadvantage and potentially better growth and fewer illnesses compared to uninfected peers.
Area of Science:
- Pediatric infectious diseases
- Gastroenterology
- Nutritional epidemiology
Background:
- Giardia lamblia is a common intestinal parasite affecting young children.
- Daycare settings facilitate parasite transmission among children.
- The clinical and nutritional impact of asymptomatic Giardia infection in this age group requires further elucidation.
Purpose of the Study:
- To investigate the prevalence and impact of Giardia lamblia infection in children attending a daycare center.
- To assess the association between asymptomatic Giardia infection and nutritional status, growth, and general health.
Main Methods:
- Monthly stool examinations were conducted for up to 12 months in 89 children (3 months to 3 years old).
- Nutritional status (height, weight) and hemoglobin levels were compared between infected and uninfected children.
- Lactase deficiency was assessed using breath hydrogen testing.
Main Results:
- Giardia lamblia infection was detected in 37% of the children, often asymptomatic with prolonged carriage.
- No significant differences in height, weight, or hemoglobin were observed between groups.
- Giardia-positive children showed a trend towards better weight and height for age and fewer gastrointestinal/respiratory symptoms.
- Lactase deficiency was more prevalent in Giardia-positive children (P < 0.02).
Conclusions:
- Asymptomatic Giardia lamblia infection in healthy daycare children does not appear to cause nutritional disadvantage.
- Children with asymptomatic Giardia infection may exhibit improved growth and reduced illness burden.
- Further research is warranted to understand the complex host-parasite interactions and potential benefits in specific contexts.
Abstract:
Giardia lamblia infection was identified in 33 of 89 (37%) 3-month-old to 3-yr-old children who were followed with monthly stool examinations for up to 12 months in a day care center. The infection was mainly asymptomatic and usually associated with prolonged carriage of the parasite. There were no significant differences for height and weight achievements and mean hemoglobin values between Giardia-positive and Giardia-negative children. However, Giardia-positive children tended to achieve higher weight and height for age than Giardia-negative children; weight for age was above the 50th percentile in 69% of Giardia-positive vs. 40% of Giardia-negative children (alpha = 0.01). Giardia-positive children tended to have fewer symptoms related to the gastrointestinal and respiratory tracts as recorded by a weekly questionnaire. Lactase deficiency was detected by breath hydrogen testing in 8 of 26 Giardia-positive vs. only 1 of 21 Giardia-negative children (P less than 0.02). Healthy day care children with asymptomatic Giardia infection show no disadvantage and perhaps even an advantage in nutritional status and freedom from other illnesses.