Giardiasis in pediatric populations: A case series highlighting nutritional and growth impacts

Giardiasis, a common cause of parasitic diarrhea, is caused by the protozoan parasite Giardia lamblia (Giardia intestinalis or Giardia duodenalis). This intestinal flagellate protozoan is prevalent among children worldwide and is a significant source of traveller's diarrhea. It is estimated that there are about 2.5 million cases of giardiasis-related diarrhea and nutritional deficits in children every year, with the majority occurring in developing countries. Since 2004, the World Health Organization has classified it as one of the neglected tropical diseases. Those most at risk for complications from giardiasis are children aged 1-5 years and undernourished individuals in developing countries who may experience malabsorption, weight loss, and growth retardation. The prevalence rates are expected to be around 2%-5% in developed countries and significantly higher at 20%-30% in developing countries. Here, we report the case series of seven pediatric children with various clinical presentations with failure to gain weight and abdominal pain being the most common among all the cases ultimately presenting with long-term sequelae like malnutrition and growth retardation. This case series underscores the importance of considering giardiasis in the differential diagnosis of pediatric patients presenting with growth retardation and gastrointestinal symptoms, particularly in endemic areas. Early diagnosis and appropriate treatment are crucial in mitigating the long-term health impacts of this neglected tropical disease.