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Occurrence of Giardia lamblia in children in day care centers
Insights
Asymptomatic Giardia lamblia excretion is common in young children attending day care centers. This parasitic infection, often without symptoms, is well-tolerated in children under 36 months.
Area of Science:
- Pediatric Infectious Diseases
- Parasitology
- Public Health
Background:
- Giardia lamblia infections are a significant cause of pediatric gastrointestinal illness.
- Day care centers are known environments for the transmission of infectious agents among young children.
- Understanding Giardia excretion patterns in this setting is crucial for public health interventions.
Purpose of the Study:
- To prospectively evaluate Giardia lamblia excretion in children attending day care centers.
- To determine the prevalence and duration of Giardia infection in a pediatric population.
- To assess the relationship between Giardia excretion, age, duration of day care attendance, and clinical symptoms.
Main Methods:
- Conducted two prevalence studies involving 600 children across 30 day care centers.
- Performed an 18-month longitudinal study on 82 children in one day care center.
- Analyzed stool specimens for Giardia cysts and trophozoites, correlating findings with age, duration of attendance, and enteric symptoms.
Main Results:
- Giardia cysts were detected in 21% and 26% of children in prevalence studies; trophozoites in 4% and 3%.
- Infection prevalence was higher in children aged 13-30 months and those attending day care for over 3 months.
- Longitudinal study revealed 33% of children excreted cysts at least once; asymptomatic excretion was common and well-tolerated.
Conclusions:
- Asymptomatic Giardia lamblia excretion is prevalent in children under 36 months attending day care.
- Duration of day care attendance and age are significant factors associated with Giardia excretion.
- Giardia infection in this age group appears to be generally well-tolerated, with no significant impact on enteric symptoms or nutritional status.
Abstract:
We prospectively evaluated excretion of Giardia lamblia in children in day care centers in Houston by conducting two prevalence studies of 600 children enrolled in 30 DCC, day care centers, and an 18-month longitudinal study in 82 children in one center. In the two prevalence surveys, Giardia cysts were identified in 72 (21%) and 67 (26%) children, respectively, who provided stool specimens. Trophozoites were found in 15 (4%) and 8 (3%), respectively. There was no correlation between the frequency of recent diarrheal episodes and the finding of Giardia. Stool specimens containing cysts were significantly (P less than 0.0001) more frequent in the 13- to 30-month-old children than in children younger than 12 months. Children attending day care centers for more than 3 months were more likely to be excreting Giardia than those attending for less than 3 months. In the longitudinal study, cysts were detected in stool specimens from 27 (33%) of the 82 children at least once during the survey. Twelve children had Giardia cysts in weekly stool specimens for a mean of 6.2 +/- 1.2 months and trophozoites for 3.3 +/- 1.2 months. The number of enteric symptoms observed in children and the classification of nutritional status based on monthly height and weekly weight measurements did not differ significantly when infected and noninfected children were compared. Asymptomatic Giardia excretion in children younger than 36 months is common and appears to be well tolerated.