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A longitudinal study of Giardia lamblia infection in north-east Brazilian children

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OBJECTIVE To evaluate the epidemiology of Giardia lamblia infection, investigate factors which might be associated with clinical manifestations and recurrence, and examine the role of copathogens in disease course.

METHODS Prospective 4-year cohort study of children born in an urban slum in north-eastern Brazil.

RESULTS Of 157 children followed for ≥ 3 months, 43 (27.4%) were infected with Giardia. The organism was identified in 8.8% of all stool specimens, and although found with similar frequency in non-diarrhoeal (7.4%) and diarrhoeal stools (9.7%), was more common in children with persistent (20.6%) than acute diarrhoea (7.6%, P=0.002). Recurrent or relapsing infections were common (46%). Children with symptomatic infections had significantly lower weight-for-age and height-for-age than asymptomatic children. Copathogens were not associated with disease course.

CONCLUSION With its protean clinical manifestations, Giardia may be associated with substantial morbidity amongst children in Brazil.

Keywords: Brazil; Giardia lamblia; asymptomatic; child; diarrhoea; malnutrition

Document Type: Research Article


Affiliations: 1: Department of Pediatrics, University of Washington School of Medicine, Seattle, USA 2: Division of Geographic and International Medicine, University of Virginia, Charlottesville, USA 3: Unidade Pesquisas Clinicas, Universidade Federal do CearĂ¡, Fortaleza, Brazil 4: Center for Vaccine Development, University of Maryland, Baltimore, USA 5: Divisions of Infectious Diseases and Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, USA

Publication date: 2001-08-01

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