Prevalence and associated risk factors for Giardia lamblia infection among children hospitalized for diarrhea in Goiânia, Goiás State, Brazil

Abstract

The objective of this study was to determine the prevalence and to identify risk factors associated with Giardia lamblia infection in diarrheic children hospitalized for diarrhea in Goiânia, State of Goiás, Brazil. A cross-sectional study was conducted and a comprehensive questionnaire was administered to the child's primary custodian. Fixed effects logistic regression was used to determine the association between infection status for G. lamblia and host, sociodemographic, environmental and zoonotic risk factors. A total of 445 fecal samples were collected and processed by the DFA methodology, and G. lamblia cysts were present in the feces of 44 diarrheic children (9.9%). A variety of factors were found to be associated with giardiasis in these population: age of children (OR, 1.18; 90% CI, 1.0 - 1.36; p = 0.052), number of children in the household (OR 1.45; 90% CI, 1.13 - 1.86; p = 0.015), number of cats in the household (OR, 1.26; 90% CI, 1.03 -1.53; p = 0.059), food hygiene (OR, 2.9; 90% CI, 1.34 - 6.43; p = 0.024), day-care centers attendance (OR, 2.3; 90% CI, 1.20 - 4.36; p = 0.034), living on a rural farm within the past six months prior hospitalization (OR, 5.4; CI 90%, 1.5 - 20.1; p = 0.03) and the number of household adults (OR, 0.59; 90% CI, 0.42 - 0.83; p = 0.012). Such factors appropriately managed may help to reduce the annual incidence of this protozoal infection in the studied population.

High occurrence of giardiasis in children living on a 'landless farm workers' settlement in Araras, São Paulo, Brazil

“…This study was based on a sample from an underprivileged population in which a high prevalence of giardiasis was largely observed when compared to studies done in other cities in Brazil 4,5,[7][8][9][10][11][12][13][16][17][18][19] . It is part of an "Extension Project to the Community" where two undergraduate students voluntarily worked on weekends, trying to make the community aware of the importance of health care.…”

Classic and molecular study of Giardia duodenalis in children from a daycare center in the region of Presidente Prudente, São Paulo, Brazil

“…E. vermicularis expels embryonic eggs that may be transmitted directly by fecal-oral ways, what can explain its high prevalence among children in this study. Similar levels of giardiasis prevalence among children have been reported 17 , but in that case the assessments were made in children that were attended in a hospital in Goiânia, Goiás State, Brazil, due to diarrhea.…”

“…Although giardiasis is related to age and social-economical level 11 , other risk factors for infection have been identified, such as presence of pets at home, specially cats, number of children at home, food hygiene, daycare centers attendance, and living on rural areas 17 . The occurrence of children presenting G. duodenalis that had pets at home was low, and in no one case pets were suspect to be the source of contamination, given that they did not present G. duodenalis cysts.…”

“…Giardia infections are more common in children, with prevalence levels around 20% in some Brazilian regions 17 . This is one of the most frequent parasitosis in developing countries 18 , with great occurrence in daycare centers and orphanage due to its direct transmission way.…”

Children's Environment in Brazil: From Domestic (Indoor) to Regional Threats

“…The association between the prevalence of intestinal parasitic diseases with socioeconomic and environmental factors was reported in the most of researches like: children from slums [71] or residing in townships with a low HDI in the N and NE regions, especially in rural areas [74]; households with no proper waste management and no solid residue collection [78]; the unhealthy condition to which this population is subjected [72,87], with a direct relationship with low maternal schooling [81,95] and low income family [80,[85][86][87][88][89][90][91]95]. The higher prevalence of Ascaris lumbricoides, Giardia duodenalis, Trichuris trichiura and hookworm infections in children living in contaminated environments [75,90,92,93] with inadequate daily caloric intake [94] may result in hospitalizations due to diarrheal disease [79], compromising their future anthropometric status [76,94].…”