ArticleJournal of the Pediatric Infectious Diseases Society2017
Determinants and Impact of Giardia Infection in the First 2 Years of Life in the MAL-ED Birth Cohort.
Article in Journal of the Pediatric Infectious Diseases Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers.
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Who cites it
101 citing papers in PubMed, 171 citations in OpenAlex.
- Associations between enteric pathogen carriage and height-for-age, weight-for-age and weight-for-height in children under 5 years old in urban Dhaka, Bangladesh.Epidemiology and infection · 2020Trial
- Giardia duodenalis infection in the context of a community-based deworming and water, sanitation and hygiene trial in Timor-Leste.Parasites & vectors · 2019Trial
- Effects of Water, Sanitation, Handwashing, and Nutritional Interventions on Child Enteric Protozoan Infections in Rural Bangladesh: A Cluster-Randomized Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Giardiavirus rewires host translation and glycolytic metabolism to support its replication inVirulence · 2026Article
- Pathogenicity and virulence ofVirulence · 2026Review
- Nitroimidazole - albendazole combination therapy, quinacrine use, and risk factors in nitroimidazole-refractory giardiasis: a prospective multicentre observational study.BMC infectious diseases · 2026Observational
- Natural history and impact of Giardia lamblia on child growth attainment and associated pathway-specific biomarkers in a Nicaraguan birth cohort.PLoS neglected tropical diseases · 2026Article
- Epidemiology and management of nitroimidazole-refractory giardiasis.Journal of travel medicine · 2026Article
- Maternal separation during breastfeeding as a risk factor for developing giardiasis: evaluation in a rodent model.Gut pathogens · 2026Article
- Prevalence of enteric pathogens in mothers and children from communities in the La Paz River Basin Bolivia; associations with water, sanitation, and hygiene conditions.Journal of water and health · 2026Article
- Updated Estimates of the Global, Regional and National Burden, and Etiology of Diarrheal Diseases Transmissible via Food: A Systematic Review and Meta-Analytical Modelling Study for the World Health Organization.medRxiv : the preprint server for health sciences · 2026Article
- Postinfectious Syndromes and Long-Term Sequelae after Giardia Infections.Emerging infectious diseases · 2025Review
- Natural history and impact ofmedRxiv : the preprint server for health sciences · 2025Article
- Giardia-induced Type 2 mucosal immunity attenuates intestinal inflammation caused by co-infection or colitis in mice.Nature microbiology · 2025Article
- Zoonotic and Environmental Sources of Infant Enteric Pathogen Infections Identified with Longitudinal Sampling.Environmental science & technology · 2025Article
- Giardia increases macrophage production of the anti-inflammatory cytokine interleukin-10 in response to lipopolysaccharide via macrophage galactose binding lectin.ImmunoHorizons · 2025Article
- Nitazoxanide Analogs: Synthesis, In Vitro Giardicidal Activity, and Effects onInternational journal of molecular sciences · 2025Article
- Review
- Giardiavirus infection alleviates growth restriction and intestinal damage caused by the intestinal parasite Giardia duodenalis.Parasites & vectors · 2025Article
- Occurrence and assemblage distribution of Giardia Duodenalis in symptomatic and asymptomatic patients in southeastern Iran (2019-2022).Gut pathogens · 2024Article
41 more citing papers are in PubMed but not listed here.
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Authors and funding
27 authors at 13 institutions in 10 countries.
Funding
Abstract
BACKGROUND.: Giardia are among the most common enteropathogens detected in children in low-resource settings. We describe here the epidemiology of infection with Giardia in the first 2 years of life in the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED), a multisite birth-cohort study. METHODS.: From 2089 children, 34916 stool samples collected during monthly surveillance and episodes of diarrhea were tested for Giardia using an enzyme immunoassay. We quantified the risk of Giardia detection, identified risk factors, and assessed the associations with micronutrients, markers of gut inflammation and permeability, diarrhea, and growth using multivariable linear regression. RESULTS.: The incidence of at least 1 Giardia detection varied according to site (range, 37.7%-96.4%) and was higher in the second year of life. Exclusive breastfeeding (HR for first Giardia detection in a monthly surveillance stool sample, 0.46 [95% confidence interval (CI), 0.28-0.75]), higher socioeconomic status (HR, 0.74 [95% CI, 0.56-0.97]), and recent metronidazole treatment (risk ratio for any surveillance stool detection, 0.69 [95% CI, 0.56-0.84]) were protective. Persistence of Giardia (consecutive detections) in the first 6 months of life was associated with reduced subsequent diarrheal rates in Naushahro Feroze, Pakistan but not at any other site. Giardia detection was also associated with an increased lactulose/mannitol ratio. Persistence of Giardia before 6 months of age was associated with a -0.29 (95% CI, -0.53 to -0.05) deficit in weight-for-age z score and -0.29 (95% CI, -0.64 to 0.07) deficit in length-for-age z score at 2 years. CONCLUSIONS.: Infection with Giardia occurred across epidemiological contexts, and repeated detections in 40% of the children suggest that persistent infections were common. Early persistent infection with Giardia, independent of diarrhea, might contribute to intestinal permeability and stunted growth.
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