title: Impact of anti-Giardia and anthelminthic treatment on infant growth and intestinal permeability in rural Bangladesh: a randomised double-blind controlled study.
abstract: In order to test the impact of Giardia and geohelminthic infection on infant growth faltering in Bangladesh, a randomised double-blind placebo controlled intervention of 36 weeks' duration was conducted in a rural community located 40 km northwest of Dhaka. Infants aged between 3 and 15 months were randomly assigned to either anti-Giardia and anthelminthic treatment, anti-Giardia treatment only, or a control. Weight and supine length were recorded every 4 weeks. Every 12 weeks intestinal permeability (lactulose/mannitol ratio), haemoglobin, plasma albumin, alpha-1-acid glycoprotein, IgG and Giardia-specific IgM (GSIgM) and eggs of the three common geohelminths and G. intestinalis cysts were determined. Data on 222 fully compliant infants were analysed. No significant differences in intestinal permeability, biochemical or anthropometric variables were found between the intervention groups, although there were associations between improvement in small intestinal mucosal function and better weight-for-age and weight-for-height (length) Z-scores. GSIgM titres indicated high endemicity with rapid re-infection of Giardia among infants; over 95% of infants were positive throughout the study, whereas the stool examination showed very few infants with either geohelminth eggs or Giardia cysts.
authors.affiliation: Department of Biological Anthropology, University of Cambridge, Cambridge, UK. rg277@cam.ac.uk
authors.forename: Rie
authors.initials: R
authors.lastname: Goto
authors.forename: C G Nicholas
authors.initials: CG
authors.lastname: Mascie-Taylor
authors.forename: Peter G
authors.initials: PG
authors.lastname: Lunn
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D000886:Anthropometry; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D001459:Bangladesh; D001942:Breast Feeding / Q000706:statistics & numerical data; D004311:Double-Blind Method; D005260:Female; D005873:Giardiasis / Q000150:complications / Q000188:drug therapy*; D006128:Growth; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000469:parasitology; D008137:Longitudinal Studies; D008297:Male; D008795:Metronidazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D009035:Mothers / Q000193:education
chemical_list: D000871:Anthelmintics; D000981:Antiprotozoal Agents; D008795:Metronidazole; D015766:Albendazole; C016724:secnidazole