title: Reduced prevalence of Giardia duodenalis in iron-deficient Rwandan children.
abstract: OBJECTIVE
  Acute symptomatic infection with Giardia duodenalis impairs iron absorption, but iron deficiency may protect against infections caused by various micro-organisms including parasites. We therefore examined the association of G. duodenalis infection and iron deficiency in 575 Rwandan children under 5 years of age.
  
  
  METHODS
  Giardia duodenalis infection was diagnosed by triplicate microscopy and PCR assays, and iron deficiency was defined as a ferritin concentration <12 ng/ml.
  
  
  RESULTS
  Largely asymptomatic G. duodenalis infection was seen in 65.3% of the children and iron deficiency in 17.4%. G. duodenalis infection was less common in iron-deficient children (51%) than in non-deficient children (68%, P = 0.002). In multivariate analysis, the odds of G. duodenalis infection were almost halved in iron-deficient children (adjusted odds ratio, 0.54; 95% confidence interval, 0.33-0.86).
  
  
  CONCLUSIONS
  In this highly endemic setting, there was no evidence that Giardia infection impairs iron status. Rather, iron deficiency appeared to protect against infection with this parasite.
authors.affiliation: Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Danquah
authors.forename: Jean-Bosco
authors.initials: JB
authors.lastname: Gahutu
authors.forename: Ralf
authors.initials: R
authors.lastname: Ignatius
authors.forename: Andre
authors.initials: A
authors.lastname: Musemakweri
authors.forename: Frank P
authors.initials: FP
authors.lastname: Mockenhaupt
mesh_terms: D017677:Age Distribution; D002097:C-Reactive Protein; D015362:Child Nutrition Disorders / Q000097:blood / Q000453:epidemiology*; D002675:Child, Preschool; D016000:Cluster Analysis; D015897:Comorbidity; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005293:Ferritins / Q000097:blood; D016829:Giardia lamblia; D005873:Giardiasis / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D016017:Odds Ratio; D016133:Polymerase Chain Reaction / Q000379:methods; D015995:Prevalence; D012432:Rwanda / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron
keywords: Giardia duodenalis; Rwanda; ferritin; iron deficiency