title: Age-dependent decline and association with stunting of Giardia duodenalis infection among schoolchildren in rural Huye district, Rwanda.
abstract: Giardia duodenalis infection is highly prevalent and a cause of underweight in pre-school children in rural Rwanda. The present study aimed at assessing the age-pattern of Giardia infection and its manifestation in older children, i.e., during school age. Stool samples were collected from 622 schoolchildren at two schools in the Huye district of southern Rwanda (rural, 301; urban, 321) and subjected to G. duodenalis specific PCR assays. Clinical and anthropometric data, socio-economic status and factors potentially associated with G. duodenalis infection were assessed. Of the 622 children (mean age, 10.4 years), 35.7% were infected with G. duodenalis (rural, 43.9%; urban, 28.0%; P<0.0001). Only few indicators of low socio-economic status were found to be associated with infection. In rural but not urban schoolchildren, infection prevalence declined significantly with age. G. duodenalis infection more than doubled the odds of stunting in both rural (adjusted OR, 2.35 (95%CI, 1.25-4.41)) and urban children (adjusted OR, 2.27 (95%CI, 1.01-5.09)). In the study area of rural southern Rwanda, G. duodenalis prevalence among children declined throughout school-age. The data suggest that while lacking overt clinical manifestation at high endemicity, G. duodenalis infection is a common cause of stunting in schoolchildren.
authors: Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Jakob
authors: J
authors: Heimer
authors: Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Olga
authors: O
authors: Staudacher
authors: Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Florian
authors: F
authors: Steiner
authors: Faculty of Social Work, Catholic University of Rwanda, Huye, Rwanda.
authors: Yvette
authors: Y
authors: Kayonga
authors: University Teaching Hospital of Butare, University of Rwanda, Butare, Rwanda.
authors: Jean Marie
authors: JM
authors: Havugimana
authors: University Teaching Hospital of Butare, University of Rwanda, Butare, Rwanda.
authors: Andre
authors: A
authors: Musemakweri
authors: Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Gundel
authors: G
authors: Harms
authors: University Teaching Hospital of Butare, University of Rwanda, Butare, Rwanda.
authors: Jean-Bosco
authors: JB
authors: Gahutu
authors: Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. Electronic address: frank.mockenhaupt@charite.de.
authors: Frank P
authors: FP
authors: Mockenhaupt
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D000886:Anthropometry; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D016829:Giardia lamblia / Q000502:physiology*; D005873:Giardiasis / Q000453:epidemiology* / Q000469:parasitology*; D006130:Growth Disorders / Q000453:epidemiology* / Q000469:parasitology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012432:Rwanda / Q000453:epidemiology; D013334:Students / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Age distribution; Giardia; Rwanda; School; Stunting