Asymptomatic Giardia infection and adverse nutritional outcomes among rural schoolchildren in Sana’a Governorate, Yemen

Abstract

Background and Aim: The association between infection with Giardia lamblia and malnutrition in school-age children is well documented. Because both conditions are common among Yemeni schoolchildren, this study aimed to determine the prevalence of Giardia infection and its associated factors and to assess its association with adverse nutritional outcomes among rural schoolchildren in Sana’a Governorate, Yemen.
Subjects and Methods: A school-based, cross-sectional study was conducted among 445 schoolchil-dren aged 6–15 years. Giardia lamblia and other intestinal protozoa were detected by microscopic examination of stool specimen sediments after concentration with the formal-ether technique. Sociodemographic, behavioral, and environmental data were collected using a structured questionnaire through face-to-face interviews, and nutritional status was assessed using anthropometric measurements. Univariate analysis was used to test the significance of the associations, and multivariable binary logistic regression was employed to identify the independent predictors of Giardia infection.
Results: Giardia infection was prevalent among 20.2% [95% confidence interval (CI): 16.6, 23.8] of schoolchil-dren.  Age 11 years (adjusted odds ratio [AOR] = 1.9, 95 % CI: 1.05, 3.31; textitp= 0.029), farmland ownership by children’s families (AOR = 2.4, 95% CI: 1.30, 4.34; p = 0.014), and not washing hands after playing with soil (AOR = 3.1, 95% CI: 1.05, 8.89; p = 0.047) were independent predictors of Giardia infection. In terms of adverse nutritional outcomes, Giardia infection was significantly associated with stunting among children aged 6–11 years (OR = 1.9, 95% CI: 1.10, 3.22; p = 0.022) but was not associated with wasting or underweight.

Conclusion: One in five rural schoolchildren in Sana’a Governorate is infected with G. lamblia. Younger age, not practicing handwashing after playing with soil, and belonging to families owning farmland can inde-pendently predict infection. Giardia infection is associated with stunting among schoolchildren. Therefore, improving the nutritional status of rural schoolchildren warrants the prevention and control of Giardia infection.