Could giardiasis be a risk factor for low zinc status in schoolchildren from northwestern Mexico? A cross-sectional study with longitudinal follow-up

Abstract

Background: Both giardiasis and zinc deficiency are serious health problems worldwide. In Mexico, the prevalence of G. intestinalis was estimated at 32% in 1994. It remains a health problem in northwestern Mexico. Recent surveys (1987, 1995, and 1999) reported zinc deficiency in the Mexican population. The association of giardiasis and malabsorption of micronutrients has been well documented, although the association with zinc remains controversial. This study investigated the association between giardiasis and zinc deficiency in schoolchildren from northwestern Mexico.

Methods: We combined a cross-sectional design with a longitudinal follow-up six months after parasite treatment. The baseline sample consisted of 114 schoolchildren (mean age 8.8 yr) from seven suburban public schools, grouped as Giardia-free (n = 65, 57%) and Giardia-infected (n = 49, 43%). Three stool analyses per child were done using Faust's method. Children with giardiasis received secnidazole. Serum zinc was determined by atomic absorption spectrophotometry. Height and weight were measured. Socioeconomic information was obtained in an oral questionnaire, and daily zinc intake was assessed using 24 hour-recalls. Pearson's correlation and ANCOVA and paired t-test analyses were used to determine the association between giardiasis and zinc status.

Results: Longitudinal analysis demonstrated a significant increase of the mean serum zinc levels in the Giardia-infected group six months after treatment (13.78 vs. 19.24 mumol/L mumol/L; p = 0.001), although no difference was found between the Giardia-free and the Giardia-infected groups (p = 0.86) in the baseline analysis. Z scores for W/A and H/A were lower in the Giardia-infected than in the Giardia-free group (p < 0.05). No difference was observed in the socioeconomic characteristics and mean daily intakes of zinc between the groups (p > 0.05).

Conclusions: Giardiasis may be a risk factor for zinc deficiency in schoolchildren from northwestern Mexico.

Figure 1

Comparison of the serum zinc levels between the Giardia-free (n = 65) and the Giardia-infected (n = 49) groups (cross-sectional analysis). A = 14.4 (1.4), *B = 13.8 (1.9), *Error Bars = (S.E.). * Non-adjusted geometric means. ** Adjusted ANCOVA (region, sex, age and intake of zinc).

Figure 2

Comparison of the serum zinc levels before (n = 49) and six months after treatment (n = 49) in the Giardia-infected schoolchildren (longitudinal analysis). A = 13.8 (1.9), *B = 19.2 (0.9), *Error Bars = (S.E.). * Non-adjusted geometric means. ** Adjusted ANCOVA (region, sex, age and intake of zinc).