Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct 3;10(10):1420.
doi: 10.3390/nu10101420.

Stunting, Beyond Acute Diarrhoea: Giardia Duodenalis, in Cambodia

Yannick Caron  1 , Rathmony Hong  2 , Ludovic Gauthier  3 , Arnaud Laillou  4 , Frank T Wieringa  5 , Jacques Berger  6 , Etienne Poirot  7
Affiliations

Stunting, Beyond Acute Diarrhoea: Giardia Duodenalis, in Cambodia

Yannick Caron et al. Nutrients. .

Abstract

Background: The adverse outcomes of malnutrition on the development of a child are well acknowledged as are the broad variety of contextual factors that may impact child nutritional status. Adequate nutrient intake and the adoption of appropriate water, sanitation and hygiene measures are largely documented for their positive influence on health. Improved sanitation and protection from human feces can significantly lower the incidence of diarrhea and environmental enteropathy. However, the impact of excessive exposure to animal feces on child health is less well documented.

Objectives: This study tests the hypothesis that there is a positive association between exposure to animal feces, morbidity and anthropometric outcomes in children under 5 years of age, in Cambodia. It aims to improve insights that can contribute to discerning high-impact policies that promote children can develop to their full potential.

Methods: Data for this study was drawn from the third follow-up round of the MyHealth project cohort study that is conducted in six districts of three Cambodian provinces (Phnom Penh, Kratie and Ratanak Kiri). The analysis included a sample of 639 children under 5 years of age.

Results: The presence of livestock and more particularly, pigs near the main household dwelling was found a risk factor associated with Giardia duodenalis infection (23%). Giardia duodenalis infection was found to be a protective factor for acute diarrhea, yet, associated with stunting in the univariate model.

Conclusions: Preventive measures that protect from extensive exposure to animal feces may be most effective to prevent infection with Giardia duodenalis and consequent stunting, thereby improving the potential for a healthy development in young Cambodian children. The results support the need for cross-sector policy measures that reinforce comprehensive early childhood interventions towards improving nutritional status as part of a wider set of child welfare and development measures.

Keywords: Giardia duodenalis; diarrhea; feces; livestock ownership; stunting.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The opinions and statements in this article are those of the authors and may not reflect official policies or opinion of the organizations that they belong.

Figures

Figure 1
Figure 1
(Left): Predicted probability of G. duodenalis infection by age. (Right): Average marginal effect of the giardia variable on acute diarrhea. Both, figures were estimated using the multivariate models presented respectively in Table 2 and Table 3. Shaded areas represent 95% CI (Confidence Interval).
See this image and copyright information in PMC

References

    1. Hoddinott J., Behrman J., Maluccio J., Melgar P., Quisumbing A., Ramirez-Zea M., Stein A., Yount K., Martorell R. Adult consequences of growth failure in early childhood. Am. J. Clin. Nutr. 2013;98:1170–1178. doi: 10.3945/ajcn.113.064584. - DOI - PMC - PubMed
    1. Horton S., Alderman H., Rivera J.A. Hunger and Malnutrition, Copenhagen Consensus 2008 Challenge Paper. Copenhagen Consensus Center; Tewksbury, MA, USA: 2008.
    1. UNICEF-WHO . Why Children Are Still Dying, and What Can Be Done? World Health Organization; Geneva, Switzerland: 2009.
    1. Dangour A., Watson L., Cumming O., Boisson S., Che Y., Velleman Y., Cavill S., Allen E., Uauy R. Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children. Cochrane Database Syst. Rev. 2013;8 doi: 10.1002/14651858.CD009382.pub2. - DOI - PMC - PubMed
    1. Save-the-Children, Ethiopia. The-Manoff-Group-Inc . Water, Hygiene and Sanitation (WASH) in Rural Households in Amhara, Oromia, SNNP and Tigray. United States Agency for International Development (USAID); Addis Ababa, Ethiopia: 2013.

MeSH terms