Longitudinal study of young children in Kenya: intestinal parasitic infection with special reference to Giardia lamblia, its prevalence, incidence and duration, and its association with diarrhoea and with other parasites.

84 young children from a rural community, Nderu, in Kenya, were each followed for up to 10 months, from January to November 1987. Their ages ranged from 10 to 28 months over the period of study. Stools were obtained once a week, as were reports from the mothers about presence of abdominal complaints, including diarrhoea. A total of 2258 stools and 1873 reports were collected. 9 parasites were commonly encountered of which Giardia lamblia was the most frequent at 44.7%. The overall estimated number of new Giardia episodes per year per child was 2.77 +/- 2.22 SD and the mean estimated duration of infection was 75.25 +/- 73.84 SD days per child. The mean proportion of positive visits per child was 0.42 +/- 0.25 SD. Giardia trophozoites, Trichomonas hominis, Chilomastix mesnili, Entamoeba histolytica, Blastocystis hominis and Hymenolepis nana were all significantly associated with unformed stools and reports of diarrhoea. There was a significant probability of finding Giardia in stool within +/- 2 weeks of a report of diarrhoea. Poly-parasitism was common and several paired associations were significantly positive, particularly between species of amoebae. Quantity of Giardia in stool (expressed as a 0 to 5+ score) was suppressed both by type and number of other parasites present.