Natural history of Giardia infection of infants and children in rural Guatemala and its impact on physical growth.

Longitudinal data on Giardia excretion, diarrheal disease, and physical growth during the first 3 yr of life collected more than 20 yr ago in 45 Guatemalan children were analyzed. This report describes the natural history of this infection and estimates its effects on growth. All children had at least one Giardia infection, prevalence and incidence rates reaching 20.2% and 5.3%, respectively by the end of the third year. The mean number of Giardia infections per child increased from 0.7 in the first to 3.6 in the third year. More than 40% of these infections lasted 2-6 wk or more and were commonly associated with diarrhea. Weight velocity was significantly lower in the second year of life in Giardia-infected than in Giardia-negative children (p = 0.03). The duration of Giardia episodes and their association with diarrhea appeared to be the most important factors associated with growth disturbance. Although simultaneous infection with other enteropathogens occurred in many children, our findings suggest that Giardia infection may have independent deleterious effects on children's growth.