Cross-sectional epidemiological investigations of Giardia lamblia in children in Pakistan

ABSTRACT BACKGROUND: The prevalence of Giardia lamblia in Pakistani children is currently unknown. The aim here was to evaluate the prevalence and risk factors of Giardia lamblia in children exhibiting diarrhea. DESIGN AND SETTING: Cross-sectional study at different district healthcare hospitals in Pakistan. METHODS: A total of 800 samples were collected from children aged 0-10 years. Information regarding personal data, demographic data and supposed risk factors was collected through a structured questionnaire. Giardia lamblia was detected through direct microscopy and antigens through the enzyme-linked immunosorbent assay (ELISA). RESULTS: The prevalence of Giardia lamblia was 2.75% through direct microscopy and inflated to 9.5% through ELISA. The demographic factors positively associated with occurrences of giardiasis were age (P = 0.035; odds ratio, OR = 1.96; 95% confidence interval, CI = 1.094-3.533), mother’s educational level (P = 0.031; OR = 2.67; 95% CI = 1.186-6.045) and father’s educational level (P = 0.004; OR = 3.56; 95% CI = 1.612-7.899). Similarly, among the supposed risk factors, rural residency (P = 0.032; OR = 1.76; 95% CI = 1.098- 2.851), absence of proper sewerage system (P = 0.000; OR = 6.60; 95% CI = 4.029-10.841) and unavailability of safe drinking water (P = 0.000; OR = 4.08; 95% CI = 2.207-7.547) were the factors strongly connected with giardiasis. Abdominal discomfort was a prominent clinical sign with 46% frequency. CONCLUSION: Various risk factors were associated with occurrences of Giardia, thus emphasizing the importance of parents’ education, safe drinking water and proper sewerage systems for Pakistani children’s health.

背景：目前巴基斯坦儿童蓝氏贾第鞭毛虫（Giardia lamblia）感染的流行率尚不明确。本研究旨在评估腹泻儿童蓝氏贾第鞭毛虫的感染流行率及其相关危险因素。
研究设计与实施场景：本研究为横断面研究，在巴基斯坦各地区的区级医疗医院开展。
方法：本研究共收集800份0至10岁儿童的样本。通过结构化问卷收集受试者的个人信息、人口学资料及潜在危险因素相关数据。采用直接镜检法检测蓝氏贾第鞭毛虫，通过酶联免疫吸附试验（ELISA）检测其特异性抗原。
结果：直接镜检法检出的蓝氏贾第鞭毛虫感染率为2.75%，经ELISA检测后感染率升至9.5%。与贾第虫病发病呈正相关的人口学因素包括年龄（P=0.035；优势比OR=1.96；95%置信区间CI=1.094~3.533）、母亲受教育程度（P=0.031；OR=2.67；95%CI=1.186~6.045）及父亲受教育程度（P=0.004；OR=3.56；95%CI=1.612~7.899）。同样，在潜在危险因素中，农村居住身份（P=0.032；OR=1.76；95%CI=1.098~2.851）、缺乏完善的排污系统（P=0.000；OR=6.60；95%CI=4.029~10.841）及无法获取安全饮用水（P=0.000；OR=4.08；95%CI=2.207~7.547）均为与贾第虫病密切相关的危险因素。腹部不适是最为显著的临床体征，出现频率达46%。
结论：多种危险因素与蓝氏贾第鞭毛虫感染相关，本研究结果凸显了加强家长健康教育、保障安全饮用水供应及完善排污系统对巴基斯坦儿童健康的重要意义。