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Article

Giardia intestinalis Is Unlikely To Be a Major Cause of the Poor Growth of Rural Gambian Infants

Peter G. Lunn^*1, Hezekioh O. Erinoso^*, Christine A. Northrop-Clewes and Stephen A. Boyce^*

^* M. R. C. Dunn Nutritional Laboratory, Downham's Lane, Milton Road, Cambridge CB4 1XJ, United Kingdom, and Keneba, The Gambia, and Human Nutrition Research Group, School of Biomedical Sciences, University of Ulster, Coleraine, BT52 1SA, Northern Ireland, United Kingdom

¹To whom correspondence should be addressed.

Parasite-specific plasma immunoglobulins have been used to indicate the presence of Giardia intestinalis infection in 60 infants living in a rural area of The Gambia. Infants were studied longitudinally between 2 and 8 mo of age. The median age for first exposure to G. intestinalis was between 3 and 4 mo, and by 8 mo all but 3 infants (95%) showed a positive titer on at least one occasion. Raised Giardia-specific IgM titers were associated with reduced weight gain in the 2 wk preceding a positive titer, but catch-up growth occurred in the following 2 wk. IgM antibody titers were also positively associated with intestinal permeability (lactulose/mannitol ratio), urinary lactose excretion, plasma concentrations of ₁-antichymotrypsin and total IgM, IgA and IgG immunoglobulins. However, infant growth over the whole 6-mo period (i.e., between 2 and 8 mo of age) was not related to mean Giardia-specific antibody titers, nor the time of first exposure to the parasite. The data suggest that giardiasis in these very young breast-fed children occurs as a mild, acute disease, and its presence could not explain the marked, long-term growth faltering observed in many of the subjects.

KEY WORDS: • giardiasis • intestinal parasite • Giardia antibodies • infant growth • The Gambia

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