Giardia duodenalis in Ugandan Children Aged 9–36 Months in Kampala, Uganda: Prevalence and Associated Factors

Giardia duodenalis is a common gastrointestinal pathogen globally that has been associated with growth failure in children. Most of the studies have been done in school-age children, and there is a paucity of data in preschool children. We determined the prevalence and factors associated with G. duodenalis infection in children aged 9–36 months presenting to Mulago Hospital with diarrhea or cough. Demographic and socio-economic characteristics, animal ownership, medical history, and physical examination findings were recorded. Stool was tested for G. duodenalis using real-time quantitative polymerase chain reaction (qPCR), and additional tests included stool microscopy and qPCR for Cryptosporidium. The overall prevalence of G. duodenalis infection was 6.7% (214/3,173). In children with diarrhea the prevalence was 6.9% (133/1,923), whereas it was 6.5% (81/1,250) in those with cough as the main symptom. Of 214 children with G. duodenalis infection, 19 (8.9%) were co-infected with Cryptosporidium. Older children (25–36 months) were more likely to have G. duodenalis infection (adjusted odds ratio [aOR]: 2.93, 95% CI: 1.93–4.43). Use of an unimproved toilet (aOR: 1.38, 95% CI: 1.04–1.83) and the wet season (aOR: 1.33, 95% CI: 1.00–1.77) were associated with increased infection. Other factors associated with infection were recurrent diarrhea (aOR: 2.46, 95% CI: 1.64–3.70) and passing of mucoid stool (aOR: 2.25, 95% CI: 1.08–4.66). Having a ruminant at the homestead was also associated with infection (aOR: 1.83, 95% CI: 1.20–2.79). Giardia duodenalis infection occurred in 1 of 15 children aged 9–36 months with diarrhea or cough in Kampala, Uganda. Further studies are needed to clarify the zoonotic significance of G. duodenalis infection in this setting.