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Nutrients 2018, 10(10), 1420;

Stunting, Beyond Acute Diarrhoea: Giardia Duodenalis, in Cambodia

Institut Pasteur du Cambodge, Laboratory of Medical Biology, 5 Boulevard Monivong, P.O. Box 983, Phnom Penh 12100, Cambodia
United Nations Children’s Fund (UNICEF), Integrated Early Childhood Development, Exchange Square, 5th Floor, No. 19&20, Street 106, Sangkat Wat Phnom, Khan Daun Penh, Phnom Penh 12100, Cambodia
Independent consultant, Phnom Penh 12100, Cambodia
Institute of Research for Development (IRD), UMR Nutripass IRD-UM2-UM1, 3400 Montpellier, France
Author to whom correspondence should be addressed.
Received: 13 August 2018 / Revised: 12 September 2018 / Accepted: 13 September 2018 / Published: 3 October 2018
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Background: The adverse outcomes of malnutrition on the development of a child are well acknowledged as are the broad variety of contextual factors that may impact child nutritional status. Adequate nutrient intake and the adoption of appropriate water, sanitation and hygiene measures are largely documented for their positive influence on health. Improved sanitation and protection from human feces can significantly lower the incidence of diarrhea and environmental enteropathy. However, the impact of excessive exposure to animal feces on child health is less well documented. Objectives: This study tests the hypothesis that there is a positive association between exposure to animal feces, morbidity and anthropometric outcomes in children under 5 years of age, in Cambodia. It aims to improve insights that can contribute to discerning high-impact policies that promote children can develop to their full potential. Methods: Data for this study was drawn from the third follow-up round of the MyHealth project cohort study that is conducted in six districts of three Cambodian provinces (Phnom Penh, Kratie and Ratanak Kiri). The analysis included a sample of 639 children under 5 years of age. Results: The presence of livestock and more particularly, pigs near the main household dwelling was found a risk factor associated with Giardia duodenalis infection (23%). Giardia duodenalis infection was found to be a protective factor for acute diarrhea, yet, associated with stunting in the univariate model. Conclusions: Preventive measures that protect from extensive exposure to animal feces may be most effective to prevent infection with Giardia duodenalis and consequent stunting, thereby improving the potential for a healthy development in young Cambodian children. The results support the need for cross-sector policy measures that reinforce comprehensive early childhood interventions towards improving nutritional status as part of a wider set of child welfare and development measures. View Full-Text
Keywords: Giardia duodenalis; diarrhea; livestock ownership; feces; stunting Giardia duodenalis; diarrhea; livestock ownership; feces; stunting

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Caron, Y.; Hong, R.; Gauthier, L.; Laillou, A.; Wieringa, F.T.; Berger, J.; Poirot, E. Stunting, Beyond Acute Diarrhoea: Giardia Duodenalis, in Cambodia. Nutrients 2018, 10, 1420.

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