{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:56:25Z","timestamp":1792068985845,"version":"4.4.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011687","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000}}],"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-002050"],"award-info":[{"award-number":["INV-002050"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p><jats:italic>Entamoeba histolytica<\/jats:italic>, <jats:italic>Giardia<\/jats:italic>, and <jats:italic>Cryptosporidium<\/jats:italic> are common intestinal protozoan parasites that contribute to a high burden of childhood morbidity and mortality. Our study quantified the association between intestinal protozoan parasites and child anthropometric outcomes among children under-5.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We analyzed data from 7,800 children enrolled in the Global Enteric Multicenter Study (GEMS) across seven study sites that were positive for intestinal protozoan parasites between December 2007 and March 2011. Parasites were assessed using stool immunoassays (ELISA). We applied multiple linear regression to test the association between any or concurrent parasite and child anthropometric outcomes: length\/height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length\/height (WHZ) z-score after 60 days of enrollment. Models were stratified by diarrheal symptoms, driven by the study design, and adjusted for potential covariates.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Findings<\/jats:title>\n<jats:p>During the follow-up at day 60 after enrollment, child anthropometric outcomes, among the asymptomatic children showed, negative associations between <jats:italic>Giardia<\/jats:italic> with HAZ [\u03b2: -0.13; 95% CI: -0.17, -0.09; p&lt;0.001] and WAZ [\u03b2 -0.07; 95% CI: -0.11, -0.04; p&lt;0.001], but not WHZ [\u03b2: -0.02; 95% CI:-0.06, 0.02; p = 0.36]; <jats:italic>Cryptosporidium<\/jats:italic> with WAZ [\u03b2: -0.15; 95% CI: -0.22, -0.09; p&lt;0.001] and WHZ [\u03b2: -0.18; 95%CI: -0.25, -0.12; p&lt;0.001], but not with HAZ [\u03b2: -0.03; 95% CI: -0.09, 0.04; p = 0.40]. For symptomatic children, no associations were found between <jats:italic>Giardia<\/jats:italic> and anthropometry; negative associations were found between <jats:italic>Cryptosporidium<\/jats:italic> with HAZ [\u03b2: -0.17; 95% CI: -0.23, -0.11; p&lt;0.001], WAZ [\u03b2: -0.25; 95% CI: -0.31, -0.19; p&lt;0.001] and WHZ [\u03b2: -0.23; 95% CI: -0.30, -0.17; p&lt;0.001]. Among the asymptomatic 24\u201359 months children, <jats:italic>Giardia<\/jats:italic> had a negative association with HAZ [\u03b2: -0.09; 95% CI: -0.15, -0.04; p = 0.001]. No significant associations were found between <jats:italic>E<\/jats:italic>. <jats:italic>histolytica<\/jats:italic> with child growth.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>While some studies have found that <jats:italic>Giardia<\/jats:italic> is not associated with (or protective against) acute diarrhea, our findings suggest that it is associated with growth shortfall. This observation underscores the need for preventive strategies targeting enteric protozoan parasites among young children, to reduce the burden of childhood malnutrition.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011687","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T17:46:42Z","timestamp":1696960002000},"page":"e0011687","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":28,"title":["Symptomatic and asymptomatic enteric protozoan parasitic infection and their association with subsequent growth parameters in under five children in South Asia and sub-Saharan Africa"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7499-7278","authenticated-orcid":true,"given":"Rina","family":"Das","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Palit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. 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