A new study co-authored by Sylvia Becker-Dreps, MD, MPH, Joan C. and Robert Huntley Professor of Family Medicine and Epidemiology and Director of the Office of Global Health Education, and Filemón Bucardo, PhD, a senior researcher at UNC-Chapel Hill, offers new insight into how a common intestinal parasite may affect children’s growth in early life.
Published in PLOS Neglected Tropical Diseases, the study followed children in a Nicaraguan birth cohort through their first three years of life to better understand how often Giardia infections occurred and whether those infections were linked to growth. In a subset of 76 children, investigators tested 2,305 stool samples and found that Giardia was common in the study population.
What stood out most was the connection between infection and growth. Children who had Giardia detected during the study had lower length-for-age scores at 36 months, and the effect was stronger among children with persistent or recurrent infections and those living in areas with higher infection rates.
The findings help move the conversation beyond diarrhea alone. While Giardia is often thought of as a short-term intestinal illness, this study suggests repeated exposure may have longer-term consequences for child development, especially during a critical window of growth.
The researchers also examined biomarkers to better understand what may be happening biologically. Children with Giardia detections showed signs consistent with damage to the intestinal lining and lower levels of a hormone involved in growth signaling, suggesting the parasite may interfere with healthy development even when classic signs of intestinal inflammation are not obvious.
For UNC Family Medicine, the publication reflects a long-standing commitment to global child health research and international collaboration. Both members of the UNC Institute for Global Health and Infectious Diseases, Becker-Dreps’ work focuses on childhood diarrhea, vaccines, nutrition, and neurodevelopment in low-resource settings, while Bucardo has spent decades studying infectious diseases of public health importance in Latin America.
The study also reflects the legacy of the UNC Program in Nicaragua, a long-running partnership with UNAN-León that supported research, training, and scientific exchange. That program was later dismantled amid the Nicaraguan government’s crackdown on independent institutions.
Today, Becker-Dreps’ research continues in rural Guatemala, where she is studying how young children develop immunity to norovirus and sapovirus. Bucardo continues his work at UNC-Chapel Hill, building on years of research that have deepened the understanding of child health in Central America.
Read the study here.