Prevalence of Giardia lamblia Infection Among Malnourished Children in Kirkuk City, Iraq: A Case–Control Study

Abstract

Background: Malnutrition and intestinal parasitic infections are major health problems among children under five years of age in developing countries. Giardia lamblia is a common protozoan parasite associated with diarrhea, malabsorption, and growth impairment.

Aim: To determine the prevalence of Giardia lamblia infection among malnourished children in Kirkuk City, Iraq, and to evaluate its association with demographic and environmental risk factors.

Methods: This hospital-based case–control study was conducted from February to December 2025 and included 240 children aged 2 months to 5 years (120 malnourished cases and 120 apparently healthy controls). Data were collected using a structured questionnaire, and anthropometric measurements were used to assess nutritional status. Stool samples were examined using the zinc sulfate concentration method for detection of Giardia lamblia. Statistical analysis was performed using chi-square test, with a p-value <0.05 considered statistically significant.

Results: The prevalence of Giardia lamblia infection was significantly higher among malnourished children compared to controls. The highest rate of infection was observed in children aged 25–36 months and among those living in rural areas. Significant associations were found between giardiasis and diarrhea, poor hygiene practices, unsafe drinking water, overcrowded living conditions, and low socioeconomic status (p<0.05).

Conclusion: Giardia lamblia infection is significantly associated with malnutrition among children in Kirkuk City. Improving sanitation, ensuring safe water supply, promoting health education, and early detection and treatment of parasitic infections are essential strategies to reduce the burden of malnutrition.