Table 2.
Risk Factors for First Giardia Detection in Monthly Surveillance Stool Samples Among 2088 Children in the MAL-ED Cohort With at Least 1 Surveillance Stool
| Risk Factor | Semi-Univariable (HR [95% CI])a | Multivariable (HR [95% CI])b |
|---|---|---|
| Child characteristics | ||
| Female (vs male) | 1.02 (0.89–1.16) | |
| Enrollment weight (per 1 z score) | 1.05 (0.98–1.12) | |
| Exclusively breastfed since birth | 0.67 (0.37–1.20) | |
| Percent days exclusively breastfed in last month (100% vs 0%) | 0.43 (0.27–0.70) | 0.46 (0.28–0.75) |
| WAZ (per 1 z score)c | 0.94 (0.88–1.00) | 0.97 (0.91–1.03) |
| LAZ (per 1 z score)c,d | 0.96 (0.89–1.03) | |
| WLZ (per 1 z score)c,d | 0.94 (0.88–1.00) | |
| Metronidazole used in previous 15 days | 0.69 (0.47–1.01) | 0.71 (0.48–1.04) |
| Metronidazole used in previous 16–30 days | 1.02 (0.73–1.42) | |
| Sociodemographic | ||
| Socioeconomic score (WAMI [27], per 0.5 unit) | 0.54 (0.42–0.69) | 0.74 (0.56–0.97) |
| Household income at or above site-specific median income | 0.79 (0.69–0.91) | |
| Maternal age (per 5 y) | 0.83 (0.75–0.93) | 0.86 (0.77–0.96) |
| Maternal education (≥6 y completed) | 0.74 (0.64–0.86) | |
| Mother married | 1.24 (0.95–1.60) | |
| Child has siblings | 1.36 (1.18–1.57) | 1.26 (1.09–1.46) |
| Mean no. of people per room in the household (per 1 unit) | 1.09 (1.04–1.16) | |
| Water | ||
| Improved (vs unimproved) drinking water [28] | 0.95 (0.72–1.25) | |
| Time to access water (>10 min) | 1.18 (0.97–1.44) | |
| Treated (vs untreated) water | 0.69 (0.54–0.88) | 0.78 (0.61–1.00) |
| Sanitation and hygiene | ||
| Improved (vs unimproved) sanitation [28] | 0.89 (0.71–1.10) | |
| Always washed hands after child defecated | 0.79 (0.71–0.89) | 0.80 (0.68–0.95) |
| Always washed hands before preparing food | 0.85 (0.77–0.95) | |
| Always washed hands after using toilet | 0.82 (0.73–0.92) | |
| Used toilet paper | 0.86 (0.76–0.98) | 0.95 (0.83–1.08) |
| Shared toilet facility | 1.10 (0.89–1.35) | |
| Environmental | ||
| Dirt floor | 1.34 (1.10–1.62) | 1.13 (0.92–1.38) |
| Household owned cows | 1.04 (0.80–1.35) | |
| Household owned chickens | 1.38 (1.12–1.70) | 1.35 (1.10–1.66) |
Abbreviations: CI, confidence interval; HR, hazard ratio; LAZ, length-for-age z score; WAMI, Water, Assets, Maternal Education, Income; WAZ, weight-for-age z score; WLZ, weight-for-length z score.
aAdjusted for site and age only (using restricted quadratic splines).
bAdjusted for site, age, and all other variables with estimates in this column (significant or strong association with Giardia detection in semi-univariable analysis, and not collinear with other variables).
cAt most recent measurement before stool collection.
dExcluding PKN.