# Prevalence and Risk Factors of Giardia intestinalis Infestation and Assemblage of Isolates Among Monastery Primary School Children in Yangon, Myanmar

## TL;DR

This study found a 11.7% Giardia intestinalis infection rate among primary school children in Yangon, Myanmar, with risk factors including poor sanitation and low parental education.

## Contribution

This is the first molecular-level study of Giardia intestinalis in a low-resource region of Myanmar.

## Key findings

- Giardia intestinalis was detected in 11.7% of 462 children.
- All isolates were identified as assemblage B.
- Risk factors included low parental education and poor sanitation practices.

## Abstract

Giardiasis is one of the major causes of diarrhea among children. To determine the prevalence, risk factors, and genotype of Giardia intestinalis, a cross-sectional descriptive study was done on stool samples of 462 children attending three monastery primary schools from North Okkalapa Township in Yangon, Myanmar from January 2016 to February 2019. Socioeconomic data were collected using a pre-tested questionnaire after obtaining informed consent. Direct wet mount, formalin-ether sedimentation, and trichrome staining techniques were used for the primary identification and then molecular identification was carried out by conventional polymerase chain reaction (PCR)-sequencing assay. G. intestinalis was identified in 11.7% (54/462) of students. There was no significant association with water source (p=0.948) and drinking untreated water (p=0.595). The infection was more common in children with low-educated parents, unsanitary garbage disposal practices, and no restrooms. All isolates were G. intestinalis assemblage B. This is the first study characterizing human isolates in a lower region of Myanmar, at the molecular level [MOU1]. These findings pointed out the high prevalence of G. intestinalis among primary school children from densely populated and low-resource settings.