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PubMed1991

Prevalence and treatment of giardiasis in chronic diarrhoea and malnutrition.

To determine the prevalence of giardiasis in Gambian children with chronic diarrhoea and to assess their response to treatment, 31 children with chronic diarrhoea and malnutrition were investigated for giardiasis using a combination of serology (specific antigiardia IgM antibody) and microscopy of faeces and jejunal biopsy specimens. Fourteen of 31 children with chronic diarrhoea had giardiasis compared with only four of 33 healthy age and sex matched control children. Four of 15 malnourished children without diarrhoea were giardia positive. Twenty-three children with chronic diarrhoea were reinvestigated after treatment with metronidazole; giardia was found in 11 of them. These results show that giardia is highly prevalent in children with chronic diarrhoea and malnutrition and that the infection does not respond to standard therapeutic measures.

Animals↗
PubMedDate not supplied

Efficacy of a combined diloxanide furoate-metronidazole preparation in the treatment of amoebiasis and giardiasis.

A combined formulation of diloxanide furoate and metronidazole was used to treat amoebiasis and giardiasis (cysts and vegetative forms) in 54 patients. Of these 34 patients had amoebiasis, 19 had giardiasis and one had mixed infection. Each patient took one tablet (containing 500 mg diloxanide furoate and 400 mg metronidazole), three times daily for 5 days, and the response to therapy was checked by clinical examination and by examination of fresh stools on days 3, 5 and 10. Abdominal pain was completely relieved in 91% and 84% of patients with amoebiasis and giardiasis, respectively, while parasitic clearance was 100% in both groups. Tolerance to the drug was adequate.

Amebiasis↗
PubMed2006

A randomized, controlled, open-label trial of a single day of mebendazole versus a single dose of tinidazole in the treatment of giardiasis in children.

BACKGROUND: Giardia duodenalis is the most commonly detected parasite in the intestinal tract of humans and 5-nitroimidazole compounds, quinacrine and furazolidone have been used against giardiasis. However, cases refractory to treatment with these drugs are becoming more common worldwide. OBJECTIVE: To compare the efficacy and safety of mebendazole versus tinidazole in the treatment of giardiasis. RESEARCH DESIGN AND METHODS: 122 children (aged 5 to 15 years) of both sexes with confirmed Giardia duodenalis cysts or trophozoites in their stool samples were randomly separated into two groups of 61 individuals. Each group received either mebendazole 200 mg three times for 1 day or tinidazole 50 mg/kg in a single dose. The evaluation of the efficacy was based on parasitological response. Parents or legal guardians of each child were asked to provide three fecal samples on days 3, 5, and 7 after treatment completion. A child was considered to be cured if no Giardia trophozoites or cysts were found in any of the three post-treatment fecal specimens evaluated by direct wet mounts and/or after Ritchie concentration techniques. RESULTS: The frequency of cure was higher for tinidazole (81.97%) than for mebendazole (63.93%); the difference was statistically significant (p < 0.05). Transient abdominal pain was more common in children treated with mebendazole (p < 0.05), whereas loss of appetite, bitter taste, headache, vomiting, and nausea were more common in the tinidazole-treated group (p < 0.05). CONCLUSIONS: Three doses of mebendazole, in a single day, are inferior to a single dose tinidazole in the treatment of giardiasis.

Adolescent↗
PubMed2002

Giardiasis in children living in post-earthquake camps from Armenia (Colombia).

BACKGROUND: An earthquake in the coffee growing region of Colombia on January 25, 1999 destroyed 70% of the houses in Armenia city. Transitory housing camps still remained until two years after the disaster. Parasitological studies found that, in this population, giardiasis was the most frequent parasitic infection. This study was carried out in order to determine the epidemiological risk factors associated with this high prevalence. METHODS: Fecal samples were obtained from 217 children aged between 3 and 13 years. Stool samples were studied by direct wet examination and stained with ferric hematoxilin for microscopical examination. Epidemiological data were collected by questionnaire and analyzed by using the Epi-info software (CDC, Atlanta 2001). RESULTS: Giardia cysts were observed in 60.4% of the samples presented and trophozoites in 4.6%. The following epidemiological and laboratory factors were significantly associated with Giardia infection: 1. Use of communal toilet (vs. individual toilet) OR: 3.9, CI95%: 1.2-16; 2. water provision by municipal ducts (vs. water provision by individual tanks) OR: 3.5, CI95% 1.1-14, and 3. presence of mucus in stool OR: 2.3, IC95%: 0.9-6.7. CONCLUSIONS: A high prevalence of giardiasis was found in children living in temporary houses after the 1999 earthquake in Armenia (Colombia). Giardiasis is an emerging disease in post-disaster situations and adequate prevention measures should be implemented during these circumstances.

Adolescent↗
PubMed2001

Serum zinc and copper levels in southeastern Turkish children with giardiasis or amebiasis.

Alterations of serum zinc (Zn) and copper (Cu) concentrations are commonly found in patients suffering from gastrointestinal infections and with hepatic, renal, cardiovascular, and malignant diseases. In this study, the serum Zn and Cu levels in 20 children with giardiasis and in 40 children with amebiasis were evaluated. The serum Zn levels showed a significant decrease when compared to controls (p<0.001). After metronidazole therapy, a significant increase in Zn levels was observed (p<0.001). There was no significant difference in serum Cu levels between patients and controls before therapy. Before therapy, the serum Cu/Zn ratio in children with either giardiasis or amebiasis was significantly higher than that of the control group. After therapy, the Cu/Zn ratio was found to be back to normal. There were no significant differences in serum Zn levels and Cu/Zn ratios between children with and without diarrhea and there was no significant difference in children with or without failure to thrive. We concluded that Zn deficiency and elevated Cu/Zn ratio could be acute-phase responses to parasitic infections in children with giardiasis or amebiasis and that a successful treatment of the primary disorder will lead to complete recovery. Further studies are in progress to confirm the benefit of Zn supplementation during the acute phase of the disease, particularly in zinc-deficient regions of the world, such as in the case of Turkey.

Acute-Phase Reaction↗
PubMed1995

Giardiasis as a threat to backpackers in the United States: a survey of state health departments.

Forty-eight of the 50 state health departments in the United States responded to a questionnaire about giardiasis in their jurisdictions. The agencies had reports of 34348 cases during 1991 and studied 80 outbreaks in the same period. Nineteen of these outbreaks were attributed to consumption of contaminated drinking water; only two outbreaks were reported among individuals identified as campers or backpackers. Only two departments considered water-associated giardiasis to be a problem for backpackers in their jurisdiction, and neither had any data to support this concern. The surveillance data of health departments indicate that giardiasis is a common communicable disease in the United States. They do not, however, provide any evidence that wilderness water is an important cause of the disease in this country.

Camping↗
PubMedDate not supplied

[Giardiasis and helminthiasis in children of both public and private day-care centers and junior and high schools in the city of Mirassol, São Paulo State, Brazil].

This study showed different frequencies of intestinal parasitosis (giardiasis and helminthiasis) among children in day-care centers and junior and high schools (public and private). The survey involved 199 individuals, 96 belonging to public schools and 103 to private institutions. The frequency of giardiasis in public institutions was shown to be greater than in private institutions. Regarding helminthiasis, frequencies were similar among day-care centers, but greater for public schools in comparison to private institutions. When levels of socio-economic status, education, basic sanitary conditions and hygiene were analyzed as determinants of intestinal parasitosis, it became evident that greater frequency of giardiasis and helminthiasis occurred among children from low-income families and those whose parents had low levels of education. The source of vegetables was also a significant factor in determining such parasitosis.

Adolescent↗
PubMed1991

Endemic giardiasis and municipal water supply.

To test the hypothesis that endemic giardiasis may be transmitted by unfiltered municipal water supplies, the incidence of laboratory-confirmed giardiasis was studied in a natural experiment due to the arrangement of the public water supply of Dunedin, New Zealand. The incidence rate ratio was 3.3 (90% CI = 1.1, 10.1) for the population receiving unfiltered (microstrained) water relative to that using sand filtered water. In a parallel case-control study of incident cases, the odds ratio for giardiasis and unfiltered (microstrained) water supply was 1.8 (90% CI = 0.5, 6.9).

Adult↗
PubMed2003

Giardiasis: recent progress in chemotherapy and drug development.

Giardiasis is a protozoal disease infecting 200 million people throughout the world. Giardiasis is widespread primarily in developing countries. Infections are correlated with poor hygienic conditions, poor water quality control, and overcrowding. There are very few therapeutics currently available, and drug development to treat giardiasis is hampered mainly by socioeconomic obstacles. This article presents the history of antigiardial chemotherapy and current state of therapeutic availability along with the future prospectus of development of antigiardial agents. In addition to accumulated knowledge about the previous and current antigiardial drugs, advanced technologies including computer-aided drug design and combinatorial synthetic chemistry, as well as high throughput screening techniques, accelerate understanding of the disease and further research toward a suitable antigiardial agent.

Animals↗
PubMed1989

Furazolidone and metronidazole for treatment of giardiasis in children.

One hundred children were entered into a randomized study to compare the efficacy and safety of furazolidone and metronidazole when given in liquid suspension for treatment of giardiasis. The study was conducted between May 1985 and February 1986. Dosages were calculated on the basis of body weight, and treatment lasted 10 days. Clinical diagnosis of giardiasis was confirmed by the presence of Giardia cysts in stools. Children were excluded from the study if stool culture was positive for pathogenic bacteria. Eighteen of the 100 children were withdrawn from the study because of noncompliance with the protocol. Of the 82 remaining patients, 37 received furazolidone and 45 metronidazole. No statistically significant differences in efficacy between treatments were found. With the exception of one case of urticaria, which occurred in a patient who received metronidazole, both drugs were well tolerated. In this study, furazolidone and metronidazole were equally safe and effective in treating children with giardiasis.

Adolescent↗
PubMed1996

Alternative treatment protocols in giardiasis: a pilot study.

The aim of the study was to test new treatment protocols for giardiasis, which are less toxic, cheaper, and easier to use than the conventional treatment. 48 children who had been diagnosed as having giardiasis in a health-screening program involving 2 schools, were randomized to receive four different treatment protocols. The children were split into 4 treatment groups: I, mebendazole 100 mg t.i.d. for 1 day; II, mebendazole 100 mg t.i.d. for 7 days; III, metronidazole 15 mg/kg as one dose for 7 days; and IV, ornidazole 40 mg/kg as a single dose. The results were evaluated by microscopic examination of stools. The responses to the treatments revealed that the effectiveness of ornidazole was 100%, metronidazole 92.9%, mebendazole for 7 days 58.3%, and mebendazole for 1 day 41.7%. Minor side-effects were seen in only 3 children receiving ornidazole: 1 had urticaria, while the other 2 suffered from vertigo and nausea. The results of this study show that ornidazole as a single dose can be used as an alternative protocol for treating giardiasis. Further studies should be done to determine the safest effective total single dose.

Adolescent↗
PubMedDate not supplied

[Outbreak of giardiasis at a preschool children establishment in the town of Perm'].

In November 2000, an outbreak of Giardiasis intestinalis with aqueous transmission was recorded in one of the microdistricts of Perm. Thirty six children aged 1-7 years fell ill, 2 parasitic carriers were identified among the staff. The diagnosis was parasitologically verified in all children with clinical manifestations. Enzyme immunoassay was positive in 87.5% of the patients with the parasitologically verified diagnosis. The aqueous nature of the outbreak was confirmed by the detection of Lamblia cysts in the samples of water from the transfer network of the microdistrict in November 2000 and by the higher incidence of giardiasis among the microdistrict's residents since April 2000. Macmiror in age-specific doses was used to treat patients. The therapeutical efficiency of one course was 100%. If outbreaks of intestinal infections of unknown etiology occur, a parasitological survey should be made among patients and those who have contacted with them. Prolonged diarrhea was one of the major symptoms of giardiasis during an outbreak of this intestinal infection.

Animals↗
PubMedDate not supplied

[Ecdysten in the treatment of giardiasis].

The drug ecdisten as tablets is the natural compound ecdisteron was extracted from Rhaponticum carthamoides (Willd.) Jljin. Ecdisten was tested in the treatment of 32 and 3 patients with persistent and acute giardiasis, respectively. A ten-day course of ecdisten, 5 mg 3 or 4 times a day, resulted in a clinical and parasitological recovery in 22 (68.7%) and 3 patients, respectively. After the reuse of a ecdisten course in 4 patients with persistent giardiasis wherein its initial dose was increased, recovery was achieved in 3 cases, the efficacy of the agent was 78.1%. Ecdisten should be used to treat giardiasis, in its chronic pattern or resistance to conventional giardicial agents.

Administration, Oral↗
PubMed2002

Single-dose therapy for giardiasis in school-age children.

A randomized controlled trial was carried out to study the efficacy of combined albendazole and praziquantel in the treatment of giardiasis in school-age children. Eighty-four children were randomly allocated to 3 groups: group 1 (n = 31) albendazole 400 mg combined with praziquantel 20 mg/kg; group 2 (n = 26) albendazole 800 mg as a single dose; group 3 (n = 27) tinidazole 50 mg/kg as a single dose. The treatment was considered curative when Giardia was not found in two consecutive stool samples. The parasitological cure rate was 74.2% for combined single-dose albendazole-praziquantel, 50% and 92.6% in the albendazole and tinidazole groups respectively (p = 0.0023). There was no statistically significant difference between the cure rates of the combined regimen and tinidazole (p > 0.05). This combined regimen was considered safe, with only minor side-effects being observed. Of the single-dose regimens, tinidazole still achieves the highest parasitological cure rate for giardiasis. The albendazole-praziquantel combined regimen may be an alternative single-dose therapy for giardiasis in children, especially as this combination will eradicate common intestinal protozoa and co-existing helminths. Whether the dosage of this combination treatment should be adjusted for G. intestinalis remains to be established by further study.

Albendazole↗
PubMedDate not supplied

[Prevalence if giardiasis in Volgograd city population].

Analyzing many year's data on the prevalence of giardiasis among Volgograd dwellers indicated that the five-year infectivity index did not substantially change and it was 6.3 +/- 0.4%. The rate of Giardia lamblia isolation was higher in healthy individuals in the high-loaded environmental topodemic regions of the city than in those in the good ones. Over 50% of all the cases of giardiasis were recorded among 7-15-year-old children, the proportion of preschool children was much less (31.9%). The rate of giardiasis detection in children who went to children's preschool facilities was twice higher than that in the unorganized population. The focality index was 6.8%, which is indicative of the low contagiousness of the disease.

Adolescent↗
PubMed2004

A descriptive epidemiology of giardiasis in New Zealand and gaps in surveillance data.

INTRODUCTION: Giardia is the most commonly notified waterborne disease in New Zealand, which has high incidence rates compared with other developed countries. Four years of giardiasis notification data were analysed to describe the epidemiological patterns of infection in New Zealand and compared with local and international data. METHODS: Anonymised information was collected nationally for 7818 notified cases of giardiasis between July 1996 and June 2000. International data were collected from the data sources of respective countries. Infection rates adjusted for confounding factors were calculated and presented by age, gender, ethnicity, and area using statistical and spatial methods. RESULTS: Most cases occurred in the 1-4 year age group followed by the 25-44 year age group, and were of Pakeha/European ethnicity. Ethnicity was unknown for 18% of cases, thus affecting demographic calculations. Rates were elevated for several Health Districts in New Zealand (West Coast, Wellington, Waikato, Auckland, Hawke's Bay, Hutt, Rotorua, and Tauranga). CONCLUSIONS: The higher rates of giardiasis observed in New Zealand, in comparison with other developed countries, may be related to environmental or social factors. Time-trend analysis suggests a seasonal pattern. This study identified vulnerable groups and major data-gaps. Recommendations for improvements in disease surveillance and data quality are discussed. Geographical information system (GIS) applications are useful for disease monitoring.

Adolescent↗
PubMed2004

Human giardiasis as an etiology of skin allergy: the role of adhesion molecules and interleukin-6.

The role of adhesion molecules; the intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) as mediators in development of skin allergy caused by giardiasis and the controlling role of the cytokine interleukin (IL)-6 over these adhesion molecules were studied. The work included 25 symptomatic giardiasis patients with skin allergy manifested by diffuse urticaria, pruritus, wheal and erythema, and had positive serum anti-Giardia immunoglobulin (Ig) E measured as mean optical density (OD) value by enzyme linked immunosorbent assay (ELISA), employed as an evidence of allergic sensitization (G.I). They were compared with 30 symptomatic giardiasis patients (G.II) and 20 apparently healthy control subjects (G.III), both latter groups had negative serum anti-Giardia IgE. The mean OD value of anti-Giardia IgE was significantly increased in G.I (P < 0.01) & insignificantly different in GIII (P > 0.05) compared with G.III. Serum levels of soluble forms of adhesion molecules; sICAM-1 & sVCAM-1, and IL-6 were determined by ELISA. sICAM-1 & sVCAM-1 serum levels were significantly increased (P < 0.001) in G.I compared with G.III and showed insignificant difference (P > 0.05) between Gs. II & III. Serum IL-6 significantly increased in G.I (P < 0.001) & G.II (P < 0.05) compared with G.III, and was significantly higher (P < 0.001) in G.I than G.II. Serum IL-6 correlated positively with serum sICAM-1 (P < 0.01) and sVCAM-1 (P < 0.001) in G.I. The results are discussed.

Adult↗
PubMed2005

Effect of oral chronic intoxication with sodium arsenite on murine giardiasis.

Chronic exposure to toxicants alters immune function that can affect the ability of the host to mount a response to infection. Giardiasis is a gastrointestinal disease in which subtle alteration in immunity of the host can transform the normal acute infection into a chronic one. In this work we used a murine giardiasis model to evaluate the effect of chronic oral intoxication with sodium arsenite on the characteristics of giardiasis. BALB/c mice were intoxicated during 45 days with water containing 50, 125 or 250 microg/mL sodium arsenite. Each group was then inoculated with G. muris cysts. Cysts excreted in the feces were isolated and quantified. The toxic effect of arsenic on intestinal trophozoites was evaluated using G. lamblia trophozoites cultured in vitro with different arsenic concentrations, corresponding to equivalent concentrations of arsenic found in the gut lumen of intoxicated mice. Mice intoxicated with 125 and 250 microg/mL of sodium arsenite and infected with G. muris cysts displayed a shorter period of cysts excretion and were resistant to secondary infection with the parasite. In vitro studies showed that G. lamblia trophozoites were able to grow in presence of high sodium arsenite concentrations, suggesting the absence of a direct toxic effect on the parasite in the gut. Since a longer period of Giardia cysts excretion is associated with suppression of the immune system, the earlier clearance of primary G. muris infection in intoxicated mice suggests the induction of an immune modification that leads to an improved ability of mice to overcome the infection.

Animals↗