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PubMed1995

Effects of giardiasis on production in a domestic ruminant (lamb) model.

OBJECTIVE: To examine the effects of giardiasis on production and carcass quality, using growing lambs as a domestic ruminant model. DESIGN: Randomized block. ANIMALS: Giardia-free lambs: 23 in infected group, 24 in control group. PROCEDURE: Six-week-old, specific-pathogen-free lambs were infected with Giardia trophozoites; control lambs received saline solution. Clinical signs of infection, body weight, and feed intake were determined for 10 weeks. Carcass weight and quality were determined at slaughter weight of 45 kg. RESULTS: Giardia infection persisted from weeks 7 to 16. For 5 weeks after challenge exposure, abnormal feces were more frequently observed in infected lambs. Giardia infection was associated with a decrease in rate of weight gain and impairment in feed efficiency. Time to reach slaughter weight was extended in infected lambs, and the carcass weight of Giardia-infected lambs was lower than that of control lambs. CONCLUSION: Giardiasis has a negative effect on domestic ruminant production. CLINICAL RELEVANCE: Giardiasis in domestic ruminants is an economically important disease, thus necessitating control or elimination of the infection.

Analysis of Variance↗
PubMedDate not supplied

Determinants of symptomatic giardiasis in childhood.

Giardia has been frequently implicated as a causative agent for acute as well as chronic diarrheal diseases in children. The present study was aimed at exploring the determinants of manifestations of Giardiasis in childhood, in relation to various host and parasite related factors. A total of 200 children with acute (100), chronic (50) or without (50) diarrhea in last 15 days were recruited for the study and evaluated with regards to nutritional status, serum immunoglobulins, secretory IgA levels, presence of Giardia in stool/duodenal aspirate/duodenal biopsy specimen and for associated infections. Lysates from acute giardiasis cases were further studied for zymodeme (banding) pattern. After correlation of all investigations, humoral immune defect in the host was found to be the major determinant of whether the Giardial infestation would be symptomatic or not, while associated bacterial infections and zymodeme patterns were not found to be important in determining the pathogenicity or presentation of giardiasis.

Animals↗
PubMed1996

[Giardiasis].

Giardiasis is a cosmopolitan parasitic disease. About 10% of adults and 20% of children in Poland is infected with Giardia lamblia but only a few per cent of cases is symptomatic. Incidence and symptomatology depend upon a number of factors including individual susceptibility. The disease is usually chronic and recurrent and acute form is found in rare cases only. Giardiasis should be suspected in patients with chronic atypical symptoms related to the alimentary tract. Nitroimidasolic compounds are used in the treatment of giardiasis.

Adult↗
PubMed2005

Treatment of Giardiasis.

Tinidazole is the first-line drug treatment of giardiasis, as it requires only a single dose to cure infection in most individuals. The related drug metronidazole is as effective, but it requires 5 to 7 days of three times a day therapy. Nitazoxanide appears in limited studies to be as effective as tinidazole or metronidazole, and it does not have the bitter taste of nitroimidazoles. A good alternate for use during pregnancy is paromomycin. Cure of infection varies between 60% and 100% with one course of treatment. Less effective and/or less well-tolerated drugs for the treatment of giardiasis include albendazole, quinacrine, and furazolidone; the use of these agents should be reserved for giardiasis refractory to treatment with the first-line agents.

Journal Article↗
PubMed1997

Evaluation of Secnidazole Gel and Tinidazole Suspension in the Treatment of Giardiasis in Children.

Giardiasis is a cosmopolitan parasitosis. Diarrhea, abdominal colic, and flatulence are the main clinical symptoms, however, malabsorption, and impairment of growth of children may occur. The 5-nitroimidazoles are the drugs of choice in the treatment of giardiasis. Methods: The efficacy and tolerability of secnidazole and tinidazole were evaluated in a randomized, open-label, clinical trial performed with 267 Giardia lamblia-positive children. Secnidazole, in a new gel formulation, and tinidazole suspension were prescribed as single oral doses of 30mg/kg and 50mg/kg, respectively. Clinical and parasitological follow-up was carried out before, and at 7, 14, and 21 days after treatment. Results: Clinical cure was observed in 77.3% and 75.7% of the patients in the secnidazole and tinidazole groups, respectively. Parasitological cure was obtained in the 91.3% and 89.6% in the secnidazole and tinidazole groups, respectively. A metallic taste after drug ingestion was more commonly reported in the tinidazole group than in the secnidazole group (p<0.05). Conclusions: The authors conclude that both secnidazole gel and tinidazole administered as a single oral dose are effective treatments for children with giardiasis since both high cure rates and good tolerability were observed.

Journal Article↗
PubMed1981

Furazolidone and quinacrine. Comparative study of therapy for giardiasis in children.

Furazolidone and quinacrine hydrochloride were compared for efficacy, toxicity, and ease of administration in 45 young children with giardiasis. With the initial course of therapy, the cure rate was 89% (17/19) with furazolidone and with quinacrine it was 64% (9/14) in children less than 5 years and 92% (11/12) in older children. Cure rates for all courses of therapy were 92% (24/26) with furazolidone and 53% (9/17) and 92% (12/13) in the younger and older children, respectively, treated with quinacrine. Quinacrine failure was usually due to severe vomiting. When re-treated with furazolidone, patients were cured. The disadvantages of furazolidone are the large volume of doses and the expense. In this study, furazolidone was more effective and better tolerated than quinacrine for the treatment of giardiasis.

Adolescent↗
PubMed1983

Giardiasis causing urticaria in a child.

We report an association between giardiasis and chronic urticaria and review the few previous cases in the literature. An unusual aspect of our case was the intensification of the urticarial response with antiprotozoal chemotherapy. We discuss the clinical features in terms of the limited current knowledge concerning immunologic mechanisms in giardiasis and the antigenic structure of Giardia lamblia.

Child, Preschool↗
PubMed1987

Giardiasis in childhood: an unnecessarily expensive diagnosis.

In 70 patients with proven giardiasis the efficacy and cost-effectiveness of the diagnostic procedure were studied retrospectively. In 53% of the patients, complaints existed for more than 6 months. Parasitological examination of three stool specimens on non-consecutive days showed a sensitivity of 95.7%. The false negative rate was 2.8%, as giardiasis was found in 3 out of 109 patients in whom duodenal biopsy was performed after a negative "triple faecal test". Of other laboratory investigations performed before the results of faecal screening were known, 75% gave normal results, thus not contributing to the diagnosis. A proposal for a cost-effective diagnostic procedure is presented.

Adolescent↗
PubMed1993

Secretin-cerulein test and fecal chymotrypsin concentration in children with intestinal giardiasis.

We studied six patients with giardiasis (five males, one female), median age 3.5 yr (range 1-11) and 12 healthy control subjects (10 males, 2 females), median age 3.5 yr (range 1-10). Intestinal biopsy and a contemporaneous secretin-cerulein test were performed in all patients, and fecal chymotrypsin was also assayed. Intestinal biopsy was normal in five of the six patients with giardiasis, whereas one of the six presented a partial atrophy of the intestinal villi. The secretin-cerulein test (1 CU/kg of secretin + 75 ng/kg of cerulein) did not show any significant difference between values in the outputs of chymotrypsin, lipase, phospholipase, and bicarbonate obtained in patients and in controls; however, in the one patient with partial intestinal mucosal atrophy, all enzymatic activity levels were below the normal limit for our laboratory. Furthermore, the mean values of fecal chymotrypsin concentration did not differ between the two groups. Fecal chymotrypsin was also reduced in the patient with an abnormal secretin-cerulein test; a second assay performed 3 mo after the suspension of treatment (Metronidazole), however, showed a normal chymotrypsin concentration.

Ceruletide↗
PubMed2004

[Parasitic zoonoses transmitted by drinking water. Giardiasis and cryptosporidiosis].

Nowadays, the parasitic zoonose organisms Giardia lamblia und Cryptosporidium spp. are among the most relevant pathogens of drinking water-associated disease outbreaks. These pathogens are transmitted via a fecal-oral route; in both cases the dose of infection is low. Apart from person-to-person or animal-to-person transmissions, the consumption of contaminated food and water are further modes of transmission. The disease is mainly characterized by gastrointestinal symptoms. In industrialized countries, the prevalence rate of giardiasis is 2-5 % and of cryptosporidiosis 1-3%. Throughout the world, a large number of giardiasis and cryptosporidiosis outbreaks associated with drinking water were published; in 2001 the first case in Germany was identified. Giardia and Cryptosporidium are detected in surface water and sporadically in unprotected groundwater. Use of these waters for drinking water abstraction makes high demands on the technology of the treatment process: because of the disinfectant resistance of the parasites, safe elimination methods are needed, which even at high contamination levels of source water guarantee safe drinking water. Further measures for prevention and control are implementation of the HACCP concept, which includes the whole chain of procedures of drinking water supply from catchment via treatment to tap and a quality management system.

Communicable Disease Control↗
PubMed1981

Giardiasis in pregnancy.

Giardiasis in pregnancy can be a debilitating disease with threatens the well-being of mother and fetus, as illustrated by three cases. The usual therapeutic agents are contraindicated in pregnancy. Paromomycin, an oral, poorly absorbed aminoglycoside, is an alternate, potentially less toxic agent for treatment of symptomatic giardiasis in pregnancy. The pharmacologic actions of paromomycin in human beings and its antiprotozoan efficacy are discussed.

Adult↗
PubMed2005

Giardiasis as a predictor of childhood malnutrition in Orang Asli children in Malaysia.

A cross-sectional study to examine the association of giardiasis with protein-energy malnutrition, vitamin A deficiency and iron deficiency anaemia was conducted among Orang Asli children in Selangor, Malaysia. A total of 281 children aged 2-15 years were studied. The data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and faecal samples. The results showed that 24.9% of the children were infected with Giardia duodenalis, while 56.5, 61.3 and 15.1% had significant underweight, stunting and wasting, respectively. Giardiasis was statistically identified as a strong predictor of significant wasting in this study population.

Adolescent↗
PubMed2000

Giardiasis as a re-emerging infectious disease and its zoonotic potential.

The reasons for considering giardiasis as a re-emerging infectious disease are presented, with emphasis on Giardia infections in child care centres, livestock and pets, and the role of zoonotic transmission. However, the aetiology and control of giardiasis is complicated by the genetic and phenotypic variability of Giardia species infective to mammals. Of particular significance has been the uncertainty about host specificity and the question of zoonotic transmission. The recent application of molecular characterisation procedures based on PCR has made an enormous contribution to an understanding of the genetic structure of Giardia populations, and this is reviewed in the context of the zoonotic transmission and molecular epidemiology of Giardia infections.

Adult↗
PubMed2001

Giardiasis in dairy calves: effects of fenbendazole treatment on intestinal structure and function.

Twelve Giardia duodenalis-infected Holstein dairy calves were allocated into a treatment (n=6) and placebo group (n=6) according to pre-study faecal cyst counts. Calves in the treatment group received an oral dose of 5 mg/kg fenbendazole once daily for 3 days, while placebo calves received a sterile saline solution. Calves were euthanised 7 days following the initiation of treatment and intestinal were collected and prepared for trophozoite quantitation, histology, electron microscopy, and disaccharidase assays. In all calves treated with fenbendazole, intestinal trophozoites were below detection limits, while in saline-treated calves, trophozoites were observed in all intestinal segments. Histologically, no significant difference was observed between treatment groups with respect to intestinal villus height or crypt depth. However, a significant decline in the number of intraepithelial lymphocytes (IEL) was observed in fenbendazole-treated calves when compared with placebo-treated calves in the duodenum (13.9+/-1.2 vs. 17.0+/-1.1 IEL/100 enterocytes) and jejunum (21.6+/-0.8 vs. 30.7+/-1.0 IEL/100 enterocytes). In addition, measurements from TEM micrographs demonstrated a significant increase in microvillus surface area in the jejunum of fenbendazole-treated calves compared with saline-treated calves (31.2+/-10.2 vs. 22.8+/-7.6 microm(2)). This increase in microvillus surface area was also associated with an increase in jejunal maltase activity in fenbendazole-treated calves compared with calves treated with saline. These results demonstrate that fenbendazole is an effective treatment for giardiasis in calves. fenbendazole treatment eliminated Giardia trophozoites from the small intestine of calves resulting in increased microvillus surface area and greater intestinal enzyme activity. This study also demonstrates that the pathogenesis of giardiasis in calves is similar to that observed in humans and laboratory animals, and provides further evidence that Giardia is a pathogen of cattle with potential economic importance.

Animals↗
PubMedDate not supplied

Giardiasis-associated arthralgia in children.

BACKGROUND: Giardiasis is the most common intestinal parasitosis in Mexico. Usual symptoms of the acute infection are diarrhea, abdominal pain, nausea, and weight loss. Children are more frequently affected than adults. Various extra-intestinal manifestations have been reported, among which are arthritis and arthralgia. METHODS: A series of 10 children with arthralgia and cysts of Giardia lamblia in feces seen during 13 years of private practice were presented. Ages ranged between 5 and 11 years, and 70% of the children are males. RESULTS: The joints involved in all cases were the knee and the ankle. No joint flogosis or changes in local temperature were observed. Other associated symptoms were abdominal pain (100%), abdominal distension (70%), flatulence (50%), less consistent stools (50%), anemia (30%), and increased erythrocyte sedimentation rate (60%). C-reactive protein and rheumatoid factor were negative in all cases. Arthralgia disappeared after treatment with metronidazole when coproparasitoscopic analyses were negative. CONCLUSIONS: Arthralgia associated with giardiasis in children is a rare entity, relatively benign, and leaves no sequelae.

Adolescent↗
PubMed1996

Giardiasis.

Despite rapid progress in understanding the biology of Giardia, several questions remain unanswered. First, there is no adequate explanation for the diverse clinical spectrum of giardiasis. Second, the mechanisms by which Giardia produces diarrhea and malabsorption are poorly understood, although some progress has been made. Finally, despite extensive studies in animal models and human infections, the key immunologic determinants for clearance of acute infection and development of protective immunity remain ill defined. This article discusses the epidemiology, pathology, diagnosis, treatment, and prevention of giardiasis.

Animals↗
PubMed1992

Human giardiasis: correlation of specific secretory IgA levels in duodenal fluid to the severity of disease and infestation by Giardia lamblia.

Giardia lamblia specific secretory immunoglobulin A (sIgA) levels in the duodenal fluid of adult giardiasis cases are reported for the first time. The sIgA levels in the study group were found to be significantly higher (p less than 0.01) than in the 20 age- and sex-matched controls comprising cases classified as non-ulcerative dyspepsia who did nor reveal any G. lamblia in their stools and the duodenal fluid. An inverse relationship between the clinical severity of giardiasis and the level of sIgA in the duodenal fluid was noted. Cases with a higher trophozoite load in duodenal aspirate tended to be associated with envanescent G. lamblia-specific antibodies.

Adult↗
PubMed1998

Association between giardiasis and allergy.

BACKGROUND: Previous studies have indicated that there may be an association between infection by the intestinal protozoan Giardia lamblia and the expression of allergic disease. OBJECT: We evaluated a group of children who attended the Outpatient Clinic of the Children's Hospital in Caracas, Venezuela, a group in which both allergic disease and giardiasis were common. METHODS: We performed feces examination and measured total and specific serum IgE (immunoglobulin E) in these children. RESULTS: We found that 70% of the children infected with G. lamblia presented symptoms of allergy, in contrast to 43% of the non-Giardia parasitized group (P <.05). In addition, the G. lamblia parasitized children showed significantly higher levels of total serum IgE (1194 IU/mL) than the non-Giardia group (822 IU/mL) (P <.005). Children infected with G. lamblia showed higher levels of specific serum IgE antibody against food allergens compared both with the non-parasitized group (P <.0001) and children infected with parasites other than Giardia (P <.05). In contrast, IgE responses against the house dust mite Dermatophagoides pteronyssinus were similar in all the groups studied. CONCLUSIONS: These results reveal a clear relationship between giardiasis and allergy, possibly because infection by this protozoon enhances sensitization towards food antigens, due to increased antigen penetration through damaged intestinal mucosa.

Antibodies, Protozoan↗