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Giardiasis

Introduction

Giardiasis is an infection of the small intestine (duodenum and jejunum) caused by the parasite Giardia lamblia. It can affect humans and animals. It can cause chronic diarrhoea and malabsorption.

Giardia exists worldwide including in developed countries, but is more common in areas with poor sanitation.

Organism

Giardia Lamblia

Transmission

Faecal-oral or from pets or birds (humans are main reservoir of infection). Can be trams
Typically from drinking water contaminated with giardia cysts (killed by boiling but NOT chlorination)
 

Epidemiology

Prevalence approx. 20-30% in developing countries
Also significant numbers of cases seen in USA
 

Pathogenesis

Trophozoite parasite multiplies in upper bowel by binary fission – large areas of mucosa may be colonized in heavy infection
  • Disrupts brush-border and affects enzyme activity.
  • Stimulates inflammatory cytokine response, secretion of fluid and electrolytes and cell damage.
Trophozoites encyst as then pass through the intestine and become infective.
 

Clinical features

Most infections are asymptomatic. Acute phase lasts 2 – 4 weeks.
Symptoms are worse in immunodeficiency.
 

Complications

Diagnosis

 

Treatment

Metronidazole or tinidazole

Prevention

Good personal hygiene
Access to clean water.

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