Giardiasis
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Introduction
- A parasitic protozoal infection caused by Giardia lamblia or Giardia intestinalis
- Worldwide in distribution but more common in developing countries
- Spread by the faeco-oral route
Clinical features
- Acute disease: watery diarrhoea with abdominal bloating
- Chronic disease: diarrhoea, steatorrhoea and weight loss from malabsorption syndrome- with lactose intolerance, xylose malabsorption and vitamin B deficiency
Complications
- Diseases related to Vitamin B deficiency
Investigations
- Stool microscopy
- Full blood count
- Duodenal aspirate for microscopy
Treatment goals
- Eradicate parasite
- Correct fluid and electrolyte deficits
- Replace malabsorbed nutrients
Drug treatment
• Metronidazole
- Adult: 2 g orally daily for 3 days or 400 mg 8 hourly for 5 days or 500 mg twelve hourly for 7 - 10 days
- Child:
- 1 - 3 years 500 mg orally daily
- 3 - 7 years 600 - 800 mg daily
- 7-10 years 1 g daily for 3 days
• Tinidazole
- Adult: 40 mg/kg orally as a single dose; or 2 g stat, repeat after 1 week, once if necessary
- Child: 50 to 75 mg/kg as a single dose; repeat after 1 week
Supportive
- Vitamin B supplementation
- Correct fluid and electrolyte deficits
Prevention
- Good communal and personal hygiene
- Potable water