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