Giardiasis

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A protozoan that infects the small intestines causing diarrhoea and malabsorption of nutrients.

Causes

Giardiasis is caused by the protozoan Giardia lamblia through ingestion of giardia cysts in contaminated food and/or drink, and touching contaminated surfaces. The cysts may survive for nearly three months in cold water.

Signs and symptoms

Symptoms can be recurrent:

• Offensive, mushy and greasy stools
• Watery diarrhoea - may alternate with soft stools or constipation
• Upper and mid-abdominal cramps
• Anorexia, nausea
• Early satiety
• Bloating, gas or flatulence, belching
• Retro sternal or epigastric burning
• Fatigue, malaise
• Weight loss
• Some cases may be asymptomatic

Differential diagnosis

• Other causes of malabsorption such as celiac disease and tropical sprue

Complications

• Diseases related to vitamin B deficiency

Investigations

• Stool microscopy
• Duodenal aspiration biopsy
• Faecal fat assessment

Treatment objectives

• Ensure adequate hydration
• Correct electrolyte derangement
• Eradicate the parasite
• Replace malabsorbed/deficient nutrients

Pharmacological treatment

Metronidazole oral

Adult:

500 mg orally every 12 hours for 5-7 days

Child:

1–3 years: 250mg orally every 12 hours for 5-7 day

3–7 years: 400mg orally every 12 hours for 5-7 day

7–10 years: 500mg orally every 12 hours for 5-7 day

OR

Tinidazole

Adult:

2 g orally at once

Child:

50 mg/kg orally at once

Prevention

• Use of safe clean drinking water
• Ensure personal and food hygiene
• Wash hands before handling or eating food and after using toilets
• Ensure proper disposal of human faeces