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