DISEASE GIARDIASIS

 

Giardiasis 

Giardiasis is a protozoal infection of the upper small intestine caused by the flagellate Giardia lambia ( also called G.intestinal and G.duodenalis ) . This parasite occurs worldwide, most abundantly in area with poor sanitation like Nepal, Bangladesh and India.

Agent: 

Only the cyst form is infectious by the oral route; trophozoite are destroyed by gastric acidity. Human are reservoir for the infection.

Mode of transmission 

Cysts are transmitted as a result of fecal contamination of water or food , by person- to- person contact or by anal - oral sexual contact.

Incubation period

1-3 weeks 

Clinical features 

 ⁃ Asymptomatic 

 ⁃ Acute diarrhea 

 ⁃ Chronic diarrhea 

 ⁃ Weight loss

 ⁃ Weakness 

 ⁃ Anorexia

 ⁃ Nausea ( vomiting)

 ⁃ Belching 

 ⁃ Mid epigastric discomfort 

 ⁃ Abdominal cramps

 ⁃ Abdominal distension

Investigations 

 • Blood: Normal

 • Stool for trophozoite 

Differential Diagnosis 

 1. Intestinal Amoebiasis

 2. Acid peptic disease 

 3. Malabsorption 

Complications 

 • Acute Diarrhea 

 • Chronic diarrhea 

 • Malabsorption 

Treatment 

If patient present with acute diarrhea 

 • ORS or IV . Fluid 

 • Nutrition and electrolytes balance 

Drugs 

 ⁃ Metronidazole 400 mg 8 hourly * 10 days 

 ⁃ Tinidazole 2gm single dose

Other 

Furazolidone 100 mg 4 times daily for 7-10 days.

Mepacrine 100 mg 3 times daily for 5-7 days 

Albendazole 400 mg once a day for 5 days 

Prevention measures 

 • Safe disposal of human excreta.

 • Proper hand washing practices after defecation and before eating .

 • Protection of water 💦 supplies against faecal contamination .

 • Use filtered and boiling water .

 • Avoid uncooked raw foods .

 • Food landlers should be periodically examined , treated and educated in food hygiene practices such as hand washing.

 • Health education of public.