Giardiasis in the Third World Countries

【关键词】  Giardiasis

　　E-mail:mhmmd_alsabbawi@yahoo.com

    Giardiasis is an infectious disease that present all over the world but spread more in the third world countries like Iraq where there is bad sanitary and living conditions.it is a dangerous disease that affect children and adults and lead to malabsorption syndrome and weight loss in the infected persons.

    What is Giardiasis?

    It is caused by parasite called Giardia lamblia which is a microscopical agent，the trophozoite live in the proximal part of small intestine attach to the mucosa causing atrophy to the intestinal villae and loss of digestive enzymes leading to malabsorption syndrome for food eaten by the subject and ultimately weight loss，when this parasite pass to the large intestine it form a cyst to protect itself from the environmental conditions.After consumption of food or water contaminated by these cysts，they excyst inside body forming trophzoite which attach to the mucosa of intestine again.

    What are symptoms of Giardiasis?

    Although most of the infections are asymptomatic but giardia infection considered as one of the common causes of chronic diarrhea and malabsorption.Acute infection causes acute diarrhea，abdominal pain，nausea and vomiting.Chronic infection may not cause diarrhea but loose stool，upper abdominal pain，flatus，nausea and lethargy.The infection may extend to several years if not eradicated completely which lead to weight loss，asthenia and growth retardation.

    How Giardiasis Diagnosed?

    It can be diagnosed by microscopical examination of stool，we can see the trophozoite or cyst of the parasite.Because of variation in excretion of the parasite in the stool there will be false negative results thus repeated examination of stool is necessary in suspected individuals.

    Some times it can be found only by examination of duodenal fluid or by duodenal biopsy.

    How the Research been Designed?

    The researcher did a study about the proportion of giardiasis in Al-Hamdania city and the towns around it as a sample of Iraqi cities by reviewing the medical laboratory reports for several years，i.e.，retrospective study，and checking the primary General Stool Examination for all ages.The researcher found that there is a significant proportion of girdiasis reaching  a rate of 5%～10% among the data taken，and as we said previously there are many false negative results，so the expected proportion rise to much more than this rate.In addition to that the researcher notice a large proportion of data contain fatty drops reaching more than 60% which is one of the signs of malabsorption syndrome caused by many diseases including giardiasis.

    What is the Treatment?

    The drug metronidazole(flagyl) which is widely used in the treatment of diarrhea can control the parasite in 90% of cases only in a dose of 250 mg t.i.d.for 5 days，while the drug tinidazole can control the parasite in 99% of cases by a single dose 40 mg/kg，and for children the drug of choice is furazolidone syrup in a dose 6 mg/kg.

    What is the Prevention?

    It is done by improvement of the general hygiene e.g.;

    proper hand washing after defecation，good cleaning of fruit and vegetables before consumption and by sterilizing of water by either boiling or filtration.It is worth to mention that chlorination of water can control bacteria only but not the parasite in the cystic stage.

    In the epidemic or endemic areas，the parasite can be prevented by administration of 500 mg( one tablet ) of tinidazole every two weeks in order to control the parasite that may enter the body via the mouth.

    Recommendations

    Giardiasis is a world wide disease especially in the poor countries and infect all ages but unfortunately we do not pay it the required attention，hence the researcher advise to perform a similar studies;retrospective or prospective study in different third world countries in order to recognize the real proportion of giardiasis in these areas for the purpose of eradication due to its importance as a major role in chronic ill health on some infected individuals which adversely affect on popular and economic resources of these countries.