Incidence, predictors and criteria for the diagnosis of giardiasis in children
Keywords:giardiasis, predictors, diagnostic criteria, children
Background. The prevalence of giardiasis among children is 355 cases per 100,000, with 80 % of cases of infestation occurring in children under the age of 14 years. The urgency of the high prevalence of protozoal pathology in children is determined by the fact that its manifestations are often masked under various pathological conditions. The purpose was to study the incidence, predictors and criteria for the diagnosis of giardiasis in children. Materials and methods. Research design is a controlled randomized trial. The study included children suffering from giardiasis (n = 55), aged 3 to 17 years. The comparison group consisted of 30 apparently healthy children. A survey of patients and collection of material performed at the outpatient and gastroenterology departments of the MHI “Chernivtsi Regional Clinical Hospital” during 2014–2016. Laboratory and instrumental investigations were conducted in Ukrainian-German laboratory “Bukintermed” and children’s gastroenterology center “Digest”. Indirect (serological one, macroscopy of the duodenal mucosa in endoscopic examination, indirect signs of giardiasis in duodenal biopsy samples) and direct methods were used (microscopy of the feces, duodenal contents, detection of vegetative forms of lamblia in duodenal biopsy samples during histological examination). A parent survey was conducted. Results. A positive result was obtained in 29 out of 565 subjects surveyed for lamblia (5.1 %). More often, additional examination was required for the presence of giardiasis in children suffering from chronic diseases of the upper gastrointestinal and hepatobiliary system, allergic reactions, intestinal dysbiosis and persistent eosinophilia. Children affected with giardiasis were more likely to have a concomitant illness than the children of the comparison group (p < 0.05). In 41.4 % of cases, children lived in conditions that were not satisfactory, did not always follow the rules of sanitary hygiene. We have established antenatal (health during pregnancy, the course of pregnancy, the presence of occupational hazards), intranatal (premature birth, stimulation of labor and cesarean section, birth trauma and asphyxia in children) and postnatal adverse factors (duration of breastfeeding, concomitant pathology). All histological features can be used as possible criteria for giardiasis in children, but with the highest probability, the following sign can be used — the presence of villous epithelium desquamation areas with simultaneous dominance of eosinophils and mast cells in the infiltrate. Conclusions. The incidence of giardiasis in children and adolescents is 5.1 %. Anamnestic factors (social, hygienic, medical and biological ones) established by us can be considered as predictors for the development of giardiasis in children. In the clinical picture of giardiasis, the defeat of the digestive tract dominates — in 96.3 % of children. To improve the accuracy of giardiasis diagnosis in children, it is necessary to use a set of direct and indirect methods of the diagnosis.
WHO: Guidelines for drinking-water quality. Vol. 1. Recommendations. Geneva: World Health Organization, 2006.
Hodzhayan AB, et al. Medicinskaja parazitologija i parazitarnye bolezni : uchebnoe posobie [Medical parasitology and parasitogenic illnesses: guidance]. Moscow; 2014. 448 p. (In Russian).
Konoferchuk EV, Antonov OV, Mikhailova TA, et al. Prevalence and modern clinical implications of lambliasis at the children living in the Omsk region. Pediatrija. Zhurnal im. G. N. Speranskogo. 2013;92(6):140-3.( In Russian).
Benere E. Variation in growth and drug susceptibility among Giardia duodenalis assemblages A, B and E in axenic in vitro culture and in the gerbil model. Parasitology. 2011;138:1354-61. doi: 10.1017/S0031182011001223.
Kalacheva RM, Nadezhin AS. Diagnosis of giardiasis (giardiasis) in children. (In Russian). Available from: www.gastroportal.ru/php/content.php?id=1646&pr=print
Copyright (c) 2017 ACTUAL INFECTOLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.