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Tawana M, Onyiche TE, Ramatla T, Thekisoe O. A 'One Health' perspective of Africa-wide distribution and prevalence of Giardia species in humans, animals and waterbodies: a systematic review and meta-analysis. Parasitology 2023; 150:769-780. [PMID: 37246558 PMCID: PMC10478065 DOI: 10.1017/s0031182023000513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 05/30/2023]
Abstract
Giardiasis, caused by Giardia duodenalis, is a leading cause of diarrhoea in resource-poor countries. To gain a better insight into the epidemiology of Giardia in Africa, we undertook a robust study to comprehend the distribution and prevalence of Giardia infection in humans, animals and their dispersal in the environment. Our protocol was registered with PROSPERO (registration number CRD42022317653). Deep literature search from 5 electronic databases, namely, AJOL, Google scholar, PubMed, ScienceDirect and Springer Link was performed using relevant keywords. Meta-analysis was performed using a random-effects model and heterogeneity among studies was evaluated using Cochran's Q and the I2-statistic. More than 500 eligible studies published from 1 January 1980 until 22 March 2022 were retrieved. In humans, exactly 48 124 Giardia spp. infection cases were registered from the 494 014 stool samples examined resulting in a pooled prevalence estimate (PPE) of 8.8% using microscopy. Whereas copro-antigen tests and molecular diagnostic methods generated PPE of 14.3 and 19.5%, respectively, with HIV+ subjects and those with diarrhoeatic stool having infection rates of 5.0 and 12.3%, respectively. The PPE of Giardia spp. infection in animals using molecular methods was 15.6%, which was most prevalent in pigs (25.2%) with Nigeria registering the highest prevalence at 20.1%. The PPE of Giardia spp. contamination from waterbodies was 11.9% from a total of 7950 samples which were detected using microscopy, with Tunisia documenting the highest infection rate of 37.3%. This meta-analysis highlights the necessity of ‘One Health’ approach for consolidated epidemiological studies and control of giardiasis in the African continent.
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Affiliation(s)
- Mpho Tawana
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
| | - ThankGod E. Onyiche
- Department of Veterinary Parasitology and Entomology, University of Maiduguri, Maiduguri, Nigeria
| | - Tsepo Ramatla
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
| | - Oriel Thekisoe
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
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Harvey TV, Carvalho JPDS, Aquino MCCD, Oliveira BCM, Barros LDD, Fehlberg HF, Rocha CMBMD, Albuquerque GR. Giardiasis in children and dogs, and the first report of assemblage E in dogs from northeastern Brazil. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2023; 32:e012222. [PMID: 36820730 DOI: 10.1590/s1984-29612023010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/15/2022] [Indexed: 02/22/2023]
Abstract
Diagnosis is crucial for controlling giardiasis. We determined the prevalence and genetically characterize isolates of Giardia duodenalis of children and dogs from rural communities in northeastern Brazil. G. duodenalis cysts were concentrated by centrifugal flotation/sedimentation. Molecular characterization was carried out using the loci ssu-rRNA, bg, tpi, and gdh. By parasitological techniques, Giardia spp. infection was detected in 72/192 children (37.5%; 95% CI: 30.6%-44.7%) and 24/139 dogs (17.3%; 95% CI: 11.4%-24.6%). By molecular analysis, infection was detected in 60/141 children (42.5%; 95% CI: 34.3%-51.2%) and 26/92 dogs (28.3%; 95% CI: 19.4%-38.6%). The total prevalence of giardiasis was 54.9% in children (106/193; 95% CI: 47.1%-61.6%) and 32.9% in dogs (47/143; 95% CI: 25.2%-41.2%). Zoonotic assemblages A and B of G. duodenalis were detected in children, and assemblage E of G. duodenalis was detected in one child and two dogs. Parallel use of parasitological and molecular techniques proved to be a more effective strategy for detecting giardiasis in children and dogs from endemic areas.
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Affiliation(s)
- Tatiani Vitor Harvey
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
| | - Jamille Pinto Dos Santos Carvalho
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
| | | | - Bruno César Miranda Oliveira
- Departamento de Apoio, Produção e Saúde Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista - UNESP, Araçatuba, SP, Brasil
| | - Luiz Daniel de Barros
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Hllytchaikra Ferraz Fehlberg
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
| | | | - George Rego Albuquerque
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
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Sangkanu S, Paul AK, Chuprom J, Mitsuwan W, Boonhok R, de Lourdes Pereira M, Oliveira SMR, Wilairatana P, Rahmatullah M, Wiart C, Nawaz M, Sin C, Kayesth S, Nissapatorn V. Conserved Candidate Antigens and Nanoparticles to Develop Vaccine against Giardia intestinalis. Vaccines (Basel) 2022; 11:vaccines11010096. [PMID: 36679941 PMCID: PMC9863896 DOI: 10.3390/vaccines11010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
Giardia intestinalis (Giardia lambia, Giardia duodenalis) infections in humans may be asymptomatic or symptomatic and associated with diarrhea (without blood), abdominal cramps, bloating, flatulence, and weight loss. The protozoan Giardia is the third most common cause of diarrhea and death in children under five, preceded only by rotavirus and by Cryptosporidium parvum and C. hominis infections. Antimicrobial drugs, particularly 5-nitroimidazole (5-NIs), are used to treat giardiasis in humans. Immunologically naive or immunocompromised host are more vulnerable to Giardia infection, whereas a degree of resistance to this protozoan is present in humans living in endemic areas. This suggests that vaccination may be a potential and appropriate means to control this parasitic disease outbreak and protect the human population. This review discusses Giardia antigens related to vaccine development. Additionally, based on the latest development of nanoparticle technology, a combination of methods for future research and development is proposed for the design of the next generation of powerful immunogens and an effective vaccine against Giardia.
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Affiliation(s)
- Suthinee Sangkanu
- School of Allied Health Sciences, Southeast Asia Water Team (SEA Water Team) and World Union for Herbal Drug Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Alok K. Paul
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7001, Australia
| | - Julalak Chuprom
- School of Languages and General Education (SOLGEN), Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Watcharapong Mitsuwan
- Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Rachasak Boonhok
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Research Excellence Center for Innovation and Health Products (RECIHP), Nakhon Si Thammarat 80160, Thailand
| | - Maria de Lourdes Pereira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Sonia Marlene Rodrigues Oliveira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Mohammed Rahmatullah
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Dhaka 1209, Bangladesh
| | - Christophe Wiart
- The Institute for Tropical Biology and Conservation, University Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Malaysia
| | - Muhammad Nawaz
- Department of Nano-Medicine Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Chea Sin
- Faculty of Pharmacy, University of Puthisastra, Phnom Penh 12211, Cambodia
| | - Sunil Kayesth
- Department of Zoology, Deshbandhu College, University of Delhi, New Delhi 110019, India
| | - Veeranoot Nissapatorn
- School of Allied Health Sciences, Southeast Asia Water Team (SEA Water Team) and World Union for Herbal Drug Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat 80160, Thailand
- Correspondence:
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Chourabi M, Boughattas S, Abdallah AM, Ismail A, Behnke JM, Al-Mekhlafi HM, Abu-Madi M. Genetic Diversity and Prevalence of Giardia duodenalis in Qatar. Front Cell Infect Microbiol 2021; 11:652946. [PMID: 34017691 PMCID: PMC8129557 DOI: 10.3389/fcimb.2021.652946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background Giardia duodenalis is a common human intestinal parasite worldwide, and the causative agent of diarrhea, with the severity of disease ranging from asymptomatic to intense and debilitating infection. G. duodenalis is known to consist of eight genetically distinct assemblages, named from A to H. No data available on the genotypes and genetic diversity of G. duodenalis circulating in Qatar. Methods We genotyped 54 human Giardia isolates, collected from asymptomatic immigrants in Qatar, using a multilocus genotyping (MLGs) tool. We also investigated relationships between the subjects’ genotypes and their demographic data. Results Genomic DNA from 54 isolates were tested by PCR and sequence analysis at three loci: glutamate dehydrogenase (gdh), β-giardin (bg) and triose phosphate (tpi)). Assemblage A was identified in nine (16.67%), assemblage B in thirty (55.55%), and a mixture of assemblages A+B in fifteen (27.78%) isolates. All assemblage A isolates, genotyped in different loci, were assigned to sub-assemblage AII, and six of them had MLGs AII-1 while one new MLG was identified in two isolates. Sequences of assemblage B isolates have high level of genetic diversity and high presence of heterogeneous peaks, especially within the gdh gene. No significant associations between genotypes and the immigrants’ demographic data were found due to the extensive number of new variants. Conclusions MLGs was used herein to genotype 54 immigrant Giardia isolates. The high level of genetic variability found in our isolates hampered MLGs determination, more investigations are now required to consolidate our findings, and to enable a comprehensive understanding of the diversity within G. duodenalis assemblage B isolates.
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Affiliation(s)
- Marwa Chourabi
- Biomedical Research Center, College of Health Sciences-QU Health, Qatar University, Doha, Qatar
| | - Sonia Boughattas
- Biomedical Research Center, College of Health Sciences-QU Health, Qatar University, Doha, Qatar
| | - Atiyeh M Abdallah
- Department of Biomedical Sciences, College of Health Sciences-QU Health, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit-QU Health, Qatar University, Doha, Qatar
| | - Ahmed Ismail
- Medical Commission, Ministry of Public Health, Doha, Qatar
| | - Jerzy M Behnke
- School of Life Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Hesham M Al-Mekhlafi
- Medical Research Centre, Jazan University, Jazan, Saudi Arabia.,Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Marawan Abu-Madi
- Biomedical Research Center, College of Health Sciences-QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Sciences, College of Health Sciences-QU Health, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit-QU Health, Qatar University, Doha, Qatar
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Belkessa S, Thomas-Lopez D, Houali K, Ghalmi F, Stensvold CR. Molecular Characterization of Giardia duodenalis in Children and Adults Sampled in Algeria. Microorganisms 2020; 9:E54. [PMID: 33379186 PMCID: PMC7823855 DOI: 10.3390/microorganisms9010054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022] Open
Abstract
The molecular epidemiology of giardiasis in Africa remains unclear. A study was carried out across four hospitals in Algeria. A total of 119 fecal samples from 55 children, 37 adults, and 27 individuals of undetermined age, all scored positive for intestinal parasites by microscopy, and were screened by real-time PCR for Giardia. Molecular characterization of Giardia was performed by assemblage-specific PCR and PCR targeting the triose phosphate isomerase gene (tpi). Of the 119 samples, 80 (67%) were Giardia-positive by real-time PCR. For 48 moderately-highly real-time PCR-positive samples, tpi genotyping assigned 22 samples to Assemblage A and 26 to Assemblage B. Contrary to Assemblage A, Assemblage B exhibited substantial genetic diversity and allelic heterozygosity. Assemblage-specific PCR proved to be specific for discriminating Assemblage A or B but not as sensitive as tpi genotyping. We confirmed that real-time PCR is more sensitive than microscopy for detecting Giardia in stool samples and that robust amplification and sequencing of the tpi gene is feasible when moderate-to-strongly real-time PCR-positive samples are used. This study is one of the few performed in Africa providing genotyping data on Giardia infections in humans. Both assemblages A and B were commonly seen and not associated with specific sociodemographic data.
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Affiliation(s)
- Salem Belkessa
- Laboratory of Analytical Biochemistry and Biotechnology (LABAB), Department of Biochemistry and Microbiology, Faculty of Biological and Agronomic Sciences, Mouloud Mammeri University of Tizi Ouzou, Tizi Ouzou 15000, Algeria; (S.B.); (K.H.)
- Department of Natural and Life Sciences, Faculty of Exact Sciences and Natural and Life Sciences, Mohamed Khider University of Biskra, Biskra 07000, Algeria
- Laboratory of Parasitology, Department of Bacteria, Parasites & Fungi, Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark;
| | - Daniel Thomas-Lopez
- Laboratory of Parasitology, Department of Bacteria, Parasites & Fungi, Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark;
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), 16973 Solna, Sweden
| | - Karim Houali
- Laboratory of Analytical Biochemistry and Biotechnology (LABAB), Department of Biochemistry and Microbiology, Faculty of Biological and Agronomic Sciences, Mouloud Mammeri University of Tizi Ouzou, Tizi Ouzou 15000, Algeria; (S.B.); (K.H.)
| | - Farida Ghalmi
- Higher National Veterinary School of Algiers, El Alia, Algiers 16000, Algeria;
| | - Christen Rune Stensvold
- Laboratory of Parasitology, Department of Bacteria, Parasites & Fungi, Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark;
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Molecular Characterization of Giardia intestinalis Detected in Humans and Water Samples in Egypt. Acta Parasitol 2020; 65:482-489. [PMID: 32124205 DOI: 10.2478/s11686-020-00176-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 01/25/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Giardia intestinalis is a common cause of gastrointestinal illness especially in children of developing countries. Giardia assemblages A and B are the major human infective genotypes. OBJECTIVE The present study aimed to investigate the role of water supply in the epidemiology of giardiasis via genotyping G. intestinalis detected in diarrheic children and in water samples in Egyptian rural areas. METHODS Stool samples of 100 diarrheic children, 40 drinking water samples and 10 raw water samples of canals were examined microscopically for Giardia. DNA was extracted from microscopically positive faecal samples and from all of the collected water samples. Amplification of Giardia tpi gene was performed by a nested PCR using assemblage A- and assemblage B-specific primers. Giardia gdh gene was amplified by a heminested PCR. Giardia genotypes were determined by restriction fragment polymorphism (RFLP) analysis of the amplified products. Sequencing of the amplified products was performed in two faecal and two water samples RESULTS: Giardia intestinalis was detected in 24 children, in none of the drinking water samples and in all canal water samples. Giardia sub-assemblage AII was identified in all stool and raw water samples. The RFLP pattern was confirmed in sequenced samples. CONCLUSION The presence of the same Giardia sub-assemblage in diarrheic children and in raw water samples shows by molecular evidence the potential for waterborne dissemination of Giardia in Egypt. Further studies are needed to monitor cyst levels and infectivity of the genotype detected in water for risk assessment and management.
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Rebih N, Boutaiba S, Aboualchamat G, Souttou K, Hakem A, Al Nahhas S. Molecular and epidemiological characterization of Giardia Intestinalis assemblages detected in Djelfa, Algeria. J Parasit Dis 2020; 44:281-288. [PMID: 32508402 DOI: 10.1007/s12639-020-01206-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 02/19/2020] [Indexed: 12/21/2022] Open
Abstract
Giardia intestinalis is a flagellated protozoan that lives and proliferates in the small intestine of the host causing giardiasis. The route of transmission is the fecal-oral route, either directly or indirectly. Limited genetic information on G. intestinalis is known in Algeria. This study aimed to estimate the prevalence of G. intestinalis assemblages in the city of Djelfa. A total of 355 fecal samples were collected from symptomatic and asymptomatic school children aged ranged between 6 and 11 years old. Genotyping was done to the Giardia positive samples (n = 30) targeting the beta-giardin gene by applying PCR/RFLP assay. Our data showed that most of the cases were asymptomatic (56.7%). Co-infection with other intestinal parasites was found in 16.6% of cases. We obtained 28/30 positive PCR products while two samples only showed false-negative results, and only 20 samples have shown strong PCR products suitable for RFLP analysis. Assemblage A (70%) was more prevalent than assemblage B (30%) and was more expressed by signs than assemblage B. Moreover, only assemblage A was associated with close contacts with domestic animals and birds. In conclusion, this study gave the first molecular data on G. intestinalis isolates in the city of Djelfa. Further expanded studies using more genes and covering other cities in Algeria are mostly needed.
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Affiliation(s)
- Nadjat Rebih
- Laboratory for Exploration and Valorization of Steppe Ecosystems, Department of Biology, Faculty of Natural and Life Sciences, University of Zîane Achour, Djelfa, Algeria
| | - Saad Boutaiba
- Laboratory for Exploration and Valorization of Steppe Ecosystems, Department of Biology, Faculty of Natural and Life Sciences, University of Zîane Achour, Djelfa, Algeria
| | - Ghalia Aboualchamat
- Department of Animal Biology, Faculty of Science, Damascus University, Damascus, Syria
| | - Karim Souttou
- Laboratory for Exploration and Valorization of Steppe Ecosystems, Department of Biology, Faculty of Natural and Life Sciences, University of Zîane Achour, Djelfa, Algeria
| | - Ahcen Hakem
- Laboratory for Exploration and Valorization of Steppe Ecosystems, Department of Biology, Faculty of Natural and Life Sciences, University of Zîane Achour, Djelfa, Algeria
| | - Samar Al Nahhas
- Department of Animal Biology, Faculty of Science, Damascus University, Damascus, Syria
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Kashinahanji M, Haghighi A, Bahrami F, Fallah M, Saidijam M, Matini M, Maghsood AH. Giardia lamblia assemblages A and B isolated from symptomatic and asymptomatic persons in Hamadan, west of Iran. J Parasit Dis 2019; 43:616-623. [PMID: 31749533 DOI: 10.1007/s12639-019-01139-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/26/2019] [Indexed: 10/26/2022] Open
Abstract
Giardia is a very abundant organism bringing about diarrhoea in human beings. The focus of this analysis was the detection of Giardia lamblia assemblages in human stool specimens in Hamadan, west of Iran, as well as the association between obtained assemblages and clinical symptoms. Faecal samples of 4066 individuals admitted to the medical and health care facilities in Hamadan were inspected microscopically for the existence of Giardia cysts/trophozoites, and the clinical symptoms of the patients were recorded. The DNA of positive samples was isolated from and the nucleotide sequences of both glutamate dehydrogenase (gdh) (n = 15) and triose phosphate isomerase (tpi) (n = 8) genes were analyzed. In direct microscopy, a total of sixty-four samples (1.6%), were considered as positive for G. lamblia cysts or trophozoites. The sequence analysis showed that 18 out of 23 sequenced isolates (78.2%) were assemblage A and 5 (21.7%) were assemblage B. Clinical symptoms were observed in 44.4% and 40% of patients with assemblages A and B, respectively. Overall, the predominant assemblage A detected in the tested samples along with bioinformatics analysis suggest a potential zoonotic transmission in the region of the study. Although advanced analyses are necessary to understand the foundation and path of the infection, it seems that more sanitary regulations regarding contact with livestock and pet animals are essential.
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Affiliation(s)
- Manizheh Kashinahanji
- 1Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Haghighi
- 2Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fares Bahrami
- 3Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Fallah
- 1Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Saidijam
- 4Department of Molecular Medicine and Genetics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Matini
- 1Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Hossein Maghsood
- 1Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Khodabakhsh-Arbat S, Hooshyar H, Sadeghi H. Prevalence of Intestinal Parasitic Infections among Patients Referring to Medical Diagnostic Laboratories, Kashan, Central Iran, 2015-2018. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2018. [DOI: 10.29252/jommid.6.2.3.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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