Giardiasis Pattern among Different Age Categories: Childhood Assemblage B Proclaim Endemicity.

BACKGROUND: Giardiasis is one of the commonest intestinal parasitic diseases that affects wide range of age groups. We aimed to detect the pattern of Giardia intestinalis assemblages among symptomatic patients at the age of 2 up to 40 years. METHODS: Stool samples were collected from 278 patients and examined microscopically and genetically for giardiasis. Giardia was diagnosed using wet mount examination and subjected to molecular assays targeting three genes, glutamate dehydrogenase (gdh) using semi-nested PCR (nPCR), ß-giardin (bg) and triose phosphate isomerase (tpi) using nPCR. Amplified products were subjected to genotyping using PCR-restriction fragment length polymorphism (PCR-RFLP) targeting gdh and bg genes. RESULTS: Among 48 samples positive by microscopy and by a minimum of one of the three used genes, genotyping was successful among 23 samples (47.9%). Assemblage B was more prevalent (16/23, 69.6%), than assemblage A (4/23, 17.4%) and 3 (13%) isolates were identified as assemblage B at gdh locus which later were identified as assemblage A at bg locus. Sub-assemblage AII (3/4, 75%) and sub-assemblage BIII (12/15, 66.7%) were predominate at gdh locus. Age groups was an estimated risk factor for infection with assemblage B with a peak (87.5%) during 6 to 12 years (P< 0.05), diarrhea and abdominal pain (OR (95%CI) = .654 (.094, .963); .201 (.048, 1.009), respectively) were significantly associated with assemblage B. CONCLUSION: It is recommended to suspect infection with giardiasis assemblage B by physicians during late childhood presenting with diarrhea and abdominal pain.

GIARDIA INTESTINALIS AND HELICOBACTER PYLORI CO-INFECTION: ESTIMATED RISKS AND PREDICTIVE FACTORS IN EGYPT.

Giardia intestinalis (G. intestinalis) and Helicobacter pylori (Hpylori) are two intestinal pathogens sharing the same mode of infection. This study determines the prevalence of G. intestinalis and H pylori co-infection estimated risks and predictive factors for susceptibility to co-infection. Stool samples were collected from 801 patients suffering gastrointestinal symptoms and living in Greater Cairo. They were subjected to coproscopic examination for detection of intestinal parasites and copro PCR-restriction fragment length polymorphism (PCR-RFLP) and sequencing targeting the glutamate dehydrogenase (gdh) gene for Giardia. Positive samples for gidrdiasis were further subjected to copro- immunoassay to detect H pylori coprontigen. Among 63 cases of giardiasis by both microscopy and PCR (84.1 % as-semblage B and 15.9% AII), 52.5% were coinfected with H pylori. Co-infection was more frequent with assemblage B (50.9%) than assemblage A (40%). Among studied variables of assemblage type, gender, or harboring more than one parasite (polyparasitism), only school age children, was signifi-cantly associated (P value: 0.02) with Giardia and H pylori co-infection. Physicians in Egypt must consider G. intestinalis and H pylori as prevailing intestinal pathogens with predominance of Giardia assemblage B. Giardia and H pylori co-infection is common in school aged children and modulates gastrointestinal manifestations. Intestinal parasitism and H pylori association is complex and necessitates further genomic studies for a better understanding of the epidemiological and clinical impact of co-infection, as well as possible strategies for their treatment and control.

Molecular detection of giardiasis among children at Cairo University Pediatrics Hospitals.

Giardiasis is a prevailing intestinal disease in children. This study aimed to determine molecular prevalence of Giardia intestinalis in children attending Cairo University Pediatrics Hospitals, using copro-PCR assays, conventional methods and to evaluate diagnostic effectiveness of used tests. 229 fecal samples were collected from children suffering from gastrointestinal symptoms and examined for Giardia by microscopy, Immuno-chromatographic test (ICT), copro-DNA using two PCR assays targeting tpi [nested-PCR (nPCR)] and 18S [conventional-PCR (cPCR)] genes. Out of 229 samples assessed, Giardia was diagnosed in 13.9, 17, 17.9, 4.8 % of cases using microscopy, ICT, nPCR (tpi) and cPCR (18S), respectively. Nominating both PCR assays as composite reference standard, microscopy and ICT were of reliable specificity (100 and 96.9 %) and accuracy (95.6 and 93.6 %) but of limited sensitivity (78.6 and 76.2 %). Kappa agreement showed, there was substantial agreement of ICT (0.776) and almost perfect agreement of microscopy (0.839) with PCR assays. Giardia showed a molecular prevalence of 18.3 % (42/229). ICT assay for Giardia surpassed microscopy but both couldn't be used as a consistent single detection method due to their lowered sensitivities. nPCR targeting tpi is a reliable diagnostic test aiding to determine true prevalence of Giardia.

Copro prevalence and estimated risk of Entamoeba histolytica in Diarrheic patients at Beni-Suef, Egypt.

Amoebiasis diagnosis is usually based on microscopy that cannot differentiate pathogenic E. histolytica from morphologically identical non-pathogenic species. 194 fecal samples were collected from diarrheic &/or dysenteric patients and examined for Entamoeba complex microscopically, E. histolytica/E. dispar coproantigen using ICT and E. histolytica coproantigen using Tech lab E. histolytica II ELISA test. Entamoeba complex trophozoites/cysts, E. histolytica/E. dispar coproantigen and E. histolytica coproantigen were detected in 22.2, 14.4 and 3.6 % of samples, respectively. Microscopy and ICT method had limited sensitivity with poor PPV (9.3 and 7.1 %, respectively) and both slightly agree with ELISA test. The prevalence of E. histolytica was low (3.6 %) in studied individuals and was 14 times lower than non-pathogenic amoebae. E. histolytica detection studied individuals was positively associated with mucoid and bloody stool, which makes them disease predictors. E. histolytica fecal ELISA assay for E. histolytica detection surpassed microscopy and E. histolytica/E. dispar ICT assay. This has highlighted the need for practical non-microscopic detection methods that can differentiate between amoeba infections to avoid unnecessary and possibly harmful therapies and to determine the true prevalence and epidemiology of E. histolytica.