Giardiasis: Nutritional Implications

Abstract

The debate about the pathogenicity of Giardia lamblia in man has ended, and the issues regarding the prevalence of clinical and subclinical infections and their nutritional impact have become the foremost considerations. Giardiasis can produce steatorrhea, maldigestion, and malabsorption of carbohydrates and of vitamins A and B 12 • The mechanisms of the absorptive dysfunction are not clear, but morphological abnormalities of the intestinal mucosa and/or bacterial overgrowth might playa role. Severe clinical giardiasis can cause "failure to thrive" in young children, but the impact, if any, of subclinical giardiasis on growth in general populations is not well defined. Proteinenergy malnutrition appears to predispose to giardial infection, perhaps because of the accompanying hypochlorhydria, immunosuppression, and altered gastrointestinal flora. The lack of a sensitive and noninvasive diagnostic test for human giardial infection limits the investigation of the nutritional correlates of giardiasis.

Treatment of Giardiasis

“…In areas where G. lamblia is endemic, treatment may not be desirable because the children are likely to become rapidly reinfected following treatment (96,231). If Giardia contributes to failure of growth and development (86,163,227), treatment, even though reinfection may occur, might allow catch-up growth (103) and might be worth the cost and effort. A drug such as albendazole, which would also treat nematode infections, might be useful in these settings; however, the requirement for 5-day dosing would make it difficult to complete therapy in many situations.…”

“…Illness can last several months if untreated and can be characterized by continued exacerbations of diarrheal symptoms. With chronic illness, malabsorption of fat, lactose, vitamin A, and vitamin B 12 are reported, and failure of children to thrive has been noted (86,112,149,184,227).…”

Faecal excretion of rotavirus and other enteropathogens in newborns of the high and low socio-economic stratum in Santiago, Chile

“…This is specially remarkable in the case of Giardia lamblia, an enteroparasite known to colonize the intestine of the host and remain there for long periods (Solomon, 1982). The outcome of infection .by enteropathogens in newborns may be related both to the properties of the agent and to the characteristics of the neonatal intestinal mucosa.…”

Prevalence and Associated Risk Factors for Giardiasis among Children in District Anantnag of Kashmir Valley, India

“…The infection may cause severe diarrhea and malabsorption syndrome resulting in growth retardation and poor psychomotor development of children [2,9]. Giardia infection also results in reduced hemoglobin (Hb) level and hypoalbuminemia [10][11][12]. Most of the infected individuals tend to be asymptomatic making the control of this parasite a difficult task [13].…”