GIARDIA LAMBLIA INTESTINAL INFECTION: ROLE OF
DIFFERENT DIAGNOSTIC MODALITIES IN EGYPTIAN CHILDREN
Shatla* HM, El-Hodhod MA* and Doryea M Metwally**
From Pediatric* and Parasitology** Departments, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Backgrounds: Giardia lamblia infestation is among the most
prevalent parasites in Egyptian infants and children. The ordinary stool
analysis can be negative in about half the cases.
Subjects and
Methods: One hundred infants and children
with significant gastro-intestinal symptoms for more than 2 weeks were
included in this study. First stool analysis was done for three times.
Negative cases were subjected to assessment of duodenal aspirate after
upper GI endoscopy. Negative cases were considered GL negative and positive
cases whether by stool analysis or duodenal aspirate analysis were
considered as the positive group. Salivary antigiardial IgA antibodies and
ELIZA test for fecal giardia antigen were evaluated in all patients.
Results: Stool analysis showed that 40 patients were
positive for giardiasis. The duodenal aspirate showed that 32 patients from
stool negative cases were positive for giardiasis. The Salivary
Antigiardial IgA test showed a sensitivity of 87.5% and a specificity of
100%. Testing for the fecal giardia antigen showed a sensitivity of 97% and
a specificity of 100%.
Conclusion: Stool analysis per se is not a sufficient test
in the diagnosis of giardia lamblia infestation. The advent of other simple
and relatively economic methods of diagnosis as salivary specific IgA and
fecal antigen detection can exclude the need for the invasive duodenal
aspirate analysis.