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[Giardia lamblia: comparison of two diagnostic methods and evaluation of response to treatment with metronidazole]
N M Guerreiro1, P M Herrera, L de Escalona
1Departamento de Pediatría, Universidad de Carabobo.
Insights
Giardia lamblia infections were common in children aged 2-6 years. Metronidazole effectively treated all pediatric giardiasis cases, with side effects mainly at higher doses.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Parasitology
Background:
- Giardia lamblia is a significant cause of pediatric gastrointestinal illness.
- Accurate diagnosis and effective treatment are crucial for managing giardiasis in children.
Purpose of the Study:
- To investigate the prevalence of Giardia lamblia infection in children.
- To evaluate the efficacy and side effects of Metronidazole treatment for pediatric giardiasis.
Main Methods:
- Prospective study of 70 children diagnosed with Giardia lamblia.
- Diagnostic methods included stool sample analysis and duodenal aspirates.
- Treatment involved Metronidazole at varying dosages (15, 30, 50 mg/kg/day) for 10 days.
Main Results:
- Giardiasis predominantly affected children aged 2-6 years (60%).
- Abdominal pain and diarrhea were the most frequent symptoms.
- Stool examination detected cysts in 97.1%, and duodenal aspirates detected trophozoites in 100% of cases.
- Metronidazole achieved a 100% cure rate across all dosage groups.
Conclusions:
- Giardia lamblia infection is prevalent in young children, with specific symptom patterns based on age.
- Metronidazole is a highly effective treatment for pediatric giardiasis.
- Adverse effects of Metronidazole were dose-dependent, primarily observed at the highest dosage.
Abstract:
During the period from March through November 1989, 70 children who were attended at the Pediatric Department at Central Hospital in Valencia, were enrolled in the study, it was thought that Giardia lamblia infection might be present. Giardia L. were identified using two different diagnostic procedures: from stool samples and duodenal aspirates for cysts or trophozoites examination. These children were treated with Metronidazole three dosage of 15, 30 and 50 mg/kg per day for a ten day period. Our study showed predominant giardiasis in children with ages ranging from 2 to 6 years old (60%) with a relationship between female and male sex 1.05:1. In this series, 72.8% of patients presented normal nutrition, and 55.7% of them were from the suburban area. The most frequent symptoms were abdominal pain, diarrhea, vomiting, abdominal distention, constipation and flatulence. The infants prevalent symptom was diarrhea (83.3%) and the older children and school children prevalent symptom was abdominal pain with 78.5 and 100% respectively. In this study, stool examination was positive in 97.1% of the children and duodenal aspirate was positive in all 70 children (100%); the first procedure showed predominant Giardia cysts (88.2%) and the second one showed predominant trophozoites (47.1%). All 70 patients (100%) were cured with Metronidazole to different dosage. Side effects were seen with only the maxim dose, such as nausea 40%, headache 10% and appearance of yeast into 50% of duodenal aspirate.