IMMUNE-MOLECULAR IDENTIFICATION OF GIARDIA INTESTINALIS IN DIARRHOEAL CHILDREN: COMPARISON OF THREE DIAGNOSTIC...

Area of Science:

• Medical Parasitology
• Infectious Diseases
• Pediatric Gastroenterology

Background:

• Giardiasis, caused by Giardia duodenalis, presents a significant global health challenge.
• Current diagnostic methods for giardiasis have limitations in accuracy and efficiency.
• Accurate diagnosis is essential for effective treatment and public health management.

Purpose of the Study:

• To evaluate and compare the diagnostic performance of various methods for Giardia duodenalis detection in diarrheal children.
• To assess the clinical utility of direct wet mount, concentration microscopy, ELISA, and n-PCR.
• To determine the most reliable diagnostic approach for giardiasis.

Main Methods:

• A study involving 100 diarrheal children from Cairo University, Egypt.
• Diagnostic techniques included direct wet mount, concentration microscopy, Ridascreen ELISA, and n-PCR targeting the beta giardin gene.
• Statistical analysis involved calculating sensitivity, specificity, predictive values, and likelihood ratios, with ELISA as the reference standard.

Main Results:

• All tested methods demonstrated a high positive likelihood ratio (LR+) for diagnosing giardiasis.
• Nested PCR (n-PCR) achieved a negative likelihood ratio (LR-) of 0.00, indicating high confidence in ruling out infection when negative.
• ELISA was ranked superior to n-PCR based on Multiattribute Utility Theory and Analytical Hierarchy Process.

Conclusions:

• ELISA and n-PCR are valuable tools for diagnosing giardiasis, with n-PCR offering excellent negative predictive power.
• ELISA is recommended as a preferred diagnostic method due to its overall performance and ranking.
• Further research may explore optimizing these diagnostic strategies for broader clinical application.