GIARDIA LAMBLIA IN DYSPEPTIC DIARRHEIC PATIENTS ATTENDING OCTOBER 6 UNIVERSITY HOSPITAL, EGYPT
Mousa A. M. Ismail1, Naglaa F. A. Imam1, Samah S. Abdel Gawad2 , and Sahar S. El-Wakil3
Departments of Parasitology, Faculties of Medicine, Cairo University1 and Beni Suef University2, and Department of Internal Medicine, Faculty of Medicine, Cairo University3
Giardiasis is a major cosmopolitan protozoan illness which usually presents with diarrhea among other manifestations. Dyspepsia is a very frequent gastrointestinal symptom that may be associated with giardiasis, but it is often overlooked as a cause or contributing factor in the development of dyspepsia in non-peptic ulcer patients. In this cross-sectional study, 80 diarrheic adult patients complaining of dyspepsia, without peptic ulcer, as a main symptom were enrolled, along with 40 control subjects. Stool samples were collected from all the study patients and subjects. The study patients had a mean age of 45.23 ± 11.27, and were 42 (53%) males and 38 (47%) females. By concentration technique and direct microscopy, Giardia lamblia (G. lamblia) trophozoites were detected in 9 (11.25%) cases. Results of coproantigen detection by ELISA and a rapid dipstick immunochromatography test were superior, detecting 13 (16.25%) and 15 (18.75%) patients, respectively. This was statistically significant compared to both results of microscopy and healthy controls, who were all G. lamblia negative by all used techniques. In conclusion, G. lamblia appears to have a role in the development or persistence of dyspepsia patients. It should be ruled out or treated, especially in patients not responding to dyspepsia treatment. Moreover, rapid coproantigen detection dipstick tests are highly recommended as a diagnostic tool, being highly sensitive and specific, especially in the absence of experienced microscopists and if only one stool sample is available.