Occurrence and molecular characterization of Giardia duodenalis in lambs in Djelfa, the central steppe of Algeria.

Little is known of the prevalence and genetic identity of Giardia duodenalis in sheep in Algeria. The present study aimed at characterizing G. duodenalis in lambs up to 6 months of age in Djelfa, Algeria. A total of 346 fecal specimens were collected from 28 farms and screened for G. duodenalis cysts by zinc sulfate flotation microscopy, and positive specimens were confirmed using a direct immunofluorescence assay. Microscopy-positive specimens were analyzed by PCR and sequence analysis of the triosephosphate isomerase and glutamate dehydrogenase genes to determine G. duodenalis assemblages. Coprological examination indicated that the overall infection rate was 7.0% (24/346). Lambs under 3 months of age had higher infection rate (18/197, 9.0%) than older (6/149, 4.0%) animals, and animals with diarrhea (7/44, 16.0%) had higher infection rate than animals without diarrhea (17/302, 5.6%). PCR sequence analyses of the 15 G. duodenalis isolates revealed the presence of assemblages A in 6 isolates, assemblage E in 7 isolates, and both in 2 isolates. Assemblage A was only found in pre-weaned lambs with diarrhea, while assemblage E was mostly found in post-weaned lambs without diarrhea. The assemblage E isolates from sheep were genetically related to those from cattle in Algeria, while assemblage A isolates were from a well-known subtype prevalent in humans. Data generated from the study improve our understanding of the transmission of G. duodenalis in Algeria.

Giardiasis outbreaks in the United States, 1971-2011.

Giardia intestinalis is the leading parasitic aetiology of human enteric infections in the United States, with an estimated 1·2 million cases occurring annually. To better understand transmission, we analysed data on all giardiasis outbreaks reported to the Centers for Disease Control and Prevention for 1971-2011. The 242 outbreaks, affecting ~41 000 persons, resulted from waterborne (74·8%), foodborne (15·7%), person-to-person (2·5%), and animal contact (1·2%) transmission. Most (74·6%) waterborne outbreaks were associated with drinking water, followed by recreational water (18·2%). Problems with water treatment, untreated groundwater, and distribution systems were identified most often during drinking water-associated outbreak investigations; problems with water treatment declined after the 1980s. Most recreational water-associated outbreaks were linked to treated swimming venues, with pools and wading pools implicated most often. Produce was implicated most often in foodborne outbreaks. Additionally, foods were most commonly prepared in a restaurant and contaminated by a food handler. Lessons learned from examining patterns in outbreaks over time can help prevent future disease. Groundwater and distribution system vulnerabilities, inadequate pool disinfection, fruit and vegetable contamination, and poor food handler hygiene are promising targets for giardiasis prevention measures.

Relación endoscópica entre duodenitis inespecífica y sobrecrecimiento bacteriano del intestino delgado / Endoscopic relationship between non specific duodenitis and snall intestine bacterial overgrowth

Cuando aparece una proliferación de la flora de tipo colónico en el intestino delgado se producen alteraciones en la digestión y absorción intestinal, que clínicamente conforman el síndrome del Sobrecrecimiento Bacteriano del Intestino Delgado (SBID). En el SBID la concentración bacteriana aumenta hasta 107-109 UFC/ml en intestino delgado. El principio del test de hidrógeno espirado es la administración de un carbohidrato (Lactulosa, dxilosa, glucosa), que al ser degradado por las bacterias produce un aumento de los niveles de hidrógeno espirado en pacientes con SBID. Hipótesis: Si la duodenitis inespecífica se manifiesta clínicamente de manera similar al (SBID) entonces puede haber una relación entre ambas patologías. Métodos: Se realizó un estudio clínico descriptivo prospectivo de una muestra seleccionada quienes tuvieron como hallazgo en la endoscopia digestiva superior duodenitis inespecífica. Se usó Video endoscopio Olympus GIF-140, en dicha endoscopia se tomó biopsia del tejido duodenal con pinza. Posteriormente el paciente fue sometido a prueba de hidrógeno en aliento aire espirado con 10 gr de Lactulosa. Resultados: La prueba de Hidrógeno en aliento resultó positiva en 18 pacientes (29,5%) y negativo en 43 (70,5%) (p=1,000). La sensibilidad fue de 29,6% y Especificidad 71% (IC 95%). Conclusiones: 1) La prueba de Hidrógeno en aire espirado con Lactulosa es una prueba con poca sensibilidad pero específica para el Diagnóstico de SBID. 2) La prevalencia de duodenitis giardiásica fue del 11,5% en la población estudiada. 3) Los hallazgos histológicos referentes a las alteraciones de las vellosidades intestinales no están correlacionados con el SBID.

When a proliferation of the flora of type colonic appears in the small intestine they are caused by alterations in the digestion and intestinal absorption, which they make up clinically the syndrome of the Small Intestine Bacterial Overgrowth (SIBO). In SIBO the bacterial concentration increased to 107-109 UFC/ml in the small intestine. The origin of the exhaled hydrogen test is the administration of a carbohydrate (Lactulose, d-xylose, glucose), which when broken down by the bacteria produce an increase in the levels of the exhaled hydrogen in patients with SIBO. Hypothesis: If the non-specific duodenitis appears clinically similar in a way to (SIBO) then there may be a connection between both pathologies. Methods: We carried out a prospective descriptive clinical trial of a selected sample who had the finding of nonspecific duodenitis in the upper endoscopy. We used Video endoscope Olympus GIF-140, in that endoscopic was taken biopsy of the duodenal tissue with forceps. Subsequently, the patient was undergone of Breath-hydrogen test with 10 gr of lactulose. Results: the hydrogen breath test was positive in 18 patients (29.5%) and negative in 43 (70.5%) (p = 1.000). The sensitivity was 29.6% and specificity 71% (95%). Conclusions: 1) Hydrogen breath test with lactulose is less sensitive but specific for the diagnosis of SIBO. 2) The prevalence of giardiasic duodenitis was 11.5% in our trial. 3.) Histological findings regarding alterations of the intestinal villi are uncorrelated with SIBO.