No abstract

Advances in our understanding of chronic giardiasis (CG) may improve our care of patients in this stage of the disease. This review proposes a new concept of CG and highlights the recent advances in our understanding and management of this condition. According to this review, management requires, initially, an accurate diagnosis, which may exclude several conditions that can mimic CG. Optimal treatment requires a tailored approach which includes the recognition of the known modifiable causes of this health condition, assessment of symptoms and potential complications, their treatment utilizing, if necessary, a multidisciplinary team, and an ongoing monitoring for the effect of therapy - weighing the efficacy of individual drugs - all of these together may lead to a successful treatment of CG.

Introduction: Despite years of relative neglect, interest in Giardia infection seems to be recently growing, perhaps in part due to its inclusion into the World Health Organization's Neglected Diseases Initiative since 2004. The purpose of this study was to provide an overview of Giardia and giardiasis research over time, as represented by the quantity of published papers. Methodology: Data for this study were collected from the electronic PubMed/Medline database of National Library of Medicine's (NLM), due to it is easily accessibility and wide use. It was accessed online between April and December 2011. Data for the period 1971-2010 were obtained and information was downloaded using the EndNote program developed by Thomson Reuters. Results: During the study period, a total of 6,964 references (articles, reviews, editorials, letter to the editor, etc.) covering different aspects of Giardia and giardiasis were located in the PubMed database after applying the search strategy reported above. Most papers were original articles and published in English. Conclusions: In this first effort to explore the development and research productivity on giardiasis over time (no previously published bibliometric studies on giardiasis exist), two interesting characteristics of the Giardia and giardiasis literature were discovered: the concentration of papers over journals disseminating the research results, and that research in this field is growing and will likely continue to grow in the coming years.

To compare the efficacy and safety of mebendazole and secnidazole in the treatment of giardiasis in adult patients, a single-centre, parallel group, open-label, randomized non-inferiority trial was carried out. One-hundred and 26 participants who had symptomatic Giardia mono-infection took part in the study. Direct wet mount and/or Ritchie concentration techniques and physical examinations were conducted at the time of enrolment and at the follow-up visit. The primary outcome measure was parasitological cure, performed at 3, 5, 10 days post-treatment. Negative faecal specimens for Giardia were ensured by the same parasitological techniques. At follow up (day 10) the parasitological cure rate for the per protocol populations was 88.7% (55/62) for MBZ and 91.8% (56/61) for SNZ. For the intention to treat populations the cure rate at the end of treatment was 85.9% (55/64) for MBZ and 90.3% (56/62) for SNZ. Both analyzes showed there was not significant statistical difference between MBZ and SNZ treatment efficacy. Both drugs were well tolerated, only mild, transient and self-limited side effects were reported and did not require discontinuation of treatment. A 3-day course of mebendazole seems to be as efficacious and safe for treatment of giardiasis as a single dose of secnidazole in adults.

Intestinal protozoan infections are a worldwide problem in both industrialised and unindustrialised countries; in the latter they may be the cause of significant morbidity and mortality. Children, in particular, are more likely to experience considerable morbidity. Most intestinal protozoan infections can cause acute or chronic diarrhoea in healthy individuals and may result in intractable, life-threatening illness in patients with immunosuppressive diseases such as AIDS. Adequate identification and treatment of these infections may provide significant benefit for individual patients and public health. This article presents an update on the pharmacotherapy currently available for amoebiasis, giardiasis and other intestinal protozoan infections.