The zoonotic significance and molecular epidemiology of Giardia and giardiasis

Thompson, R.C.A.

doi:10.1016/j.vetpar.2004.09.008

Cited by 408 publications

(406 citation statements)

References 72 publications

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“…Los perros y primates podrían ser fuentes potenciales de infección humana. Sin embargo, la transmisión a través de los primeros es improbable y a través de los segundos parece ser mínima 25,26 .…”

Section: La Epidemiología De La Amebiasisunclassified

Amebiasis: aspectos clínicos, terapéuticos y de diagnóstico de la infección

Chacín-Bonilla

2013

Rev. méd. Chile

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609artículos de revisión L a amebiasis se considera como una causa importante de morbilidad y mortalidad en el mundo y constituye dentro de las enfermedades de origen parasitario, especialmente en el mundo en desarrollo, la tercera causa de muerte después de la malaria y la esquistosomiosis 1,2 . El reconocimiento de Entamoeba dispar y Entamoeba moshkovskii en humanos ha complicado más el diagnóstico de E. histolytica. Estas tres especies son morfológicamente indistinguibles y las dos primeras se consideran comensales. Sin embargo, estudios recientes sugieren que puedan desempeñar un papel patógeno. En Bangladesh e India, E. dispar y E. moshkovskii se observaron asociadas con síntomas gastrointestinales 3 y se ha demostrado que E. dispar produce lesiones intestinales y hepáticas en conejillos de Indias 4 . La distribución mundial y la magnitud de la infección de estas tres especies no son conocidas, ya que la mayoría de los diagnósticos, especialmente en el tercer mundo, se siguen basando en la observación microscópica lo que no permite diferenciarlas. Los datos actuales sugieren que E. dispar es 10 veces más común que E. histolytica en individuos asintomáticos pero las prevalencias locales de ambas especies varían significativamente 1 . No todas las infecciones con E. histolytica conducen a la enfermedad y sólo una de cada 10 infecciones progresan hacia la enfermedad 3 . El objetivo de esta revisión es describir y discutir los avances recientes en la amebiasis con énfasis en los aspectos clínicos, de diagnóstico y manejo de la infección. La epidemiología de la amebiasisLa amebiasis es común y ampliamente diseminada, pero la prevalencia varía según las áreas geográficas. Alrededor de 50 millones de personas

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Section: La Epidemiología De La Amebiasisunclassified

Amebiasis: aspectos clínicos, terapéuticos y de diagnóstico de la infección

Chacín-Bonilla

2013

Rev. méd. Chile

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“…When PQ was co-administered with ABZ, it increases the serum level of albendazole sulphoxide, the active metabolite of ABZ (Homeida et al, 1994). Based on these evidences, two clinical trials were conducted (Pengsaa et al, 2002;2004). In the first one, a combined single dose of ABZ 400 mg and PZQ 20 mg/kg achieved a parasitological cure rate of 74.2%; more than ABZ 800 mg as a single dose (50%), but less than TNZ 50 mg/kg as a single dose (92.6%) (Pengsaa et al, 2002).…”

Section: Randomized Clinical Trialsmentioning

confidence: 99%

“…cats and dogs) (Bouzidet al, 2015). Pets are prevalently infected with host-specific assemblages (C and D in dogs, F in cats), but the zoonotic A and B assemblages were also reported in several settings, and may prevail in environments commonly contaminated with cysts from the feces of humans or other animals (Thompson, 2004;Ballweberet al, 2010). Although their role as reservoir and the associated risk for their owners is unclear, their treatment to potentially reduce the risk of transfer to human beings cannot be ignored.…”

Section: -Nitroimidazole Compoundsmentioning

confidence: 99%

Combination therapy in the management of giardiasis: What laboratory and clinical studies tell us, so far

et al. 2016

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Treatment failures in patients suffering from giardiasis is not uncommon feature. The most frequent approach in these cases is to treat these patients with longer repeated courses and/or higher doses of the primary therapy, or using drugs from a different class to avoid potential cross-resistance. However, a higher rate of adverse events may limit this strategy. In this context, combination therapy (CT) is emerging as a valuable option against refractory giardiasis. In the attempt to evaluate the benefits of CT, a number of experimental studies, clinical series, and randomized clinical trials (RCTs), as well as several veterinary studies have been performed, with varying results. Here, we present a critical analysis of the available information regarding CT for the treatment of Giardia infection, as well as the authors' opinion with respect to its use. RCTs of combination therapy are limited and the optimal combinations and administration strategies need yet to be clarified. Analyses of the cost-effectiveness and RCTs of CTs for Giardia infection are required to assess the role of these drugs for the control of giardiasis, mainly in the case of treatment failures linked to suspected drug tolerance are the case. KeywordsGiardia To view all the submission files, including those not included in the PDF, click on the manuscript title on your EVISE Homepage, then click 'Download zip file'. HighlightsTreatment failures are not uncommon in giardiasis.Published studies have shown combination therapy in giardiasis to be safe and effective.Observations encourage the study of combinations of metronidazole with albendazole or quinacrine.Combination therapy could be a useful alternative in the case of treatment failures linked to suspected drug tolerance. Treatment failures in patients suffering from giardiasis are not uncommon feature. The most frequent approach in these cases is to treat these patients with longer repeated courses and/or higher doses of the primary therapy, or using drugs from a different class to avoid potential cross-resistance. However, a higher rate of adverse events may limit this strategy. In this context, combination therapy (CT) is emerging as a valuable option against refractory giardiasis. In the attempt to evaluate the benefits of CT, a number of experimental studies, clinical series, and randomized clinical trials (RCTs), as well as several veterinary studies have been performed, with varying results. Here, we present a critical analysis of the available information regarding CT for the treatment of Giardia infection, as well as the authors' opinion with respect to its use. RCTs of combination therapy are limited and the optimal combinations and administration strategies need yet to be clarified. Analyses of the cost-effectiveness and RCTs of CTs for Giardia infection are required to assess the role of these drugs for the control of giardiasis, mainly in the case of treatment failures linked to suspected drug tolerance are the case.

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“…Although the adverse consequences of Giardia infection and its pathogenic potential are best recognized in humans 0304-4017/$ -see front matter © 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.vetpar.2011.12.023 (Thompson, 2004), it is also a well known causative agent of diarrhea in dogs and cats. Diarrhea is common in both animal species, with many possible causes: non-infectious (stress, disturbances in water balance, nutritional and immune status, malnutrition, neoplasia, inflammatory disease) and infectious (bacterial, parasitic, or viral infections) causes, but also any combination of the above (Payne and Artzer, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Currently, seven Giardia genotypes, designated assemblages and in some cases assigned distinct species names, are recognized. Dogs are infected by parasites of four assemblages (A, B, C, D), of which assemblages C and D (also defined as G. canis) are found exclusively in dogs, while parasites of assemblages A and B (also defined as G. enterica) are zoonotic (Covacin et al, 2011;Thompson, 2004;Thompson and Monis, 2011).…”

Section: Introductionmentioning

confidence: 99%

Control of Giardia infections with ronidazole and intensive hygiene management in a dog kennel

Fiechter

Deplazes

Schnyder

2012

Veterinary Parasitology

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Infections with the intestinal protozoan parasite Giardia in dogs and cats are common. Clinical signs vary from asymptomatic to small bowel diarrhea and associated discomfort. The control of infections in dogs is frequently a frustrating issue for animal owners and veterinarians. Drugs with antiprotozoal activity such as fenbendazole and metronidazole are recommended, however, they do not show 100% efficacy and superinfections occur regularly. Ronidazole is currently the drug of choice for the treatment of Tritrichomonas foetus in cats and there is now limited information available about its efficacy against Giardia spp. In the kennel investigated, dogs regularly showed loose feces and the presence of Giardia (assemblage C, renamed as G. canis) cysts. An elimination strategy of this parasite involving strict hygiene management and disinfection of the enclosures with 4-chlorine-M-cresol, oral treatment with ronidazole (30-50mg/kg BW bid for 7 days) and two shampooings (containing chlorhexidine) at the beginning and the end of the treatments was implemented for a group of 6 dogs. As a control another group of 7 dogs was transferred to the disinfected enclosures and shampooed, but left untreated. Dog feces were tested for the presence of Giardia cysts (SAF concentration technique) or Giardia antigen with a commercial ELISA (NOVITEC(®)) and a quick immunochromatography-based test (SensPERT(®)) before and between 5 and 40 days after the last treatment. All ronidazole-treated dogs were negative for Giardia cysts and antigen up to 26 days after the last treatment, while between 1 and 5 of the control animals tested positive in each of the test series. At this point, also dogs of the control group were again moved into clean enclosures, shampooed twice and treated with ronidazole. Five, 12 and 19 days after the last treatment, the dogs in the control group tested negative for Giardia cysts and antigen. However, all animals had again positive results at later time points in at least one of the three applied diagnostic techniques within 33-61 days after treatment. Furthermore, all dogs had episodes of diarrhea (for 1-4 days) within 14-31 days after treatment and unformed feces during the whole experiment. The positive effect of ronidazole against Giardia infections in dogs could be confirmed in this study. In particular, the combination of ronidazole treatment combined with the disinfection of the environment and shampooing of the dogs was highly effective in reducing Giardia cyst excretion and may therefore constitute an alternative control strategy for canine giardiosis. t r a c tInfections with the intestinal protozoan parasite Giardia in dogs and cats are common. Clinical signs vary from asymptomatic to small bowel diarrhea and associated discomfort. The control of infections in dogs is frequently a frustrating issue for animal owners and veterinarians. Drugs with antiprotozoal activity such as fenbendazole and metronidazole are recommended, however, they do not show 100% efficacy and superinfections occur ...

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The zoonotic significance and molecular epidemiology of Giardia and giardiasis

Cited by 408 publications

References 72 publications

Amebiasis: aspectos clínicos, terapéuticos y de diagnóstico de la infección

Amebiasis: aspectos clínicos, terapéuticos y de diagnóstico de la infección

Combination therapy in the management of giardiasis: What laboratory and clinical studies tell us, so far

Control of Giardia infections with ronidazole and intensive hygiene management in a dog kennel

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