Abstract

Giardiasis is a common intestinal infection, recently included by the World Health Organization in the ‘Neglected Diseases Initiative’. Despite the efficacy of nitroimidazoles; the main antigiardial chemotherapeutics, adverse effects and resistance enforced developing non-chemical alternatives. The present study aimed to assess the therapeutic efficacy of ethanol extract of olibanum (OL), propolis (PR), and their combination versus metronidazole (MTZ) against G. lamblia infection. Sixty Swiss male albino mice were randomly divided into 6 groups; 10 mice each,: Group I: normal control (non-treated; non-infected). Group II: infected with G. lamblia cysts, non-treated. On the 6th day postinfection (dPI), the remaining 4 infected groups were treated orally with: Group III: (OL). Group IV: (PR). Group V: combination of (OL+PR). Group VI: (MTZ). These mice were subjected to direct parasitological diagnosis of Giardia trophozoite in intestinal exudate, immunochromatographic test for antigen detection and histopathological studies. After 7 days therapy, complete clearance of Giardia trophozoites were in the combination of (OL+PR) and MTZ groups therapy. Lower percentages of reduction (91%) & (83%) were recorded in PR and OL-treated groups, respectively. Histopathological examination showed marked healing of intestinal mucosa using non-chemical combination and different degrees of dysplasia using MTZ, while partial healing was observed using olibanum and propolis separately. Olibanum, propolis and their combination were proved to enhance the clearance of Giardia trophozoites; with progressive improvement of the histopathological changes of jejunal mucosa, making good non-chemical alternative antigiardial therapeutics sidestepping the obstacles of metronidazole like dysplasia and teratogenicity.

Highlights

  • Giardia lamblia is a very common intestinal protozoan causing diarrhea among children and affects about 200 million people per year; mainly in Africa, Asia and America [1]

  • Superiority of immunochromatographic method over conventional microscopy is linked to its capability of detection of minimal quantities of antigens, even with low burden of the parasite, wherever several fecal samples are required by conventional microscopy, especially with the intermittent cyst shedding in chronic infections [5], or damaged cysts with frozen fecal samples [6]

  • In comparison to control infected group (GII), there was a high significant difference among all studied groups (P

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Summary

Introduction

Giardia lamblia is a very common intestinal protozoan causing diarrhea among children and affects about 200 million people per year; mainly in Africa, Asia and America [1]. False-negative results due to intermittence and low number of the cysts shed in fecal samples may be encountered. To overcome these obstacles, a combination of diagnostic methods is frequently indicated [4]. These mice were subjected to direct parasitological diagnosis of Giardia trophozoite in intestinal exudate, immunochromatographic test for antigen detection and histopathological studies. Results: After 7 days therapy, complete clearance of Giardia trophozoites were in the combination of (OL+PR) and MTZ groups therapy. Conclusion: Olibanum, PR and their combination were proved to enhance the clearance of Giardia trophozoites; with progressive improvement of the histopathological changes of jejunal mucosa, making good non-chemical alternative antigiardial therapeutics sidestepping the obstacles of MTZ like dysplasia and teratogenicity

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