Abstract
BackgroundGiardia duodenalis is an important intestinal protozoan in humans worldwide with high infection rates occurring in densely populated and low resource settings. The parasite has been recorded to cause diarrhea in children. This study was carried out to identify G. duodenalis assemblages and sub-assemblages in children presenting with diarrhea in Kenya.MethodsA total of 2112 faecal samples were collected from children aged ≤5 years and screened for the presence of Giardia cysts using microscopy. A total of 96 (4.5 %) samples were identified as Giardia positive samples and were genotyped using glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi) and β-giardin loci.ResultsThe three markers successfully genotyped 72 isolates and grouped 2 (1.4) isolates as Assemblage A, 64 (88.9) as Assemblage B and 7 (9.7 %) consisted of mixed infections with assemblage A and B. A further analysis of 50 isolates using GDH Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) categorized 2 assemblage A isolates as sub-assemblage AII while 6 and 14 assemblage B isolates were categorized into sub-assemblage BIII and BIV respectively. A mixed infection with sub-assemblage BIII and BIV was recorded in 28 isolates. Over half (55.6 %) of Giardia infections were recorded among the children between 13 to 48 months old.ConclusionThis paper reports the first data on the assemblages and sub-assemblages of Giardia duodenalis in children representing with diarrhea in Kenya.
Highlights
Giardia duodenalis is an important intestinal protozoan in humans worldwide with high infection rates occurring in densely populated and low resource settings
We report the detection and genetic variability of G. duodenalis in Human Immunodeficiency Virus infected and/or uninfected children presenting with diarrhoea in outpatient clinics at Mukuru informal settlement on the outskirt of Nairobi, Kenya and those admitted at the Paediatric ward at the Mbagathi district hospital in Nairobi
Multi-locus PCR Microscopy showed 98 stool samples to be positive for Giardia of which 80(83 %) were positive using the PCR tests targeting GDH, Tpi and β giardin loci while sixteen were negative
Summary
Giardia duodenalis is an important intestinal protozoan in humans worldwide with high infection rates occurring in densely populated and low resource settings. This study was carried out to identify G. duodenalis assemblages and sub-assemblages in children presenting with diarrhea in Kenya. Giardia duodenalis is a flagellated protozoan infecting humans and a wide range of animals worldwide, mainly transmitted through food and water contaminated with cysts [1, 2]. Three sub-assemblages have been identified within Assemblage A and namely AI, AII and AIII [5, 10]. The sub-assemblage AI is zoonotic, while subtype AII predominantly occurs in humans [11] and subtype AIII has solely been identified in animals (mainly wild ungulates) [12]. Studies searching for differences in clinical symptoms between people infected with assemblages A and B have reported varying results. Some studies reported a strong association between intermittent diarrhoea and
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