Trends and clinico-epidemiological profile of patients with Giardiasis: Five-year experience from a university hospital of northern India

Abstract

Background: Giardiasis is an important cause of diarrheal disease and is associated with morbidity in children and adults worldwide. We aimed to study the prevalence of Giardiasis, its clinical presentations, seasonal trends in detection, and coinfection with other intestinal parasites along with comparison of fecal antigen and microscopy for the detection of Giardiasis. Materials and Methods: It is a retrospective study conducted from Jan. 2017 to Dec. 2021 at our university hospital. Iodine and normal saline mounts and enzyme-linked immunosorbent assay (ELISA) were used for the detection of Giardiasis in stool samples. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of tests were computed. Results: Of 8364 patients, 432 (5.2%) had Giardiasis by microscopy and/or ELISA. Giardiasis was more common in males compared to females (318/5613 [5.6%] vs. 114/2751 [4.1%]; P = 0.003) and among those ≤10 y compared to older individuals (102/560 [18.2%] vs. 330/7804 [4.2%]; P <0.0001). Most cases were detected in the month of May to October. The most common clinical presentation was diarrhea (80.1%) and abdominal pain (72.9%) followed by malnutrition (60.2%) and loss of appetite (46.8%). Using microscopy as gold standard, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ELISA were 95%, 91%, 91%, 95%, and 93%, respectively. Conclusion: Awareness and knowledge amongst the primary healthcare professionals and family physicians will help in early diagnosis and treatment of Giardiasis. Fecal antigen detection should be done along with microscopy for detection of Giardiasis.