Risk Of Giardia Infection Research Articles

Risk of Giardia infection for drinking water and bathing in a peri-urban area in São Paulo, Brazil

A high incidence of waterborne diseases is observed worldwide and in order to address contamination problems prior to an outbreak, quantitative microbial risk assessment is a useful tool for estimating the risk of infection. The objective of this paper was to assess the probability of Giardia infection from consuming water from shallow wells in a peri-urban area. Giardia has been described as an important waterborne pathogen and reported in several water sources, including ground waters. Sixteen water samples were collected and examined according to the US EPA (1623, 2005). A Monte Carlo method was used to address the potential risk as described by the exponential dose response model. Giardia cysts occurred in 62.5% of the samples (<0.1–36.1 cysts/l). A median risk of 10−1 for the population was estimated and the adult ingestion was the highest risk driver. This study illustrates the vulnerability of shallow well water supply systems in peri-urban areas.

Lack of an Adverse Effect of Giardia intestinalis Infection on the Health of Peruvian Children

Giardia intestinalis is a common gastrointestinal protozoan worldwide, but its effects on childhood growth in developing countries are not clearly understood. The authors aimed to describe its effects on child growth. They followed 220 Peruvian children daily for diarrhea, weekly for stool samples, and monthly for anthropometry. The authors modeled the effect of nutritional status on the risk of Giardia infection and the risk of diarrhea attributable to Giardia using negative binomial regression. They modeled the effects of Giardia infection on growth using linear regression, with 85% of children becoming infected with Giardia and 87% of these becoming reinfected. In multivariable analysis, the risk of Giardia infection did not vary with weight for age (relative risk = 1.00, 95% confidence interval: 0.89, 1.12) or height for age (relative risk = 0.92, 95% confidence interval: 0.82, 1.04). Giardiasis did not affect growth at 1 or 2 months following the first infection at any age interval. The longitudinal prevalence of Giardia between 6 and 24 months of age was not associated with height gain in that interval (p = 0.981). Giardia was not associated with an increased risk of diarrhea at any age interval. Study results question the importance of Giardia as a childhood pathogen in developing countries where giardiasis is hyperendemic.

Risk factors for sporadic giardiasis: a case-control study in southwestern England.

To investigate risk factors for sporadic infection with Giardia lamblia acquired in the United Kingdom, we conducted a matched case-control study in southwest England in 1998 and 1999. Response rates to a postal questionnaire were 84% (232/276) for cases and 69% (574/828) for controls. In multivariable analysis, swallowing water while swimming (p<0.0001, odds ratio [OR] 6.2, 95% confidence intervals [CI] 2.3 to 16.6), recreational fresh water contact (p=0.001, OR 5.5, 95% CI 1.9 to 15.9), drinking treated tap water (p<0.0001, OR 1.3, 95% CI 1.1 to 1.5 for each additional glass per day), and eating lettuce (pç=0.01, OR 2.2, 95% CI 1.2 to 4.3) had positive and independent associations with infection. Although case-control studies are prone to bias and the risk of Giardia infection is minimized by water treatment processes, the possibility that treated tap water is a source of sporadic giardiasis warrants further investigation.

Occurrence of pathogenic microorganisms in the Saint Lawrence River (Canada) and comparison of health risks for populations using it as their source of drinking water

A 300-km portion of the Saint Lawrence hydrological basin in the province of Québec (Canada) and 45 water treatment plants were studied. River water used by drinking water treatment plants was analyzed (6-L sample volumes) to determine the level of occurrence of bacterial indicators (total coliforms, fecal coliforms, and Clostridium perfringens) and pathogens (Giardia lamblia, Cryptosporidium, human enteric viruses). Pathogens and bacterial indicators were found at all sites at a wide range of values. Logistic regression analysis revealed significant correlations between the bacterial indicators and the pathogens. Physicochemical and treatment practices data were collected from most water treatment plants and used to estimate the level of removal of pathogens achieved under cold (0 degree C-4 degrees C) and warm (20 degrees C-25 degrees C) water temperature conditions. The calculated removal values were then used to estimate the annual risk of Giardia infection using mathematical models and to compare the sites. The estimated range of probability of infection ranged from 0.75 to less than 0.0001 for the populations exposed. Given the numerous assumptions made, the model probably overestimated the annual risk, but it provided comparative data of the efficacy of the water treatment plants and thereby contributes to the protection of public health.

Epidemiology of giardiasis in Tasmania: a potential risk to residents and visitors.

Giardia infection is an ongoing problem in Tasmania and occurs throughout the state. It has been postulated that part of the problem is the reservoir of infection in native animals which is suggested to contribute to infections in humans. To date, however, no detailed study on the epidemiology of giardiasis in Tasmania has been carried out. Information regarding the prevalence of Giardia infection in humans and the risk of intrafamilial transmission was obtained from the Department of Community and Health Services and from the direct examination of human or animal fecal samples. Giardia has been found to be present in a wide range of native and domestic animals and in humans of all ages from all over the state. Giardiasis is endemic in Tasmania and poses a risk to locals as well as to visitors to the state, especially those who participate in wilderness activities such as bushwalking. These people must be aware of the possible risk of Giardia infection and should take precautionary measures to avoid infection.