GIARDIA LAMBLIA

Lecture by Dr. Stephen J Ndombi MBCHB, MMED, MD

Senior Consultant physician and Senior Lecturer
University of Nairobi
Geographical distribution, habitat and
morphology
• The parasite is of worldwide distribution
• Normally it is found in the duodenum and upper part of the jejunum
• Morphologically exists in two phases trophozoite and cyst as shown
below:
Life cycle
Pathogenesis and clinical presentation
• The parasite located in the duodenum and jejunum causes mechanic
barrier and interference with digestion and absorptionespecially of fat
• This interference leads to steatorrhea (passage of fat in stool)
• The stool is bulky and foul smelling and messy
• It characteristically floats on toilet closets and is hard to flush away
• The fat malabsorption is accompanied by fat soluble vitamin
deficiency (A,D,E, K), with resultant constitutional symptoms
• Allergic skin reactions are common especially in children
• Abdominal pain, anorexia, nausea and weight loss
Diagnosis and treatment
• Diagnosis is by stool examination and identification of the cysts and
occasionally trophozoite in the diarrhoeal stool
• Various techniques can be used to sample duodenal aspirates
(endoscopic techniques and string test)
• Treatment is achieved by administering Metronidazole, Secnidazole,
Tinidazole and even Paromomycine
Control and prevention
• Good personal hygiene and washing hands before meals
• Proper excreta disposal
• Drinking of safe water (water treatment)
• Treatment of infected individuals
• Seewage treatment and avoidance of use of seewage to irrigate
vegetables or usage of human waste as fertilisers
• Health education about transmission of the parasite
• Control of house flies