Mengistu Damitie^1,2, Zeleke Mekonnen³, Seid Tiku¹, Dante Santiago², Luc Leyns¹

¹Vrije University Brussel, Belgium, Faculty of Bio-science Engineering

²Jimma University, Institute of Health Sciences, Faculty of Public Health, Department of Environmental Health and Technology

³Jimma University, Institute of Health Sciences, School of Medical Laboratory Sciences

Abstract

Introduction: Giardia duodenalis is the most frequently reported intestinal parasite that causes gastrointestinal disorder in humans, particularly in developing countries where permissible circumstances promote transmission of parasites. However, there is insufficient information regarding the parasite in these areas, thus this study aimed at determining the clinical significance of Giardia duodenalis genotypes in Southern Ethiopia.

Methods: From February to May 2016, ten health facilities in the region were selected randomly and stool samples were collected from 70 giardiasis patients who were seeking medical care in the facilities. The isolates were genotyped using Giardia duodenalis triosephosphate isomerase gene nested-polymerase chain reaction assay and the patients’ clinical history and related data were collected through pre tested structured questionnaire. The data was analyzed using Pearson Chi-Square tests and multinomial logistic regression model.

Results: The genotyping results showed that 44.3% (31/70) of the isolates were assemblage A, 38.6% (27/70) assemblage B and 17.1% (12/70) combination of both assemblages. Symptoms of giardiasis showed correlations with assemblages. Cases with assemblage A infection associated with the occurrence of diarrhea, assemblage B with abdominal pain and nausea/vomiting. Mixed infection of both assemblages correlated concurrently with the occurrence of diarrhea and abdominal pain. The distribution of assemblages and clinical symptoms of the disease however did not differ with sex and age of patients.

Conclusions: The genotyping analysis showed that assemblages A and B are the predominant genotypes of Giardia duodenalis among patients in Southern Ethiopia. Cases with assemblages A and B infections differ in their associations with the clinical symptoms of giardiasis. Infection with assemblage B associated with greater numbers of giardiasis symptoms than infection with assemblage A. However, the present study recommends the need for further investigations regarding other factors, such as host factors that may influence the clinical manifestations of the disease.

Keywords: Giardia duodenalis, assemblages, giardiasis symptoms, clinical significance, Ethiopia