Giardia duodenalis Assemblages Associated with Diarrhea in Children in South India Identified by PCR-RFLP

Sitara S. R. Ajjampur Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Premi Sankaran Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Arun Kannan Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Kirthi Sathyakumar Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Rajiv Sarkar Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Beryl P. Gladstone Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Gagandeep Kang Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Department of Community Health, Christian Medical College, Vellore, India

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Giardial diarrhea in a birth cohort of 452 children in an urban slum in South India was characterized. Of the 155 episodes that occurred in 99 children, 73% were acute diarrhea. Children with better educated mothers and a toilet at home had lower odds of acquiring giardial diarrhea, whereas low socioeconomic status and drinking municipal water were associated with greater risk. Children with co-infections tended to have a slightly longer duration of diarrhea (P = 0.061) and showed significantly more wasting after an episode than children with diarrhea resulting from Giardia alone (P = 0.032). Among the 99 cases, 50 diarrheal and 51 asymptomatic Giardia positive samples were genotyped by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) at the triose phosphate isomerase gene. Assemblage B was predominant both in giardial diarrhea (80%) and asymptomatic giardiasis (94%). Children with Assemblage A subgroup-II alone or dual infections with both assemblage A and B had diarrhea more frequently (P = 0.07).

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  • 1

    Ali SA, Hill DR, 2003. Giardia intestinalis. Curr Opin Infect Dis 16 :453–460.

  • 2

    Al-Mekhlafi MS, Azlin M, Nor Aini U, Shaik A, Sa’iah A, Fatmah MS, Ismail MG, Ahmad Firdaus MS, Aisah MY, Rozlida AR, Norhayati M, 2005. Giardiasis as a predictor of childhood malnutrition in Orang Asli children in Malaysia. Trans R Soc Trop Med Hyg 99 :686–691.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Bertrand I, Albertini L, Schwartzbrod J, 2005. Comparison of two target genes for detection and genotyping of Giardia lamblia in human feces by PCR and PCR-restriction fragment length polymorphism. J Clin Microbiol 43 :5940–5944.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Lalle M, Pozio E, Capelli G, Bruschi F, Crotti D, Caccio SM, 2005. Genetic heterogeneity at the beta-giardin locus among human and animal isolates of Giardiaduodenalis and identification of potentially zoonotic subgenotypes. Int J Parasitol 35 :207–213.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Traub R, Wade S, Read C, Thompson A, Mohammed H, 2005. Molecular characterization of potentially zoonotic isolates of Giardia duodenalis in horses. Vet Parasitol 130 :317–321.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Amar CF, Dear PH, Pedraza-Diaz S, Looker N, Linnane E, McLauchlin J, 2002. Sensitive PCR-restriction fragment length polymorphism assay for detection and genotyping of Giardia duodenalis in human feces. J Clin Microbiol 40 :446–452.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Chatterjee BD, Thawani G, Sanyal SN, 1989. Etiology of acute childhood diarrhoea in Calcutta. Trop Gastroenterol 10 :158–166.

  • 8

    Awasthi S, Pande VK, 1997. Prevalence of malnutrition and intestinal parasites in preschool slum children in Lucknow. Indian Pediatr 34 :599–605.

  • 9

    Gladstone BP, Muliyil J, Jaffar S, Wheeler JG, Lefevre AM, Iturriza-Gomara M, Gray JJ, Bose A, Estes MK, Brown DW, Kang G, 2007. Infant morbidity in an Indian slum birth cohort. Arch Dis Child 00 :479–484.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Banerjee I, Ramani S, Primrose B, Moses P, Iturriza-Gomara M, Gray JJ, Jaffar S, Monica B, Muliyil JP, Brown DW, Estes MK, Kang G, 2006. Comparative study of the epidemiology of rota-virus in children from a community-based birth cohort and a hospital in South India. J Clin Microbiol 44 :2468–2474.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Banerjee I, Iturriza-Gomara M, Rajendran P, Primrose B, Ramani S, Gray JJ, Brown DW, Kang G, 2007. Molecular characterization of G11P[25] and G3P[3] human rotavirus strains associated with asymptomatic infection in South India. J Med Virol 79 :1768–1774.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Ajjampur SS, Gladstone BP, Selvapandian D, Muliyil JP, Ward H, Kang G, 2007. Molecular and spatial epidemiology of cryptosporidiosis in children in a semiurban community in South India. J Clin Microbiol 45 :915–920.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Monica B, Ramani S, Banerjee I, Primrose B, Iturriza-Gomara M, Gallimore CI, Brown DW, Fathima M, Moses PD, Gray JJ, Kang G, 2007. Human caliciviruses in symptomatic and asymptomatic infections in children in Vellore, South India. J Med Virol 79 :544–551.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Newman RD, Moore SR, Lima AA, Nataro JP, Guerrant RL, Sears CL, 2001. A longitudinal study of Giardia lamblia infection in north-east Brazilian children. Trop Med Int Health 6 :624–634.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    WHO, 1986. Use and interpretation of anthropometric indicators of nutritional status. Report of a WHO working group. Bull World Health Organ 64 :929–941.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Sulaiman IM, Fayer R, Bern C, Gilman RH, Trout JM, Schantz PM, Das P, Lal AA, Xiao L, 2003. Triosephosphate isomerase gene characterization and potential zoonotic transmission of Giardia duodenalis. Emerg Infect Dis 9 :1444–1452.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Baruch AC, Isaac-Renton J, Adam RD, 1996. The molecular epidemiology of Giardia lamblia: a sequence-based approach. J Infect Dis 174 :233–236.

  • 18

    Haque R, Roy S, Kabir M, Stroup SE, Mondal D, Houpt ER, 2005. Giardia assemblage A infection and diarrhea in Bangladesh. J Infect Dis 192 :2171–2173.

  • 19

    Yason JA, Rivera WL, 2007. Genotyping of Giardia duodenalis isolates among residents of slum area in Manila, Philippines. Parasitol Res 101 :681–687.

  • 20

    Amar CF, Dear PH, McLauchlin J, 2003. Detection and genotyping by real-time PCR/RFLP analyses of Giardia duodenalis from human feces. J Med Microbiol 52 :681–683.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Kohli A, Bushen OY, Pinkerton RC, Houpt E, Newman RD, Sears CL, Lima AA, Guerrant RL, 2008. Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children. Trans R Soc Trop Med Hyg 102 :718–725.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Aydin AF, Besirbellioglu BA, Avci IY, Tanyuksel M, Araz E, Pahsa A, 2004. Classification of Giardia duodenalis parasites in Turkey into groups A and B using restriction fragment length polymorphism. Diagn Microbiol Infect Dis 50 :147–151.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Read C, Walters J, Robertson ID, Thompson RC, 2002. Correlation between genotype of Giardia duodenalis and diarrhoea. Int J Parasitol 32 :229–231.

  • 24

    Sahagun J, Clavel A, Goni P, Seral C, Llorente MT, Castillo FJ, Capilla S, Arias A, Gomez-Lus R, 2008. Correlation between the presence of symptoms and the Giardia duodenalis genotype. Eur J Clin Microbiol Infect Dis 27 :81–83.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Homan WL, Mank TG, 2001. Human giardiasis: genotype linked differences in clinical symptomatology. Int J Parasitol 31 :822–826.

  • 26

    Gelanew T, Lalle M, Hailu A, Pozio E, Caccio SM, 2007. Molecular characterization of human isolates of Giardia duodenalis from Ethiopia. Acta Trop 102 :92–99.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Eligio-Garcia L, Cortes-Campos A, Jimenez-Cardoso E, 2005. Genotype of Giardia intestinalis isolates from children and dogs and its relationship to host origin. Parasitol Res 97 :1–6.

    • PubMed
    • Search Google Scholar
    • Export Citation
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