Pharmaceutics – level 3 &4 –parasitology – LAB 4 T/ Mohammed Hail Al Adeemy

Diagnosis of Giardia lamblia

Giardia lamblia transmitted by the faecal-oral route with
infective cysts being ingested in food, water, or from
hands contaminated with faeces.
Infection with G. lamblia is called giardiasis.
Giardia lamblia has a direct life cycle as shown in Figure:

Laboratory Diagnosis of giardiasis is by:

 Finding G. lamblia trophozoites in fresh diarrhoeic
specimens particularly in mucus. They are often
difficult to detect because they attach themselves
to the wall of the intestine.

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Pharmaceutics – level 3 &4 –parasitology – LAB 4 T/ Mohammed Hail Al Adeemy

 Finding G. lamblia cysts in more formed specimens.

Stool Examination
- Direct examination :
Direct examination of stool by saline and iodine mount
is done to demonstrate: trophozoites and cysts .Like
examination of E. histolytica.

NOTE :
Repeated stool examination (at least three consecutive
samples) should be done because sensitivity varies from
60% to 80% with one stool and more than 90% after
three stools examination.
- Concentration techniques:
Like zinc sulfate floatation or formalin ether
sedimentation methods are employed to increase the
chance of detection.

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Pharmaceutics – level 3 &4 –parasitology – LAB 4 T/ Mohammed Hail Al Adeemy

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Pharmaceutics – level 3 &4 –parasitology – LAB 4 T/ Mohammed Hail Al Adeemy

Duodenal sampling:
If stool examination is negative, then direct duodenal
samples like aspirates (obtained by entero-test) or
biopsy (done by endoscopy) should be processed.

Stool culture :
Giardia can be cultivated in axenic media.

Stool antigen detection :(copro-antigen)

The enzyme linked inmunosorbent assay (ELISA) and
direct fluorescent antibody tests (DFA) are available
using labeled monoclonal antibodies against cyst wall
protein antigens.

Antibody detection :
Both indirect fluorescent antibody (IFA) and ELISA
formats are developed to detect antibodies in serum.

Molecular diagnosis :
Detection of Giardia nucleic acid by polymerase chain
reaction (PCR) or by gene probes is highly sensitive and
specific.
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