Subphylum Mastigophora:Giardia Lamblia

A Micropara Project
presented to
Mr. Kenneth T. Benignos, MBA-HTM, MT, RMT
In Partial Fulfillment of the Requirements 
for Micropara

By:
Joel G.Banot

Elisha Terencio

Hazel Joy Morales

Department of College of Nursing and Allied Health Sciences

Northern Negros State College of Science and Technology
Sagay City, Negros Occidental
April 18,2023
CHARACTERISTICS AND PROPERTIES:
-most distinctive of the flagellates.
-has both a trophozoite and cyst stage

Trophoziote
-are bionucleated (look like a face).12-15 um(micromole).
-ventral surface bears adhesive disk to adhere to surface of intestinal cell.
-8 flagella (2 anterior, 2 posterior, 2 ventral ,2 caudal);all arise from kinestone.
-median bodies occur behind adhesive disk;function is unknown.

Cyst
-ovoid in shape;8-12 um long x 7-10 um wide
-thin cyst wall
-four nuclie present,often concentrated at on end.
-flagella shorten and are retracted within cyst.
-axonemes provide internal support.

Epidemiology/Pathogenesis:
Mechanism of action
-During attachment, the ventral disc has a domed conformation and enables Giardia to attach
to the host intestinal epithelia within seconds.Giardia uses flagellar motility to find suitable
sites for attachment to the intestinal villi. Flagellar beating is also required for Giardia dia to
complete cell division and cytokinesis, and may be necessary for encystation/excystation.

Life cycle 
-chain of infection
A. 
Giardia cysts can contaminate food, water, and surfaces, and they can cause giardiasis
when swallowed in this infective stage of their life cycle. Infection occurs when a
person swallows Giardia cysts from contaminated water, food, hands, surfaces, or
objects.
B.
When Giardia cysts are swallowed, they pass through the mouth, esophagus, and
stomach into the small intestine where each cyst releases two trophozoites through a
process called excystation. The Giardia trophozoites then feed off and absorb
nutrients from the infected person.
C.
Giardia trophozoites multiply by splitting in two in a process called longitudinal
binary fission,remaining in the small intestine where they can be free or attached to
the inside lining of the small intestine.
D.
The Giardia trophozoites then move toward the colon and transform back into cyst
form through a process called encystation. The Giardia cyst is the stage found most
commonly in stool.
E.
Both Giardia cysts and trophozoites can be found in the stool of someone who
has giardiasis and may be observed microscopically to diagnose giardiasis. Giardia
cysts are immediately infectious when passed in the stool or shortly afterward, and
the cysts can survive several months in cold water or soil .
Disease:
Gardiasis
-is a illness caused by a parasite G. Lamblia that may result in diarrhea and stomach cramps.
-Symptoms;Range from none to abdominal discomfort causing acute or chronic diarrhea and
other GI signs,Gray greasy,voluminous malodorous diarrhea
-Flatulence
-World wide distribution;prevalence ranges from 2.4-67.5%.

Cases of M. Lamblia in the Philippines 

The Philippines had the highest number of samples positive for G. lamblia (73.9 %), followed
by Malaysia (27.3 %) and Thailand (22.6 %), with Ct values ranging from 30.49 to 34.41 and
CVs ranging from 0.1 to 0.18. Thus, it can be deducted that Giardia cysts and G. lamblia are
frequently detected in untreated water.

Diagnosis
-Trophozoites in diarrheic feces;cysts in formed feces
-at least 3 exams(one every other day)

Stool examination
Macroscopy: offensive odour,pale colored and fatty stool
Microscopy: salaine and iodine wet preparations (direct smears)

Enterotest (string test)

Detect the presence of motility of the organism or specific morphological forms of
trophozoites of Gardia.

Serological test
Antigen detection in feces:direct Immunoflurescent test
Antibody detection: direct Immunoflourescent test

•result
Giardiasis is diagnosed by the identification of cysts or trophozoites in the feces, using direct
mounts as well as concentration procedures. Cysts are typically seen in wet mount
preparations, while trophozoites are seen in permanent mounts.

•interpretation 
A test that detects Giardia antigens (positive result) means that the person has giardiasis. If
the infected person does not have symptoms of infection, they may be a carrier or have a
chronic infection.If the test does not detect antigens (negative result), it may need to be
repeated to rule out giardiasis.

Treatment

metronidazole-utilizes the anaerobic metabolic pathways present in Giardia.

-once the drug activates,it binds covalently to DNA macromolecules.
-DNA damage in form of loss of helical structure,impaired template
function,and strand breakage.
-Inhibits trophozoite respiration
-Reductive activation may also lead to toxic radicals which reacts with essential
cell components.

Tinidanzole-disrupting the DNA helical structure, thus inhibiting nucleic acid synthesis.
Nitazoxanide-exhibits antiprotozoal activity by interfering with the pyruvate
ferredoxin/flavodoxin oxidoreductase dependent electron transfer reaction, an
essential reaction need for anaerobic energy metabolism of various
microorganisms.
-induces lesions in the cell membranes and depolarizes the mitochondrial
membrane while inhibiting quinone oxidoreductase,nitroreductase-1 and
protein disulphide isomerase enzymes

Prevention and Control

Practice Good Hand Hygiene.
Avoid Water That Might Be Contaminated.
Avoid Food That Might Be Contaminated.
Practice Safer Sex.
Clean and Disinfect.