Diagnostic Value of Coproantigen for Detection of Giardia Infection in Stunted Children

Fanny Anggraeni Octoviani, Agnes Kurniawan, Ika Puspa Sari, Nisa Fauziah, Lia Faridah, Riyadi Adrizain

Abstract


Background: Giardiasis is a protozoa infection caused by Giardia intestinalis, which commonly infects children, impairing children’s growth, development, and cognitive function. Standard diagnosis is carried out by microscopic examination of stool. This study aimed to evaluate coproantigen examination in stunted children compared to microscopic examination.

Methods: A cross-sectional study was performed on stools collected from a survey among stunted children in Bandung in 2019. Stools were preserved in 10% formaldehyde and kept at -20oC until used. Direct microscopy examination with 2% lugol solution and coproantigen ELISA test using Giardia Cryptosporidium (combo test) coproantigen test kit were performed in Parasitology Laboratory Faculty of Medicine, Universitas Indonesia.

Result: A total of 99 stools originated from stunted children aged 2-6 years. with boys predominant (52.5%). Microscopic examination showed that 12.1% (12/99) of the children were harboring intestinal parasites, such as the protozoa Giardia intestinalis, Blastocystis spp, and Entamoeba coli (E. coli). Giardia was the primary infection (9.1%), of which single Giardia infection (n = 8) and mixed infection of Giardia and Blastocystis spp (n = 1).  Interestingly, coproantigen examination resulted in 6 positive samples, and 4 samples agreed with the microscopy result. With a sensitivity of 44.4% and a specificity of 97.7%. The positive and negative predictive values were 66.7% and 94.7%, respectively.

Conclusion: A moderate prevalence of Giardia in stunted children in Bandung regency has been observed. The combo coproantigen test method has high specificity and is suitable for use as a confirmation test to exclude Giardia infection.


Keywords


Coproantigen, Diagnosis, Giardiasis, Stunting

Full Text:

PDF

References


  1. Halliez MCM and Buret AG. Extra-intestinal and long term consequences of Giardia duodenalis infections. World J Gastroenterol. 2013;19(47): 8974–85.
  2. Dunn N, Juergens AL. Giardiasis. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022-.[cited 2022 August 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513239/.
  3. Ettehad GH, Daryani A, Nemati A. Effect of Giardia infection on nutritional status in primary schoolchildren, in northwest Iran. Pak J Biol Sci. 2010;13(5):229–34.
  4. Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Matern Child Nutr. 2018;14(4):e12617.
  5. Osman KA, Zinsstag J, Tschopp R, Schelling E, Hattendorf J, Umer A, et al. Nutritional status and intestinal parasites among young children from pastoralist communities of the Ethiopian Somali region. Matern Child Nutr. 2020;16(3):e12955.
  6. Al-Mekhlafi HM, Al-Maktari MT, Jani R, Ahmed A, Anuar TS, Moktar N, et al. Burden of Giardia duodenalis infection and its adverse effects on growth of schoolchildren in rural Malaysia. PLoS Negl Trop Dis. 2013;7(10):e2516.
  7. United Nations Children’s Fund, World Health Organization, World Bank Group. Levels and trends in child malnutrition: UNICEF/WHO/The World Bank Group joint child malnutrition estimates: key findings of the 2020 edition. Geneva: WHO; 2020. [cited 2022 August 25]. Available from:. https://www.who.int/publications/i/item/9789240003576
  8. Pusat Data dan Informasi, Kementerian Kesehatan RI. Situasi anak pendek (Stunting) di Indonesia. Buletin Jendela Data dan Informasi Kesehatan. 2020;2:1–14.
  9. Cascais-Figueiredo T, Austriaco-Teixeira P, Fantinatti M, Silva-Freitas ML, Santos-Oliveira JR, Coelho CH, et al. Giardiasis alters intestinal fatty acid binding protein (I-FABP) and plasma cytokines levels in children in Brazil. Pathogens. 2019;9(1):7.
  10. Hooshyar H, Rostamkhani P, Arbabi M, Delavari M. Giardia lamblia infection: review of current diagnostic strategies. Gastroenterol Hepatol Bed Bench. 2019;12(1):3–12.
  11. Feng Y, Xiao L. Zoonotic potential and molecular epidemiology of Giardia species and giardiasis. Clin Microbiol Rev. 2011;24(1):110–40.
  12. Verhagen LM, Incani RN, Franco CR, Ugarte A, Cadenas Y, Sierra Ruiz CI, et al. High malnutrition rate in Venezuelan Yanomami compared to Warao Amerindians and Creoles: significant associations with intestinal parasites and anemia. PLoS One. 2013;8(10):e77581.
  13. Santos CK, Grama DF, Limongi JE, Costa FC, Couto TR, Soares RM, et al. Epidemiological, parasitological and molecular aspects of Giardia duodenalis infection in children attending public daycare centers in southeastern Brazil. Trans R Soc Trop Med Hyg. 2012;106(8):473–9.
  14. Julianti F, Rusjdi SR, Abdiana A. Hubungan Infeksi Protozoa Intestinal dengan Status Gizi Murid Sekolah Dasar di Kecamatan Ulakan Tapakis Kabupaten Padang Pariaman. J Kesehatan Andalas 2017;6(1):13–9.
  15. Garcia LS, Arrowood M, Kokoskin E, Paltridge GP, Pillai DR, Procop GW, et al. Practical guidance for clinical microbiology laboratories: laboratory diagnosis of parasites from the gastrointestinal tract. Clin Microbiol Rev. 2017;31(1):e00025–17.
  16. Jahan N, Khatoon R, Ahmad S.A Comparison of microscopy and enzyme linked immunosorbent assay for diagnosis of Giardia lamblia in human faecal specimens. J Clin Diagn Res. 2014;8(11):DC04–6.
  17. Silva RK, Pacheco FT, Martins AS, Menezes JF, Costa-Ribeiro H Jr, Ribeiro TC, et al. Performance of microscopy and ELISA for diagnosing Giardia duodenalis infection in different pediatric groups. Parasitol Int. 2016;65(6):635–40.
  18. Kopel E, Grotto I, Grossman T, Haklai Z, Marva E, Anis E. Long-term predictors of recurrent laboratory-confirmed giardiasis: a 10-year national surveillance study. J Pediatric Infect Dis Soc. 2014;3(4):343–6.
  19. Sadaka HA, Gaafar MR, Mady RF, Hezema NN. Evaluation of ImmunoCard STAT test and ELISA versus light microscopy in diagnosis of giardiasis and cryptosporidiosis. Parasitol Res. 2015;114(8):2853–63.
  20. Chakarova B. Comparative evaluation of the diagnostic methods for detection of Giardia intestinalis in human fecal samples. Trakia J Sci. 2010;8(Suppl 2):174–9.
  21. Rocha MO, Mello RT, Guimaraes TM, Toledo Vd, Moreira Md, Costa CA. Detection of a Giardia lamblia coproantigen by using a commercially available immunoenzymatic assay, in Belo Horizonte, Brazil. Rev Inst Med Trop Sao Paulo. 1999;41(3):151–4.




DOI: https://doi.org/10.15850/amj.v10n3.2860

Article Metrics

Abstract view : 474 times
PDF - 219 times


 This Journal indexed by

                  

          

 

Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats