A COMPARATIVE STUDY OF GIARDIA LAMBLIA DETECTION BY USING OF MICROSCOPIC, SEROLOGIC, AND MOLECULAR METHODS, IN SULAIMANI PROVINCE

Safin Hamad Ismail a and Shahnaz AbdulKadir Ali b


a Ministry of Health, Sulaimani Directorate of Health, Public Health Laboratory, Kurdistan Region, Iraq. 
b Department of Microbiology, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 


Submitted: 2/12/2019; Accepted: 1/12/2020; Published: 21/12/2020
ABSTRACT


Background 

Giardia lamblia is an intestinal flagellated protozoan parasite that infects humans and animals. Giardiasis causing more than 200 million symptomatic infections globally it is one of the most common causes of diarrhea in developing countries, and frequent cause water-born/food-born parasitic diseases. 


Objectives

This study was carried out to investigate the prevalence rate of G. lamblia in Sulaimani Province hospitals and to identify the best and accurate method for identification. 


Patients and Methods

In the present study, 355 fecal specimens were collected from patients in three hospitals (Dr. Jamal A. Rashid Pediatric Teaching Hospitals, Ibrahim Pasha Health Center and Directorate of Preventive Health) in Sulaimani Province during the 1st November 2018 to the 30 April 2019. All samples examined by direct microscopic examination using Saline Wet Mount, and antigen detection by ELISA technique (RIADASCREEN Giardia ELISA kit). DNA extracted by used (QIAamp Fast DNA Stool Mini Kit 50), and for PCR amplification, used JW1, the forward primer: 5’ GCG CAC CAG GAATGT CTT GT 3’ and JW2, the reverse primer 5’ TCA CCT ACG GAT ACC TTG TT 3’ to amplify a 183-bp region of the 18S G. lamblia rRNA gene.

Results

Out of 355 stool samples, fifty samples were positive for G. lamblia at a prevalence rate of (14.1%) by Direct wet mount and ELISA, and forty of them were positive (11.4%) by PCR. Males showed a higher (18.1%) prevalence rate than females (5.4%). The highest rate (26.9%) of infection was found in (13-18) age groups, while the lowest rate (2.3%) was fond in (6-12) year of ages. The prevalence rate in rural area was higher than urban area (15.7%), (13.4%) respectively. The sequences alignments were 91.30% and 98.52% similar to M90523.1 and M90524.1 respectively. In comparison to Microscopic exam, both ELISA and PCR recorded the same specificity rate 99.67% as direct wet mount, but were different sensitivity rate 100% and 80% respectively. 


Conclusion

Direct wet mount and ELISA was more sensitive than PCR (80%), but they were specific at the same rate (99.67%), and this indicate that there is more than one gene of G. lamblia is endemic in Sulaimani Province.



KEYWORDS

Giardia; Direct wet mount; ELISA; PCR; Comparison.