Assemblages and Subassemblages of Giardia duodenalis in Rural Western, Kenya: Association with Sources, Signs, and Symptoms

Erick Barasa; Briston Indieka; Nathan Shaviya; Ezra Osoro; Geofrey Maloba; Denis Mukhongo; Valentine Budambula; Tom Were

doi:10.1155/2024/1180217

Assemblages and Subassemblages of Giardia duodenalis in Rural Western, Kenya: Association with Sources, Signs, and Symptoms

J Parasitol Res. 2024 Feb 5:2024:1180217. doi: 10.1155/2024/1180217. eCollection 2024.

Authors

Erick Barasa¹, Briston Indieka², Nathan Shaviya¹, Ezra Osoro³, Geofrey Maloba³, Denis Mukhongo⁴, Valentine Budambula⁵, Tom Were⁶

Affiliations

¹ Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, P. O. Box 190-50100, Kakamega, Kenya.
² Department of Biomedical Science and Technology, Maseno University, Postal address, Private Bag Maseno, Kenya.
³ Department of Medical Biochemistry, Masinde Muliro University of Science and Technology, P. O. Box 190-50100, Kakamega, Kenya.
⁴ Department of Biological Sciences, Alupe University, P. O. Box 845-50400, Busia, Kenya.
⁵ Department of Environment and Health, Technical University of Mombasa, Mombasa, Kenya.
⁶ Department of Laboratory Medicine and Human Pathology, Masinde Muliro University of Science and Technology, Kakamega, Kenya.

Abstract

Background: Giardia duodenalis causes sporadic or epidemic infections in humans. The parasite comprises assemblages A-H with A and B subdivided further into AI-IV and BI-IV subassemblages. Attempts aimed at linking these genotypes with sources and gastrointestinal manifestations of the infection are largely unexplored in rural communities.

Methods: In this cross-sectional study, G. duodenalis infection was genotyped and associated with sources, and gastrointestinal signs and symptoms of the disease among residents of Busia County, a rural setting in western Kenya. Demographic and clinical information were captured using standardized forms. Stool specimens were obtained from the patients and used for genotyping at glutamate dehydrogenase and triose-phosphate isomerase loci using the polymerase chain reaction and restriction fragment length polymorphism.

Results: Assemblage B (63.6%) was the most prevalent G. duodenalis infection, while A (20.5%) and mixed A/B (15.9%) were also detected. Among the subassemblages, AI (5.7%), AII (8.0%), AIII (3.4), BIII (30.7%), and BIV (17.0%) were diagnosed including the mixed AII/BIII (15.9%), BIII/BIV (15.9%), AI/AIII (2.3%), and AI/AII (1.1%) infections. Binary logistic regression indicated associations for assemblage A with stomach upset, history of nitroimidazole treatment, and residing in a homestead with cattle and B with age < 18 years, history of eating outdoors, vomiting, steatorrhea, and residing in a homestead with cattle, goats, and poultry (p < 0.05 for all). Among the subassemblages, associations were found for AI with residing in a homestead having cattle and history of nitroimidazole treatment, BIII with residing in a homestead having cattle and poultry, and BIV with steatorrhea (p < 0.05 for all). Altogether, this study illustrates that G. duodenalis assemblage B and subassemblage BIII are the most predominant and are linked to age < 18 years, gastrointestinal manifestations, and living in a homestead with domestic ruminants and poultry.

Conclusion: Targeted mass prophylactic treatment of domestic animals and utilization of gastrointestinal presentations, age < 18 years, and a history of nitroimidazole use are useful in the diagnosis and prevention of giardiasis among residents of rural communities.