From the Guidelines
Pediatric symptoms of giardia typically include diarrhea, abdominal pain, bloating, and weight loss, and diagnosis is usually made by stool examination for parasites or antigen testing, as suggested by the current guidelines 1. The symptoms of giardia in children can vary, but common symptoms include:
- Diarrhea that is foul-smelling and greasy
- Abdominal pain
- Bloating and gas
- Nausea and vomiting
- Weight loss Some children may remain asymptomatic despite infection, while others may experience fatigue, decreased appetite, and failure to thrive in prolonged cases. According to the study published in Gastroenterology in 2019 1, giardia infection typically lasts 2–6 weeks but can become chronic and may recur after treatment. The Centers for Disease Control and Prevention guidelines suggest testing for ova and parasite examination, with further molecular testing of stools when these are negative but suspicion is still high. The highest risks of giardia infection are exposure in endemic areas, drinking untreated or contaminated water, hikers drinking untreated water from streams or lakes, exposure in a day-care setting, and men who have sex with men, as noted in the study 1. In terms of treatment, metronidazole, tinidazole, or nitazoxanide may be used, but the specific treatment regimen should be determined based on the individual child's needs and medical history. Prevention of giardia infection includes proper handwashing, avoiding untreated water, and proper food handling, which can help reduce the risk of transmission through the fecal-oral route.
From the Research
Pediatric Symptoms of Giardia
- Giardiasis infection may be asymptomatic, or can cause diarrhoea (sometimes severe), weight loss, malabsorption, and, in children, failure to thrive 2
- Approximately 50 to 75% of infected children are asymptomatic 3
- Other children present acute or chronic diarrhea 3
- Common symptoms in children with giardiasis include:
- Co-parasitism is frequent (45%) in children with giardiasis 4
Treatment and Cure Rates
- Metronidazole is a common treatment for giardiasis in children, but treatment failure is not uncommon 4
- First-line treatment failure after a standard dose of metronidazole was 20%, lowering to 8.3% when a higher dose was administered (p < 0.001) 4
- Tinidazole has been shown to be effective in treating giardiasis in children, with a cure rate of 80% in one study 5
- Quinacrine can be considered as a second-line treatment, with 100% effectiveness in one study 4
Risk Factors for Treatment Failure
- Children <2 years are at higher risk of treatment failure (OR 3.49; 95% CI 1.06-11.53; p = 0.040) 4