What are the symptoms of ova and parasites (O&P) infection that cause diarrhea?

From the Guidelines

Diarrhea caused by ova and parasites should be treated with albendazole 400 mg or mebendazole 100 mg as a single dose, as recommended by the most recent guidelines 1. When considering the treatment of diarrhea caused by ova and parasites, it is essential to prioritize the most recent and highest quality evidence. The guidelines from the Journal of Infection 1 provide the most up-to-date recommendations for the treatment of parasitic infections, including those caused by ova and parasites. Some key points to consider when treating diarrhea caused by ova and parasites include:

• The importance of proper diagnosis, which can be achieved through stool sample analysis, often with multiple specimens collected over several days.
• The need for patients to stay well-hydrated and practice good hygiene, including thorough handwashing, to prevent reinfection or transmission to others.
• The potential for persistent symptoms to warrant follow-up testing to confirm clearance of the infection.
• The importance of completing the full medication course to ensure complete eradication of the parasite. It is also important to note that the treatment of diarrhea caused by ova and parasites may vary depending on the specific parasite identified, and that other treatments, such as metronidazole or nitazoxanide, may be necessary for other types of parasitic infections 1. However, based on the most recent evidence, albendazole 400 mg or mebendazole 100 mg as a single dose is the recommended treatment for diarrhea caused by ova and parasites.

From the Research

Ova and Parasites Symptoms Diarrhea

• Diarrhea is a common symptom of ova and parasites infection, as seen in giardiasis infection which may cause diarrhoea (sometimes severe) 2.
• Stool ova and parasite (O&P) examinations are routinely ordered initial tests in patients admitted to the hospital with acute diarrhea, despite low test positivity rates 3.
• The yield of inpatient O&P exams was 2.15% (37/1723), with Blastocystisspp. being the most common parasites found 3.
• Patients with positive tests, excluding Blastocystisspp., had at least one of the following risk factors: smoking, prior parasitic disease, HIV-positive status, travel to an endemic area, and institutionalization 3.
• Empirical anti-parasitic treatment with broad-spectrum anti-parasitic agents such as oral Tinidazole and Albendazole can be effective in returning travellers with persistent abdominal symptoms, including diarrhea, despite no positive stool-test 4.
• The improvement in GI symptoms, energy level, and general well-being shortly after anti-parasitic treatment justifies this empirical approach in returning-travellers with persistent abdominal symptoms 4.

Treatment Options

• Albendazole and mebendazole are broad-spectrum anthelmintics that can be used to treat intestinal nematode infections, including ascariasis, hookworm infections, trichuriasis, strongyloidiasis, and enterobiasis 5.
• Albendazole is also used for treatment of filarial infections, such as lymphatic filariasis, onchocerciasis, loiasis, mansonellosis, and dirofilariasis, alone or in combination with other drugs 5.
• Metronidazole is commonly used to treat giardiasis, and is usually given three times daily for five to 10 days 2.
• The efficacy of albendazole, mebendazole, and metronidazole has been evaluated in patients with HIV infection and in those with pulmonary tuberculosis, and has been shown to be effective in treating concurrent parasitic diseases 6.