Efficient Diagnosis of Giardiasis Among Nursery and Primary School Children in Santiago, Chile by Capture Elisa for the Detection of Fecal Giardia Antigens

Amanda J. GoldinLondon School of Hygiene and Tropical Medicine, Southern Division of the University of Chile, London, United Kingdom

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Werner AptLondon School of Hygiene and Tropical Medicine, Southern Division of the University of Chile, London, United Kingdom

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Ximena AguileraLondon School of Hygiene and Tropical Medicine, Southern Division of the University of Chile, London, United Kingdom

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Ines ZulantayLondon School of Hygiene and Tropical Medicine, Southern Division of the University of Chile, London, United Kingdom

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David C. WarhurstLondon School of Hygiene and Tropical Medicine, Southern Division of the University of Chile, London, United Kingdom

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Michael A. MilesLondon School of Hygiene and Tropical Medicine, Southern Division of the University of Chile, London, United Kingdom

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Fecal samples were obtained from 722 of 820 children attending 7 nursery schools and 1 primary school in the city of Santiago, Chile. Microscopy of formol-ether concentrates showed that 33% of the children were infected with Giardia lamblia. Prevalences among primary school students (5–10 years of age) of G. lamblia (38%), Endolimax nana (43%), and Entamoeba coli (25%) were overall higher than among nursery school students (3 months-5 years of age; prevalences 29%, 21%, and 16%, respectively). There was no apparent association between socio-economic intake and levels of G. lamblia infection: the private nursery school had the highest recorded level of infection (40%). One hundred sixty-two triplicate stool specimens were used to compare microscopy with an enzyme-linked immunosorbent assay (ELISA) for the detection of Giardia fecal antigens. The ELISA was highly sensitive and specific either visually (95% and 97%, respectively) or by optical density determination (99% and 96%, respectively). Incorporation of nonimmune rabbit immunoglobulin-coated control wells did not enhance sensitivity and specificity. The antigen detection ELISA is an extremely effective tool for the epidemiological investigation of giardiasis.

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