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Review
. 2011 May;18(2):197-201.
doi: 10.1051/parasite/2011182197.

Human giardiasis in Serbia: asymptomatic vs symptomatic infection

A Nikolić  1 , I Klun, B Bobić, V Ivović, M Vujanić, T Zivković, O Djurković-Djaković
Affiliations
Review

Human giardiasis in Serbia: asymptomatic vs symptomatic infection

A Nikolić et al. Parasite. 2011 May.

Abstract
in English, French

Despite the public health importance of giardiasis in all of Europe, reliable data on the incidence and prevalence in Western Balkan Countries (Serbia, Bosnia and Herzegovina, Croatia, Montenegro and FYR Macedonia) are scarce, and the relative contribution of waterborne and food-borne, or person-to-person and/or animal-to-person, transmission of human giardiasis is not yet clear. To provide baseline data for the estimation of the public health risk caused by Giardia, we here review the information available on the epidemiological characteristics of asymptomatic and symptomatic human infection in Serbia. Although asymptomatic cases of Giardia represent a major proportion of the total cases of infection, high rates of Giardia infection were found in both asymptomatic and symptomatic populations. No waterborne outbreaks of giardiasis have been reported, and it thus seems that giardiasis mostly occurs sporadically in our milieu. Under such circumstances, control measures to reduce the high prevalence of giardiasis in Serbia have focused on person-to-person transmission, encouraging proper hygiene, but for more targeted intervention measures, studies to identify other risk factors for asymptomatic and symptomatic infections are needed.

Malgré l’importance en termes de santé publique de la giardiase humaine dans toute l’Europe, les données fiables sur son incidence et sa prévalence dans les pays de l’ouest des Balkans (Serbie, Bosnie-Herzégovine, Croatie, Monténégro et République de Macédoine) sont rares, et ses diverses modalités de transmission, via l’eau, les aliments, de l’animal à l’homme et de personne à personne ne sont pas encores claires. Afin d’apporter des données de base pour l’évaluation en santé publique du risque Giardia, l’article passe en revue les informations disponibles sur les caractéristiques épidémiologiques des infections humaines asymptomatiques et symptomatiques en Serbie. La giardiase asymptomatique concerne la majorité des cas d’infections, mais des taux élevés d’infections tant asymptomatiques que symptomatiques ont été trouvés dans des populations. Aucune épidémie d’origine aquatique n’ayant été observée, il semble que la giardiase survient surtout sporadiquement dans nos régions, c’est pourquoi les mesures visant à réduire la haute fréquence de la giardiase en Serbie se sont concentrées sur la transmission de personne à personne, avec la nécessité de promouvoir des mesures d’hygiène appropriées, d’interventions plus ciblées, d’études pour identifier d’autres facteurs de risque à la fois pour les infections asymptomatiques et symptomatiques.

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Figures

Fig. 1.
Fig. 1.
Asymptomatic human Giardia infection in Central Serbia: (A) map with prevalence (%) in 20 study regions and (B) distribution of prevalence in 115 settlements throughout Central Serbia.
Fig. 2.
Fig. 2.
Changes in incidence of symptomatic human Giardia infections in Serbia vs (A) Vojvodina and Central Serbia and (B) other Western Balkan Countries (Bosnia and Herzegovina, Croatia, Montenegro and FYR Macedonia) between 2005 and 2008.
Fig. 3.
Fig. 3.
Total monthly counts of giardiasis for the four-year study period (2005-2008) in Serbia.
See this image and copyright information in PMC

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