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      Effectiveness of Fenbendazole and Metronidazole Against Giardia Infection in Dogs Monitored for 50-Days in Home-Conditions

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          Abstract

          A field trial performed in-home conditions was conducted on 24 dogs naturally infected with Giardia, in order to compare the efficacy of fenbendazole and metronidazole. Animals were allocated in groups randomly in order to obtain two groups of 12 dogs each with similar parasitic loads of Giardia cysts: dogs in Group A were treated with fenbendazole (Panacur®, Intervet Italia Srl) administered at the dose of 50 mg/kg orally once a day for 5 consecutive days, dogs in Group B were treated with metronidazole (Flagyl®, Zambon Italia Srl) administered orally at the dose of 50 mg/kg, once a day for 5 consecutive days. All the dogs that were shedding Giardia cysts after the first treatment (Day 0) were retreated (either at Day 7 or at Day 14 or at Day 21) until a negative result was obtained with the same treatment. Additionally, all the dogs were re-examined at Day 50. All the dogs were tested for the presence of Giardia cysts using a fecal flotation method (FLOTAC). The percent efficacy of the treatments (A and B) was calculated at each sampling point (Days 7, 14, 21, and 50) as reduction in mean Giardia cysts. After the first therapy, on day 7, 4/12 (33.3%) dogs tested positive for Giardia cysts in the Group A and 5/12 (41.7%) in the Group B. Efficacies at (Days 7, 14, 21, and 50) of the treatments against Giardia infection were 80.9, 94, 100, and 97% in the Group A and 70.8, 99, 100, and 97.1% in the Group B. Statistically significant differences were not observed between the efficacy of Fenbendazole and Metronidazole against infection by G. duodenalis ( P = 0.686). Molecular analysis revealed full homology (i.e., 100% with JN416550) with the canine specific assemblage D in six positive dogs. Different hypotheses might explain the re-appearance of the Giardia cysts in some dogs after treatment, e.g., re-infection from the home environment, the correct medication given by the owners, the diet, as well as treatment failure, but also biological issues related to the intermittent excretion of Giardia cysts.

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          Most cited references52

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          Genetic heterogeneity at the beta-giardin locus among human and animal isolates of Giardiaduodenalis and identification of potentially zoonotic subgenotypes.

          Human giardiasis, caused by the intestinal flagellate Giardia duodenalis, is considered a zoonotic infection, although the role of animals in the transmission to humans is still unclear. Molecular characterisation of cysts of human and animal origin represents an objective means to validate or reject this hypothesis. In the present work, cysts were collected in Italy from humans (n=37) and animals (dogs, one cat and calves, n=46), and were characterised by PCR amplification and sequencing of the beta-giardin gene. As expected, only Assemblages A and B were identified among human isolates. The host-specific Assemblages C and D were found in the majority of dog isolates; however, 6 dog isolates were typed as Assemblage A. The cat-specific Assemblage F has been identified in the single feline isolate available. Among calf isolates, most were typed as Assemblages A (n=12) and B (n=5), whereas the host-specific Assemblage E was rarely found (n=3). Sequence heterogeneity in the beta-giardin gene allowed a number of subgenotypes to be identified within Assemblage A (8 subgenotypes), B (6 subgenotypes), D (2 subgenotypes), and E (3 subgenotypes). Five of these subgenotypes, namely A1, A2, A3, A4 and B3, were found to be associated with infections of humans, of dogs and of calves; these data, therefore, supported the role of these animals as a source of infection for humans.
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            FLOTAC: new multivalent techniques for qualitative and quantitative copromicroscopic diagnosis of parasites in animals and humans.

            Accurate diagnosis of parasitic infections is of pivotal importance for both individual patient management and population-based studies, such as drug efficacy trials and surveillance of parasitic disease control and elimination programs, in both human and veterinary public health. In this study, we present protocols for the FLOTAC basic, dual and double techniques, which are promising new multivalent, sensitive, accurate and precise methods for qualitative and quantitative copromicroscopic analysis. These various methods make use of the FLOTAC apparatus, a cylindrical device with two 5-ml flotation chambers, which allows up to 1 g of stool to be prepared for microscopic analysis. Compared with currently more widely used diagnostic methods for parasite detection in animals (e.g., McMaster and Wisconsin techniques) and humans (e.g., Kato-Katz and ether-based concentration techniques), the FLOTAC techniques show higher sensitivity and accuracy. All FLOTAC techniques can be performed on fresh fecal material as well as preserved stool samples, and require approximately 12-15 min of preparation time before microscopic analysis.
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              The zoonotic significance and molecular epidemiology of Giardia and giardiasis.

              The taxonomy and molecular epidemiology of Giardia and Giardia infections are reviewed in the context of zoonotic and waterborne transmission. Evidence to support the zoonotic transmission of Giardia is very strong, but how frequent such transmission occurs and under what circumstances, have yet to be determined. Zoonotic origin for waterborne outbreaks of Giardia infection appears to be uncommon. Similarly, livestock are unlikely to be an important source of infection in humans. The greatest risk of zoonotic transmission appears to be from companion animals such as dogs and cats, although further studies are required in different endemic foci in order to determine the frequency of such transmission.
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                Author and article information

                Contributors
                Journal
                Front Vet Sci
                Front Vet Sci
                Front. Vet. Sci.
                Frontiers in Veterinary Science
                Frontiers Media S.A.
                2297-1769
                26 March 2021
                2021
                : 8
                : 626424
                Affiliations
                [1] 1Department of Veterinary Medicine and Animal Production, University of Naples Federico II , Naples, Italy
                [2] 2European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità , Rome, Italy
                [3] 3Department of Veterinary Science, University of Parma , Parma, Italy
                Author notes

                Edited by: Donato Traversa, University of Teramo, Italy

                Reviewed by: Jan S. Suchodolski, Texas A&M University, United States; Joachim Müller, University of Bern, Switzerland; Richard Malik, The University of Sydney, Australia

                *Correspondence: Laura Rinaldi lrinaldi@ 123456unina.it

                This article was submitted to Parasitology, a section of the journal Frontiers in Veterinary Science

                Article
                10.3389/fvets.2021.626424
                8032893
                33842570
                f8fc2e68-98c0-43f5-b807-ac9012d657e5
                Copyright © 2021 Ciuca, Pepe, Bosco, Caccio, Maurelli, Sannella, Vismarra, Cringoli, Kramer, Rinaldi and Genchi.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 05 November 2020
                : 27 February 2021
                Page count
                Figures: 0, Tables: 1, Equations: 1, References: 52, Pages: 7, Words: 5944
                Categories
                Veterinary Science
                Original Research

                giardia,dogs,50 days post-treatment,fenbendazole,metronidazole,assemblage

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