Skip to main content
SpringerLink
Log in

Can Giardia lamblia Assemblages Drive the Clinical Outcome of Giardiasis?

  • Giardia/Crypto (S Singer, Section Editor)
  • Published:
Current Tropical Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To carry out a bibliographic survey from June 2001 until March 2021 on the possible association between Giardia lamblia genotypes and clinical manifestations of giardiasis.

Recent Findings

G. lamblia infection leads to a broad spectrum of clinical conditions, ranging from asymptomatic to acute or chronic symptomatic forms. There are several open questions regarding the direct damage of the parasite and the host response to giardiasis pathogenesis. The wide genetic variability of G. lamblia prompts speculation on the possible relationship between its assemblages and the clinical manifestations.

Summary

Studies in human giardiasis focus on the association between individual symptoms and infection by assemblages A, B, or even E. This review points out that this topic is still little explored and the results are inconclusive and contradictory.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ramírez JD, Heredia RD, Hernández C, León CM, Moncada LI, Reyes P, et al. Molecular diagnosis and genotype analysis of Giardia duodenalis in asymptomatic children from a rural area in central Colombia. Infect Genet Evol. 2015;32:208–13. https://doi.org/10.1016/j.meegid.2015.03.015.

    Article  CAS  Google Scholar 

  2. Kohli A, Bushen OY, Pinkerton RC, Houpt E, Newman RD, Sears CL, et al. Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children. Trans R Soc Trop Med Hyg. 2008;102(7):718–25. https://doi.org/10.1016/j.trstmh.2008.03.002.

    Article  Google Scholar 

  3. de Lucio A, Martínez-Ruiz R, Merino FJ, Bailo B, Aguilera M, Fuentes I, et al. Molecular genotyping of Giardia duodenalis isolates from symptomatic individuals attending two major public hospitals in Madrid, Spain. PLoS ONE. 2015;10(12): e0143981. https://doi.org/10.1371/journal.pone.0143981.

    Article  CAS  Google Scholar 

  4. Wang Y, Gonzalez-Moreno O, Roellig DM, Oliver L, Huguet J, Guo Y, Feng Y, Xiao L. Epidemiological distribution of genotypes of Giardia duodenalis in humans in Spain. Parasit Vectors. 2019;12(1):432. https://doi.org/10.1186/s13071-019-3692-4.

    Article  CAS  Google Scholar 

  5. Breathnach AS, McHugh TD, Butcher PD. Prevalence and clinical correlations of genetic subtypes of Giardia lamblia in an urban setting. Epidemiol Infect. 2010;138(10):1459–67. https://doi.org/10.1017/S0950268810000208.

    Article  CAS  Google Scholar 

  6. Gelanew T, Lalle M, Hailu A, Pozio E, Cacciò SM. Molecular characterization of human isolates of Giardia duodenalis from Ethiopia. Acta Trop. 2007;102(2):92–9. https://doi.org/10.1016/j.actatropica.2007.04.003.

    Article  CAS  Google Scholar 

  7. Broglia A, Weitzel T, Harms G, Cacció SM, Nöckler K. Molecular typing of Giardia duodenalis isolates from German travellers. Parasitol Res. 2013;112(10):3449–56. https://doi.org/10.1007/s00436-013-3524-y.

    Article  CAS  Google Scholar 

  8. Liu A, Yang F, Shen Y, Zhang W, Wang R, Zhao W, Zhang L, Ling H, Cao J. Genetic analysis of the gdh and bg genes of animal-derived Giardia duodenalis isolates in Northeastern China and evaluation of zoonotic transmission potential. PLoS ONE. 2014;9(4): e95291. https://doi.org/10.1371/journal.pone.0095291.

    Article  Google Scholar 

  9. Štrkolcová G, Maďar M, Hinney B, Goldová M, Mojžišová J, Halánová M. Dog’s genotype of Giardia duodenalis in human: first evidence in Europe. Acta Parasitol. 2015;60(4):796–9. https://doi.org/10.1515/ap-2015-0113.

    Article  Google Scholar 

  10. Farthing MJ. Giardiasis. Gastroenterol Clin North Am. 1996;25(3):493–515. https://doi.org/10.1016/s0889-8553(05)70260-0.

    Article  CAS  Google Scholar 

  11. Carvalho-Costa FA, Gonçalves AQ, Lassance SL, Silva Neto LM, Salmazo CA, Bóia MN. Giardia lamblia and other intestinal parasitic infections and their relationships with nutritional status in children in Brazilian Amazon. Rev Inst Med Trop São Paulo. 2007;49(3):147–53. https://doi.org/10.1590/s0036-46652007000300003.

    Article  Google Scholar 

  12. Halliez MC, Buret AG. Extra-intestinal and long term consequences of Giardia duodenalis infections. World J Gastroenterol. 2013;19(47):8974–85. https://doi.org/10.3748/wjg.v19.i47.8974.

    Article  Google Scholar 

  13. Coronato-Nunes B, Calegar DA, Monteiro KJL, Hubert-Jaeger L, Reis ERC, Xavier SCDC, et al. Giardia intestinalis infection associated with malnutrition in children living in northeastern Brazil. J Infect Dev Ctries. 2017;11(7):563–70. https://doi.org/10.3855/jidc.8410.

    Article  Google Scholar 

  14. MAL-ED Network Investigators. Childhood stunting in relation to the pre- and postnatal environment during the first 2 years of life: the MAL-ED longitudinal birth cohort study. PLoS Med. 2017;14(10): e1002408. https://doi.org/10.1371/journal.pmed.1002408.

    Article  Google Scholar 

  15. DuPont HL. Giardia: both a harmless commensal and a devastating pathogen. J Clin Invest. 2013;123(6):2352–4. https://doi.org/10.1172/JCI69932.

    Article  CAS  Google Scholar 

  16. Bartelt LA, Platts-Mills JA. Giardia: a pathogen or commensal for children in high-prevalence settings? Curr Opin Infect Dis. 2016;29(5):502–7. https://doi.org/10.1097/QCO.0000000000000293.

    Article  Google Scholar 

  17. Thompson RC, Hopkins RM, Homan WL. Nomenclature and genetic groupings of Giardia infecting mammals. Parasitol Today. 2000;16(5):210–3. https://doi.org/10.1016/s0169-4758(99)01624-5.

    Article  CAS  Google Scholar 

  18. Adam RD. Biology of Giardia lamblia. Clin Microbiol Rev. 2001;14(3):447–75. https://doi.org/10.1128/CMR.14.3.447-475.2001.

    Article  CAS  Google Scholar 

  19. Feng Y, Xiao L. Zoonotic potential and molecular epidemiology of Giardia species and giardiasis. Clin Microbiol Rev. 2011;24(1):110–40. https://doi.org/10.1128/CMR.00033-10.

    Article  CAS  Google Scholar 

  20. Fantinatti M, Bello AR, Fernandes O, Da-Cruz AM. Identification of Giardia lamblia assemblage E in humans points to a new anthropozoonotic cycle. J Infect Dis. 2016;214(8):1256–9. https://doi.org/10.1093/infdis/jiw361.

    Article  Google Scholar 

  21. Zahedi A, Field D, Ryan U. Molecular typing of Giardia duodenalis in humans in Queensland - first report of assemblage E. Parasitology. 2017;144(9):1154–61. https://doi.org/10.1017/S0031182017000439.

    Article  CAS  Google Scholar 

  22. Ryan U, Zahedi A. Molecular epidemiology of giardiasis from a veterinary perspective. Adv Parasitol. 2019;106:209–54. https://doi.org/10.1016/bs.apar.2019.07.002.

    Article  Google Scholar 

  23. Pacheco FTF, Carvalho SS, Cardoso LS, Andrade LS, das Chagas GMT, Gomes DC, et al. Immune response markers in sera of children infected with Giardia duodenalis AI and AII subassemblages. Immunobiology. 2019;224(4):595–603. https://doi.org/10.1016/j.imbio.2019.04.001.

  24. Cascais-Figueredo T, Austriaco-Teixeira P, Fantinatti M, Silva-Freitas ML, Santos-Oliveira JR, Coelho CH, et al. Giardiasis alters intestinal fatty acid binding protein (I-FABP) and plasma cytokines levels in children in Brazil. Pathogens. 2019;9(1):7. https://doi.org/10.3390/pathogens9010007.

    Article  CAS  Google Scholar 

  25. Pavanelli MF, Colli CM, Bezagio RC, Góis MB, de Alcântara Nogueira de Melo G, de Almeida Araújo EJ, de Mello Gonçales Sant'Ana D. Assemblages A and B of Giardia duodenalis reduce enteric glial cells in the small intestine in mice. Parasitol Res. 2018;117(7):2025–33. https://doi.org/10.1007/s00436-018-5853-3.

  26. Bénéré E, Van Assche T, Cos P, Maes L. Variation in growth and drug susceptibility among Giardia duodenalis assemblages A, B and E in axenic in vitro culture and in the gerbil model. Parasitology. 2011;138(11):1354–61. https://doi.org/10.1017/S0031182011001223.

    Article  CAS  Google Scholar 

  27. Bénéré E, Van Assche T, Cos P, Maes L. Intrinsic susceptibility of Giardia duodenalis assemblage subtypes A(I), A(II), B and E(III) for nitric oxide under axenic culture conditions. Parasitol Res. 2012;110(3):1315–9. https://doi.org/10.1007/s00436-011-2627-6.

    Article  Google Scholar 

  28. Fantinatti M, Lopes-Oliveira LAP, Cascais-Figueredo T, Austriaco-Teixeira P, Verissimo E, Bello AR, Da-Cruz AM. Recirculation of Giardia lamblia assemblage A after metronidazole treatment in an area with assemblages A, B, and E sympatric circulation. Front Microbiol. 2020;11:571104. https://doi.org/10.3389/fmicb.2020.571104.

    Article  Google Scholar 

  29. Requena-Méndez A, Goñi P, Rubio E, Pou D, Fumadó V, Lóbez S, Aldasoro E, Cabezos J, Valls ME, Treviño B, Martínez Montseny AF, Clavel A, Gascon J, Muñoz J. The use of quinacrine in nitroimidazole-resistant Giardia duodenalis: an old drug for an emerging problem. J Infect Dis. 2017;215(6):946–53. https://doi.org/10.1093/infdis/jix066.

    Article  CAS  Google Scholar 

  30. Einarsson E, Ma’ayeh S, Svärd SG. An up-date on Giardia and giardiasis. Curr Opin Microbiol. 2016;34:47–52. https://doi.org/10.1016/j.mib.2016.07.019.

    Article  Google Scholar 

  31. Tungtrongchitr A, Sookrung N, Indrawattana N, Kwangsi S, Ongrotchanakun J, Chaicumpa W. Giardia intestinalis in Thailand: identification of genotypes. J Health Popul Nutr. 2010;28(1):42–52. https://doi.org/10.3329/jhpn.v28i1.4522.

    Article  Google Scholar 

  32. Lebbad M, Petersson I, Karlsson L, Botero-Kleiven S, Andersson JO, Svenungsson B, et al Multilocus genotyping of human Giardia isolates suggests limited zoonotic transmission and association between assemblage B and flatulence in children. PLoS Negl Trop Dis. 2011;5(8):e1262. https://doi.org/10.1371/journal.pntd.0001262.

  33. Al-Mohammed HI. Genotypes of Giardia intestinalis clinical isolates of gastrointestinal symptomatic and asymptomatic Saudi children. Parasitol Res. 2011;108(6):1375–81. https://doi.org/10.1007/s00436-010-2033-5.

    Article  Google Scholar 

  34. Atherton R, Bhavnani D, Calvopiña M, Vicuña Y, Cevallos W, Eisenberg J. Molecular identification of Giardia duodenalis in Ecuador by polymerase chain reaction-restriction fragment length polymorphism. Mem Inst Oswaldo Cruz. 2013;108(4):512–5. https://doi.org/10.1590/S0074-02762013000400019.

    Article  CAS  Google Scholar 

  35. Fahmy HM, El-Serougi AO, El Deeb HK, Hussein HM, Abou-Seri HM, Klotz C, et al. Giardia duodenalis assemblages in Egyptian children with diarrhea. Eur J Clin Microbiol Infect Dis. 2015;34(8):1573–81. https://doi.org/10.1007/s10096-015-2389-7.

    Article  CAS  Google Scholar 

  36. Oliveira-Arbex AP, David EB, Oliveira-Sequeira TC, Bittencourt GN, Guimarães S. Genotyping of Giardia duodenalis isolates in asymptomatic children attending daycare centre: evidence of high risk for anthroponotic transmission. Epidemiol Infect. 2016;144(7):1418–28. https://doi.org/10.1017/S0950268815002514.

    Article  CAS  Google Scholar 

  37. Pijnacker R, Mughini-Gras L, Heusinkveld M, Roelfsema J, van Pelt W, Kortbeek T. Different risk factors for infection with Giardia lamblia assemblages A and B in children attending day-care centres. Eur J Clin Microbiol Infect Dis. 2016;35(12):2005–13. https://doi.org/10.1007/s10096-016-2753-2.

    Article  CAS  Google Scholar 

  38. Puebla LJ, Núñez FA, García AB, Rivero LR, Millán IA, Prado RC. Prevalence of Giardia duodenalis among children from a central region of Cuba: molecular characterization and associated risk factors. J Parasit Dis. 2017;41(2):405–13. https://doi.org/10.1007/s12639-016-0816-z.

    Article  Google Scholar 

  39. Mohamed AMA, Bayoumy AM, Abo-Hashim AH, Ibrahim AA, El-Badry AA. Giardiasis in symptomatic children from Sharkia, Egypt: genetic assemblages and associated risk factors. J Parasit Dis. 2020;44(4):719–24. https://doi.org/10.1007/s12639-020-01254-0.

    Article  Google Scholar 

  40. Pacheco FTF, de Carvalho SS, Santos SA, das Chagas GMT, Santos MC, Santos JGS, et al. Specific IgG and IgA antibody reactivities in sera of children by enzyme-linked immunoassay and comparison with Giardia duodenalis diagnosis in feces. Ann Lab Med. 2020;40(5):382–9. https://doi.org/10.3343/alm.2020.40.5.382.

  41. Read C, Walters J, Robertson ID, Thompson RC. Correlation between genotype of Giardia duodenalis and diarrhoea. Int J Parasitol. 2002;32(2):229–31. https://doi.org/10.1016/s0020-7519(01)00340-x.

    Article  CAS  Google Scholar 

  42. Haque R, Roy S, Kabir M, Stroup SE, Mondal D, Houpt ER. Giardia assemblage A infection and diarrhea in Bangladesh. J Infect Dis. 2005;192(12):2171–3. https://doi.org/10.1086/498169.

    Article  Google Scholar 

  43. Yang R, Lee J, Ng J, Ryan U. High prevalence Giardia duodenalis assemblage B and potentially zoonotic subtypes in sporadic human cases in Western Australia. Int J Parasitol. 2010;40(3):293–7. https://doi.org/10.1016/j.ijpara.2009.08.003.

    Article  Google Scholar 

  44. Sarkari B, Ashrafmansori A, Hatam GR, Motazedian MH, Asgari Q, Mohammadpour I. Genotyping of Giardia lamblia isolates from human in southern Iran. Trop Biomed. 2012;29(3):366–71.

    CAS  Google Scholar 

  45. Wegayehu T, Karim MR, Li J, Adamu H, Erko B, Zhang L, Tilahun G. Multilocus genotyping of Giardia duodenalis isolates from children in Oromia Special Zone, central Ethiopia. BMC Microbiol. 2016;16:89. https://doi.org/10.1186/s12866-016-0706-7.

    Article  CAS  Google Scholar 

  46. Skhal D, Aboualchamat G, Al Mariri A, Al NS. Prevalence of Giardia duodenalis assemblages and sub-assemblages in symptomatic patients from Damascus city and its suburbs. Infect Genet Evol. 2017;47:155–60. https://doi.org/10.1016/j.meegid.2016.11.030.

    Article  Google Scholar 

  47. Kashinahanji M, Haghighi A, Bahrami F, Fallah M, Saidijam M, Matini M, et al. Giardia lamblia assemblages A and B isolated from symptomatic and asymptomatic persons in Hamadan, west of Iran. J Parasit Dis. 2019;43(4):616–23. https://doi.org/10.1007/s12639-019-01139-x.

    Article  Google Scholar 

  48. Ahmad AA, El-Kady AM, Hassan TM. Genotyping of Giardia duodenalis in children in upper Egypt using assemblage-specific PCR technique. PLoS ONE. 2020;15(10): e0240119. https://doi.org/10.1371/journal.pone.0240119.

    Article  CAS  Google Scholar 

  49. Rebih N, Boutaiba S, Aboualchamat G, Souttou K, Hakem A, Al NS. Molecular and epidemiological characterization of Giardia intestinalis assemblages detected in Djelfa. Algeria J Parasit Dis. 2020;44(2):281–8. https://doi.org/10.1007/s12639-020-01206-8.

    Article  Google Scholar 

  50. Mahmoudi MR, Mahdavi F, Ashrafi K, Forghanparast K, Rahmati B, Mirzaei A, et al. Report of Giardia assemblages and giardiasis in residents of Guilan province-Iran. Parasitol Res. 2020;119(3):1083–91. https://doi.org/10.1007/s00436-019-06595-1.

    Article  CAS  Google Scholar 

  51. Ghoshal U, Shukla R, Pant P, Ghoshal UC. Frequency, diagnostic performance of coproantigen detection and genotyping of the Giardia among patients referred to a multi-level teaching hospital in northern India. Pathog Glob Health. 2016;110(7–8):316–20. https://doi.org/10.1080/20477724.2016.1254141.

    Article  CAS  Google Scholar 

  52. Crotti D, D’Annibale ML, Fonzo G, Lalle M, Cacciò SM, Pozio E. Dientamoeba fragilis is more prevalent than Giardia duodenalis in children and adults attending a day care centre in Central Italy. Parasite. 2005;12(2):165–70. https://doi.org/10.1051/parasite/2005122165.

    Article  CAS  Google Scholar 

  53. Minvielle MC, Molina NB, Polverino D, Basualdo JA. First genotyping of Giardia lamblia from human and animal feces in Argentina, South America. Mem Inst Oswaldo Cruz. 2008;103(1):98–103. https://doi.org/10.1590/s0074-02762008000100015.

    Article  CAS  Google Scholar 

  54. Pelayo L, Nuñez FA, Rojas L, Furuseth Hansen E, Gjerde B, Wilke H, et al. Giardia infections in Cuban children: the genotypes circulating in a rural population. Ann Trop Med Parasitol. 2008;102(7):585–95. https://doi.org/10.1179/136485908X355247.

    Article  CAS  Google Scholar 

  55. Ferreira FS, Machado Sá da Bandeira RA, Constantino CA, da Fonseca AM, Gomes Jda G, Rodrigues RM, Atouguia JL, Centeno-Lima SC. Molecular and clinical characterization of Giardia duodenalis infection in preschool children from Lisbon, Portugal. J Parasitol Res. 2013;2013:252971. https://doi.org/10.1155/2013/252971.

  56. Rafiei A, Roointan ES, Samarbafzadeh AR, Shayesteh AA, Shamsizadeh A, Pourmahdi BM. Investigation of possible correlation between Giardia duodenalis genotypes and clinical symptoms in southwest of Iran. Iran J Parasitol. 2013;8(3):389–95.

    Google Scholar 

  57. Choy SH, Al-Mekhlafi HM, Mahdy MA, Nasr NN, Sulaiman M, Lim YA, et al. Prevalence and associated risk factors of Giardia infection among indigenous communities in rural Malaysia. Sci Rep. 2014;4:6909. https://doi.org/10.1038/srep06909.

    Article  CAS  Google Scholar 

  58. Tamer GS, Kasap M, Er DK. Genotyping and phylogenetic analysis of Giardia duodenalis isolates from Turkish children. Med Sci Monit. 2015;21:526–32. https://doi.org/10.12659/MSM.892318.

    Article  Google Scholar 

  59. Faria CP, Zanini GM, Dias GS, Sousa MDC. Associations of Giardia lamblia assemblages with HIV infections and symptomatology: HIV virus and assemblage B were they born to each other? Acta Trop. 2017;172:80–5. https://doi.org/10.1016/j.actatropica.2017.04.026.

    Article  Google Scholar 

  60. Lecová L, Weisz F, Tůmová P, Tolarová V, Nohýnková E. The first multilocus genotype analysis of Giardia intestinalis in humans in the Czech Republic. Parasitology. 2018;145(12):1577–87. https://doi.org/10.1017/S0031182018000409.

    Article  CAS  Google Scholar 

  61. Köster PC, Malheiros AF, Shaw JJ, Balasegaram S, Prendergast A, Lucaccioni H, et al. Multilocus genotyping of Giardia duodenalis in mostly asymptomatic indigenous people from the Tapirapé Tribe, Brazilian Amazon. Pathogens. 2021;10(2):206. https://doi.org/10.3390/pathogens10020206.

    Article  CAS  Google Scholar 

  62. Belkessa S, Thomas-Lopez D, Houali K, Ghalmi F, Stensvold CR. Molecular characterization of Giardia duodenalis in children and adults sampled in Algeria. Microorganisms. 2020;9(1):54. https://doi.org/10.3390/microorganisms9010054.

    Article  CAS  Google Scholar 

  63. Coradi ST, David EB, Oliveira-Sequeira TCG, Ribolla PEM, Carvalho TB, Guimarães S. Genotyping of Brazilian Giardia duodenalis human axenic isolates. J Venom Anim Toxins incl Trop Dis. 2011;17(3):353–7.

    Article  CAS  Google Scholar 

  64. Hussein EM, Zaki WM, Ahmed SA, Almatary AM, Nemr NI, Hussein AM. Predominance of Giardia lamblia assemblage A among iron deficiency anaemic pre-school Egyptian children. Parasitol Res. 2016;115(4):1537–45. https://doi.org/10.1007/s00436-015-4888-y.

    Article  Google Scholar 

  65. Sahagún J, Clavel A, Goñi P, Seral C, Llorente MT, Castillo FJ, et al. Correlation between the presence of symptoms and the Giardia duodenalis genotype. Eur J Clin Microbiol Infect Dis. 2008;27(1):81–3. https://doi.org/10.1007/s10096-007-0404-3.

    Article  Google Scholar 

  66. Mirrezaie E, Beiromvand M, Tavalla M, Teimoori A, Mirzavand S. Molecular genotyping of Giardia duodenalis in humans in the Andimeshk County, Southwestern Iran. Acta Parasitol. 2019;64(2):376–83. https://doi.org/10.2478/s11686-019-00051-x.

    Article  CAS  Google Scholar 

  67. Rafiei A, Baghlaninezhad R, Köster PC, Bailo B, Hernández de Mingo M, Carmena D, Panabad E, Beiromvand M. Multilocus genotyping of Giardia duodenalis in Southwestern Iran. A community survey. PLoS One. 2020;15(2):e0228317. https://doi.org/10.1371/journal.pone.0228317.

  68. Ajjampur SS, Sankaran P, Kannan A, Sathyakumar K, Sarkar R, Gladstone BP, et al. Giardia duodenalis assemblages associated with diarrhea in children in South India identified by PCR-RFLP. Am J Trop Med Hyg. 2009;80(1):16–9.

    Article  Google Scholar 

Download references

Funding

This work was supported by CNPq Universal Program (Grant 435015/2018–4), FAPERJ (E-26/202.078/2020), and Instituto Oswaldo Cruz/FIOCRUZ—Brazilian Ministério da Saúde (internal funds PAEF IOC-023-FIO-18–53). M.F. was supported by a fellowship from FAPERJ (E-26/202.077/2020). M.F. was supported by a fellowship from CAPES (Brasil Sem Miséria/Brazilian governmental program), CNPq (PDJ), INOVA FIOCRUZ Program, and FAPERJ Nota 10. M.P.-G. was supported by a fellowship from PIBIC/CNPq. A.M.D.-C. has a research fellowship from CNPq (1D) and FAPERJ (CNE). We are gratefull to Dr. Matthew Darmadi for kindly reviewing this manuscript.

Author information

Authors and Affiliations

  1. Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil

    Maria Fantinatti, Monique Gonçalves-Pinto & Alda Maria Da-Cruz

  2. Disciplina de Parasitologia-DMIP, Faculdade de Ciências Médicas, UERJ, Rio de Janeiro, Brazil

    Alda Maria Da-Cruz

Authors
  1. Maria Fantinatti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Monique Gonçalves-Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alda Maria Da-Cruz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alda Maria Da-Cruz.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Giardia/Crypto

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fantinatti, M., Gonçalves-Pinto, M. & Da-Cruz, A.M. Can Giardia lamblia Assemblages Drive the Clinical Outcome of Giardiasis?. Curr Trop Med Rep 9, 101–106 (2022). https://doi.org/10.1007/s40475-022-00259-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40475-022-00259-4

Keywords

Search

Navigation