Journal of Parasitic Diseases

, Volume 43, Issue 4, pp 616–623 | Cite as

Giardia lamblia assemblages A and B isolated from symptomatic and asymptomatic persons in Hamadan, west of Iran

  • Manizheh Kashinahanji
  • Ali Haghighi
  • Fares Bahrami
  • Mohammad Fallah
  • Masoud Saidijam
  • Mohammad Matini
  • Amir Hossein MaghsoodEmail author
Original Article


Giardia is a very abundant organism bringing about diarrhoea in human beings. The focus of this analysis was the detection of Giardia lamblia assemblages in human stool specimens in Hamadan, west of Iran, as well as the association between obtained assemblages and clinical symptoms. Faecal samples of 4066 individuals admitted to the medical and health care facilities in Hamadan were inspected microscopically for the existence of Giardia cysts/trophozoites, and the clinical symptoms of the patients were recorded. The DNA of positive samples was isolated from and the nucleotide sequences of both glutamate dehydrogenase (gdh) (n = 15) and triose phosphate isomerase (tpi) (n = 8) genes were analyzed. In direct microscopy, a total of sixty-four samples (1.6%), were considered as positive for G. lamblia cysts or trophozoites. The sequence analysis showed that 18 out of 23 sequenced isolates (78.2%) were assemblage A and 5 (21.7%) were assemblage B. Clinical symptoms were observed in 44.4% and 40% of patients with assemblages A and B, respectively. Overall, the predominant assemblage A detected in the tested samples along with bioinformatics analysis suggest a potential zoonotic transmission in the region of the study. Although advanced analyses are necessary to understand the foundation and path of the infection, it seems that more sanitary regulations regarding contact with livestock and pet animals are essential.


Assemblage A and B Clinical symptoms Giardia lamblia Iran 



We are thanking to all staffs and officers of Health Centers of Hamadan city.

Authors’ contribution

M. Kashinahanji and A.H. Maghsood planned the research, carried it out, analyzed data and, assessed clinical records. They also cooperated in the manuscript writing. M. Fallah, M. Saidijam and M. Matini statistical analysis, assisted for sample collection and study design. F. Bahrami and A. Haghighi executed the laboratory assays and cooperated in the manuscript writing and revision.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

The present research was accomplished in agreement with the ethical standards of the Declaration of Helsinki and has been permitted by Hamadan University of Medical Sciences ethics committee (Grant No. 9208072464) with respect to the human rights and a written informed consensus was attained from every participant before gathering data.

Financial support

This study was funded by Vice-chancellor for Research and Technology, Hamadan University of Medical Sciences (Grant No. 9208072464).


  1. Abbas BM, AL-Saqur IM, Majeed HA (2016) Detection and genotyping of Giardia lamblia in clinical and environmental samples in some regions of Baghdad city. Int J Curr Microbiol Appl Sci 5:459–468CrossRefGoogle Scholar
  2. Al-Mohammed HI (2011) Genotypes of Giardia intestinalis clinical isolates of gastrointestinal symptomatic and asymptomatic Saudi children. Parasitol Res 108(6):1375–1381PubMedCrossRefGoogle Scholar
  3. Ankarklev J, Jerlström-Hultqvist J, Ringqvist E, Troell K, Svärd SG (2010) Behind the smile: cell biology and disease mechanisms of Giardia species. Nat Rev Microbiol 8(6):413PubMedCrossRefGoogle Scholar
  4. Arani AS, Alaghehbandan R, Akhlaghi L, Shahi M, Lari AR (2008) Prevalence of intestinal parasites in a population in south of Tehran, Iran. Rev Inst Med Trop Sao Paulo 50(3):145–149PubMedCrossRefGoogle Scholar
  5. Babaei Z, Oormazdi H, Akhlaghi L, Rezaie S, Razmjou E, Soltani-Arabshahi S, Meamar A, Hadighi R (2008) Molecular characterization of the Iranian isolates of Giardia lamblia: application of the glutamate dehydrogenase gene. Iran J Public Health 37(2):75–82Google Scholar
  6. Badparva E, Kheirandish F, Ebrahimzade F (2014) Prevalence of intestinal parasites in Lorestan Province, west of Iran. Asian Pac J Trop Dis 4:S728–S732CrossRefGoogle Scholar
  7. Bahrami F, Zamini G, Haghighi A, Khademerfan M (2017) Detection and molecular identification of human Giardia isolates in the west of Iran. Biomed Res 28(13):5687–5692Google Scholar
  8. Bertrand I, Albertini L, Schwartzbrod J (2005) Comparison of two target genes for detection and genotyping of Giardia lamblia in human feces by PCR and PCR-restriction fragment length polymorphism. J Clin Microbiol 43(12):5940–5944PubMedPubMedCentralCrossRefGoogle Scholar
  9. Cacciò SM, Ryan U (2008) Molecular epidemiology of giardiasis. Mol Biochem Parasitol 160(2):75–80PubMedCrossRefGoogle Scholar
  10. Cacciò SM, Lalle M, Svärd SG (2017) Host specificity in the Giardia duodenalis species complex. Infect Genet Evol 66:335–345PubMedCrossRefGoogle Scholar
  11. Coradi S, David E, Oliveira-Sequeira T, Ribolla P, Carvalho T, Guimarães S (2011) Genotyping of Brazilian Giardia duodenalis human axenic isolates. J Venom Anim Toxins Incl Trop Dis 17(3):353–357CrossRefGoogle Scholar
  12. Fallah E, Nahavandi KH, Jamali R, Poor BM, Asgharzadeh M (2008) Molecular identification of Giardia duodenalis isolates from human and animal reservoirs by PCR-RFLP. J Biol Sci 8(5):1–6Google Scholar
  13. Fantinatti M, Bello AR, Fernandes O, Da-Cruz AM (2016) Identification of Giardia lamblia assemblage E in humans points to a new anthropozoonotic cycle. J Infect Dis 214(8):1256–1259PubMedCrossRefGoogle Scholar
  14. Foronda P, Bargues M, Abreu-Acosta N, Periago M, Valero M, Valladares B, Mas-Coma S (2008) Identification of genotypes of Giardia intestinalis of human isolates in Egypt. Parasitol Res 103(5):1177–1181PubMedCrossRefGoogle Scholar
  15. Gasparinho C, Ferreira FS, Mayer AC, Mirante MC, Vaz Nery S, Santos-Reis A, Portugal-Calisto D, Brito M (2017) Molecular characterization of Giardia lamblia in children < 5 years of age with diarrhoea attending the Bengo General Hospital, Angola. Trans R Soc Trop Med Hyg 111(11):497–503PubMedCrossRefGoogle Scholar
  16. Haque R, Roy S, Kabir M, Stroup SE, Mondal D, Houpt ER (2005) Giardia assemblage A infection and diarrhea in Bangladesh. J Infect Dis 192(12):2171–2173PubMedCrossRefGoogle Scholar
  17. Helmy MM, Abdel-Fattah HS, Rashed L (2009) Real-time PCR/RFLP assay to detect Giardia intestinalis genotypes in human isolates with diarrhea in Egypt. J Parasitol 95(4):1000–1004PubMedCrossRefGoogle Scholar
  18. Ijaz MK, Rubino JR (2012) Impact of infectious diseases on cognitive development in childhood and beyond: potential mitigational role of hygiene. Open Infect Dis J 6(1):65–70CrossRefGoogle Scholar
  19. Itagaki T, Kinoshita S, Aoki M, Itoh N, Saeki H, Sato N, Uetsuki J, Izumiyama S, Yagita K, Endo T (2005) Genotyping of Giardia intestinalis from domestic and wild animals in Japan using glutamete dehydrogenase gene sequencing. Vet Parasitol 133(4):283–287PubMedCrossRefGoogle Scholar
  20. Lalle M (2010) Giardiasis in the post genomic era: treatment, drug resistance and novel therapeutic perspectives. Infect Disord Drug (Formerly Current Drug Targets-Infectious Disorders) 10(4):283–294CrossRefGoogle Scholar
  21. Liu A, Zhang X, Zhang L, Wang R, Li X, Shu J, Zhang X, Shen Y, Zhang W, Ling H (2012) Occurrence of bovine giardiasis and endemic genetic characterization of Giardia duodenalis isolates in Heilongjiang Province, in the Northeast of China. Parasitol Res 111(2):655–661PubMedCrossRefGoogle Scholar
  22. Lopez-Romero G, Quintero J, Astiazarán-García H, Velazquez C (2015) Host defences against Giardia lamblia. Parasite Immunol 37(8):394–406PubMedCrossRefGoogle Scholar
  23. Mahdy AM, Surin J, Wan KL, Mohd-Adnan A, Al-Mekhlafi MH, Lim Y (2009) Giardia intestinalis genotypes: risk factors and correlation with clinical symptoms. Acta Trop 112(1):67–70CrossRefGoogle Scholar
  24. Nahavandi KH, Fallah E, Asgharzadeh M, Mirsamadi N, Mahdavipour B (2011) Glutamate dehydrogenase and triose-phosphate-isomerase coding genes for detection and genetic characterization of Giardia lamblia in human feces by PCR and PCR-RFLP. Turk J Med Sci 41(2):283–289Google Scholar
  25. Nasiri V, Esmailnia K, Karim G, Nasir M, Akhavan O (2009) Intestinal parasitic infections among inhabitants of Karaj City, Tehran province, Iran in 2006–2008. Korean J Parasitol 47(3):265PubMedPubMedCentralCrossRefGoogle Scholar
  26. Palmer CS, Traub RJ, Robertson ID, Devlin G, Rees R, Thompson RA (2008) Determining the zoonotic significance of Giardia and Cryptosporidium in Australian dogs and cats. Vet Parasitol 154(1–2):142–147PubMedCrossRefGoogle Scholar
  27. Pestehchian N, Rasekh H, Babaei Z, Yousefi HA, Eskandarian AA, Kazemi M, Akbari M (2012) Identification of genotypes of Giardia duodenalis human isolates in Isfahan, Iran, using polymerase chain reaction–restriction fragment length polymorphism. Adv Biomed Res 1:84PubMedPubMedCentralCrossRefGoogle Scholar
  28. Rafiei A, Sadat Roointan E, Samarbaf-Zadeh AR, Shayesteh AA (2013) Genotype analysis of giardia lamblia isolated from children in ahvaz, southwest of iran. Jundishapur J Microbiol 6(3):279–283Google Scholar
  29. Rayani M, Unyah NZ, Hatam G (2014) Molecular identification of Giardia duodenalis isolates from Fars province, Iran. Iran J Parasitol 9(1):70PubMedPubMedCentralGoogle Scholar
  30. Rayani M, Hatam G, Unyah NZ, Ashrafmansori A, Abdullah WO, Hamat RA (2017) Phylogenetic analysis of Giardia lamblia human genotypes in Fars Province, Southern Iran. Iran J Parasitol 12(4):522PubMedPubMedCentralGoogle Scholar
  31. Read C, Walters J, Robertson I, Thompson R (2002) Correlation between genotype of Giardia duodenalis and diarrhoea. Int J Parasitol 32(2):229–231PubMedCrossRefGoogle Scholar
  32. Read CM, Monis PT, Thompson RA (2004) Discrimination of all genotypes of Giardia duodenalis at the glutamate dehydrogenase locus using PCR-RFLP. Infect Genet Evol 4(2):125–130PubMedCrossRefGoogle Scholar
  33. Sadeghi H, Borji H (2015) A survey of intestinal parasites in a population in Qazvin, north of Iran. Asian Pac J Trop Dis 5(3):231–233CrossRefGoogle Scholar
  34. Salman YJ, Al-Taee A-RA, Abid AM (2016) Prevalence of Giardia lamblia among iraqi displaced peoples in Kirkuk province. Int J Curr Microbiol Appl Sci 5:753–760CrossRefGoogle Scholar
  35. Sarkari B, Ashrafmansori A, Hatam G, Motazedian M, Asgari Q, Mohammadpour I (2012) Genotyping of Giardia lamblia isolates from human in southern Iran. Trop Biomed 29(3):366–371PubMedGoogle Scholar
  36. Sprong H, Cacciò SM, van der Giessen JW (2009) Identification of zoonotic genotypes of Giardia duodenalis. PLoS Negl Trop Dis 3(12):e558PubMedPubMedCentralCrossRefGoogle Scholar
  37. Sulaiman IM, Fayer R, Bern C, Gilman RH, Trout JM, Schantz PM, Das P, Lal AA, Xiao L (2003) Triosephosphate isomerase gene characterization and potential zoonotic transmission of Giardia duodenalis. Emerg Infect Dis 9(11):1444PubMedPubMedCentralCrossRefGoogle Scholar
  38. Traub R, Monis P, Robertson I, Irwin P, Mencke N, Thompson R (2004) Epidemiological and molecular evidence supports the zoonotic transmission of Giardia among humans and dogs living in the same community. Parasitology 128(3):253–262PubMedCrossRefGoogle Scholar
  39. World Health Organization (1979) Parasitic zoonoses. Report of a WHO Expert Committee with participation of FAO. Tech Rep Ser No. 637, Geneva, WHOGoogle Scholar

Copyright information

© Indian Society for Parasitology 2019

Authors and Affiliations

  1. 1.Department of Medical Parasitology and Mycology, School of MedicineHamadan University of Medical SciencesHamadanIran
  2. 2.Department of Medical Parasitology and Mycology, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
  3. 3.Zoonoses Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
  4. 4.Department of Molecular Medicine and Genetics, School of MedicineHamadan University of Medical SciencesHamadanIran

Personalised recommendations