Objective: Giardiasis, a zoonotic, diarrhoeal disease with worldwide occurrence, is routinely diagnosed by
microscopic examination of stool samples. However, implementation of this method relies on skilled personal, it is
time consuming and relatively low in sensitivity. A superior diagnostic approach to detect the causative agent Giardia
intestinalis would, hence, be highly desirable. The current study aimed to assess real-time polymerase chain
reaction (PCR) for the detection of G. intestinalis as an alternative to microscopy.
Material and methods: Stool samples from healthy schoolchildren, aged 8-14 years, from eight schools of the
Centre-Ouest and Plateau Central regions in Burkina Faso were collected within a cross-sectional study in February
2015. Microscopic examination was performed on two faecal samples collected over two consecutive days from 441
schoolchildren. Each faecal specimen was examined using Kato-Katz and formol-ether methods of concentration in
addition to direct examination. Real-time PCR was used to detect G. intestinalis in all microscopy-positive and a
random sample of microscopy-negative samples.
Results: Microscopic examination revealed 94 microscopy-positive samples, and an overall G. intestinalis
prevalence of 27.2%. Using the microscopic examination as the ‘gold’ standard, the overall sensitivity of real-time
PCR was demonstrated to be 76.6% ranging from 58.3% to 94.1% and the specificity was 96.2% ranging from
96.2% to 100% across schools.
Conclusion: Real-time PCR appears to be a solid detection method for G. intestinalis in the current setting.
However, it needs to be further optimized to become a more sensitive tool for G. intestinalis diagnosis in low-income
settings

Giardia intestinalis; Molecular diagnosis; Stool; Burkina Faso