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Report about the most common
              parasite
                    In
                Gaza Strip



Prepared by :
Mohammed Adnan Qazzaz
Gaza Strip is a narrow
zone of land (360 km2)
situated on the
southeastern corner of
the Mediterranean
Sea. It is bordered on
the south by Egypt, on
the west by the
Mediterranean, on the
east by Negev desert
and on the north by
the green line. Over
one million inhabitants
live in Gaza Strip.
In order to monitor changes in the frequency of
intestinal parasites, the records of 8,417 stool
specimens of patients attending the Ahli Arab
Hospital in the Gaza city in the period 1995-2000
were reviewed and analyzed. Of these 2,506
(29.77%) were positive.
Although 9 different parasites were encountered, the
most common pathogenic parasites identified were:
Entamoeba histolytica (70.19%), Ascaris lumbricoides
(14.64%)
, and Giardia lamblia (10.34%). The other parasites
present were: Trichuris trichiura , Hymenolepis nana
,     Enterobius       vermicularis,    Strongyloides
, stercolaris, Taenia saginata , and Echinococcus
granulosus. The overall monthly
incidence of parasites did not show clear seasonal
patterns.
The prevalence of intestinal parasites has dropped
significantly over the reviewed years from 36.35% in
1995 to 21.20% in 2000. This decline in prevalence
reflects the continuing efforts of the public health
authorities to improve primary health care, water supply
services and sanitation conditions.

.
The hospital records of 8,417 stool specimens were
analyzed. The annual distribution of the specimens and
the percentage of specimens containing parasites are
presented in Table 1. The overall prevalence of parasites
was 29.77%. As can be seen from the table the overall
frequency of parasites has decreased from 36.35% in
the year 1995 to 21.20% in the year 2000
Table 1. Overall distribution of tested stool specimens and
positive cases of intestinal parasites at the Ahli Arab hospital
The numbers and types of parasites seen over the six
years are shown in Table 2. The most common parasites
identified were; E. histolytica , A. lumbricoides and
G. lamblia . The same table also shows that changes
have occurred in the types of parasites over the
reviewed years. In general, E.histolytica was the most
commonly isolated parasite and represented around
three quarters of all parasites throughout the
investigated years. Moreover, E. histolytica was the only
parasite that showed consistent and significant annual
increase.
Most         of      the      remaining        identified
parasites, however, showed a significant decrease. For
instance, A. lumbricoides and G. lamblia which were
respectively responsible for 14.56% and 12.30% of
parasitosis in the year 1995 became numerically less in
the year 2000 and represented only 9.22% and 8.53% of
the positive specimens, respectively. T. saginata and E.
garanulosus remained uncommon parasites in Gaza and
only 2 cases of each were recorded in the whole study
period.
distribution of the recovered parasites over the six years is
illustrated in the figure below :
Generally the percentage of positive specimens per month did
not deviate from the yearly overall percentage. Additionally,
there was no apparent seasonal variation for any of the recorded
parasites. The monthly
The most commone parasite in Gaza Strip :

Gardia lamblia
Entamoeba hostolytica
Oientamoeba fragilis
Blastocystic hominis
Entamoeba coli
Endolimax nana
Ascaris lumbricoides
Entrobius vermicularis
Chilomastix mesuini
Trichuris trichiura
Cryptosporidium parvum
Strongyloides stercoralis
Taenia saginata
Hymenolopis nana
Entamoeba hostolytica and Entamoeba coli:



Most physicians in Gaza prescribe medicaments for patient's
suffering from Entamoeba histolytica/dispar without parasitologic
diagnosis. Additionally, stool analysis performed by the routine
methods usually reports the species as E. histolytica without con-
firmation. In this study, 92 stool specimens were collected and
analyzed by wet mount, iron haematoxylin staining, antigen
detection of E. histolytica and polymerase chain reaction (PCR).
The total number of E. histolytica identified by PCR was 64
(69.6%) that of E. dispar was 21 (22.8%). Mixed infection with
both E. histolytica and E. dispar was evident in 7 specimens
(7.6%). In the light of these results approximately 30% of
suspected clinical amoebiasis cases were negative for E.
histolytica. It is recommended to use PCR for diagnosis of stool
specimens from patients with E. histolytica/dispar and that
treatment should be prescribed for only patients positive for E.
Gardia lamblia :
Giardia lamblia (synonymous with Lamblia
intestinalis and Giardia duodenalis) is a flagellated
protozoan parasite that colonises and reproduces in the small
intestine, causing giardiasis its most common in Khan Yuins City
and it cause 12.30% of parasitic infection in Gaza strip .
Dientamoeba fragilis :
Some cases are reported in Gaza strip but it's not so common .




Blastocystic hominis :
Some cases are reported in Gaza strip but it's not so common .
this protozoa is not always pathogen .
Endolimax nana :


Its intestinal protozoa . Originally thought to be non-pathogenic,
studies suggest it can cause intermittent or chronic
diarrhea.Additionally, it is very significant in medicine because it
can provide false positives for other tests, notably the similar
species Entamoeba histolytica, the pathogenresponsible for
amoebic dysentery, and because its presence indicates the host
has consumed fecal material. It forms cysts with four nuclei
which excyst in the body and become trophozoites. Endolimax
nana nuclei have a large endosome somewhat off-center and
small amounts of visible chromatin or none at all.
Ascaris lumbricoides :
Ascaris lumbricoides is the giant roundworm of
humans, belonging to the phylumNematoda.
 An ascarid nematode, it is responsible for the
disease ascariasis in humans, and it is the largest and
most common parasitic worm in humans. A quarter of
the human population is estimated to be infected by
this parasite. Ascariasis is prevalent worldwide and
more so in tropical and subtropical countries.
Here in Gaza it cause 9.5% of protozoal infestation and
its common in children more than the adult and its
reported in almost all the cites in Gaza Strip .
Entrobius vermicularis :
It’s the most common helminthes that infect child in
Gaza Strip and its very easy to be diagnosed . any itching
in the anus region of a child in Gaza strip is referred to
Entrobius worms . and its cause 38.6%, of the parasite
infestation in Gaza .
Trichuris trichiura :
Its common in Gaza valley region and it cause 7.3% of
the helminthal infestation in Gaza Strip .
Strongyloides stercoralis :
It cause 11.0% of helminthal infestation in Gaza strip
A study in Gaza valley region shows that :



in Gaza Valley, out of 352 children surveyed, 265 (75.28%) were positive for
intestinal helminths. Prevalence of Ascaris lumbricoides was 71.87%, followed
byTrichuris trichiura (26.42%), Enterobius vermicularis (13.92%) and . Single
species infection was seen in 38.63% of the infected children, whereas 36.64%
were infected with multiple species of helminth parasites. The prevalence of
infection peaked in the age group of 11-15 years (84.91%) followed by the age
group of 6-10 years (81.70%) and age group of 0-5 years (50.54%) .The
differences in prevalence rates between male, female and rural urban children
was insignificant .Water source, defecation site, personal hygiene and maternal
education were significant risk factors in predicting the intestinal helminth
infection.
Conclusion :

The present study reveals that intestinal helminths are
abundant among schoolchildren of Gaza valley. This
situation strongly calls for the institution of control
measures, including treatment of infected
individuals, improvement of sanitation
practices, provision of clean water and further studies
on the abundance of intestinal protozoan infections in
the children of Gaza valley. The impact of each
measure would be maximized through a health
education program directed at schoolchildren and
their mothers in particular, and to communities in
general.
Taenia saginata :

This is the beef tape worm and it is not so common in Gaza but
some cases were reported . produces only mild abdominal
symptoms .
Hymenolopis nana :

Dwarf tapeworm it cause 4.1% of helminthal infestation .
Cryptosporidium parvum :
This one most of the infections is asymptomatic . however In
some people "often immuniocompromised " can cause sever
diarrhea . And 6.6% of tested people were positive for it .
Final Conclusion :

The highest incidence rate in proportion to the total
number of investigated samples was recorded in Jabalia
area 17.0% followed by Deir el balaharea 16.6%, Beit
hanoun 15.6% and Gaza town 14.0%. The infection rate
was higher in younger age group (6- 9 years) in which
several of pupils reported variable symptoms like
abdominal pain, cramps, weight loss, diarrhea, and
anorexia. The rate of infection was higher in children
from overcrowded areas, rural areas, low income
families and it was reported more in male than female
pupils.
The worst parasite in Gaza and in whole Palestine is the Israeli occupation

            Freedom for Gaza . Freedom For whole Palestine
Treatment of some protozoa and helminthes
                 Drugs for treatment of protozoal infection

             Organism                        Drug Of Choice             Other Drugs
                                                                Tetracycline,500mg 4 times
                                        Iodoquinol, 650mg 3time       daily for 10 days
        Dientamoeba fragilis
                                            daily for 20 days      Paromoycin,500 mg 3
                                                                   times daily for 7 days
                                              Nifurtimox
         Trypanosome Cruzi                          Or
                                              benznidizol

                        Hemolymphatic           Suramin              Pentamidine Or Eflonithine
Trypanosome Brucei
                         Advanced CNS
                                              Melarsoprol                   Eflonithine
                            disease
                                                                      Furazolidone, 100 mg 4
                                         Metronidazol, 250mg3
                                                                       times daily for 7 days
                                                   times
          Gardia Lamblia                                                        Or
                                                     Or
                                                                     Albendazole ,400 mg daily
                                        dailyfor 5 days Tinidazole
                                                                            for 5 days
                                         Tetracycline , 500 mg 4      Metronidazol 750,mg 3
          Blantidium coli
                                         times daily for 10 daily      times daily for 5 days
Paromoycin,500-750 mg 3 times       Azithromycin, 500 mg daily for
    Cryptosporidium species
                                    daily for 10 days                        21day

                              Metronidazol, 2 gonce or 250 mg 3
                                    times daily for 7days
     Trichomonas vaginalis
                                              Or
                                    Tinidazole , 2 g once

                   Visceral
                                                                     Meglumine antimonite
                                                                             Or
                              Sodium stibogluconate , 20 mg IV
                                                                         Pentamidine
                   Mucosal            or IM for 28 day
                                                                             Or
                                                                       Amphotericine B
Lishmaniasis
                                                                     Meglumine antimonite
                                                                              Or
                              Sodium stibogluconate , 20 mg IV
                  Ctaneous                                               Pentamidine
                                      or IM for 20 day
                                                                              Or
                                                                         Ketoconazole
Drugs for treatment of helminthic infection :


                          Drugs For Treatment Trematodes
              Organism                 Drug Of Choice       Other Drugs
                   Haematobium
    Schistosoma          mansoni       praziquantel        metrifonate
                     japonicum
                                          Bithionol
          Fasciola hepatica
                                      triclabendazole
                                      Praziquantel or
         Fasciolopsis buski
                                       niclosamide
         Clonorchis sinensis           praziquantel         Albendazole

      Paragonimus westermani           praziquantel         Bithionol
Drugs For Treatment cestodes
        Organism                   Drug Of Choice          Other Drugs

Diphyllobothrium latem      Praziquantel or niclosamide


     Taenia solium          Praziquantel or niclosamide


    Taenia saginata         Praziquantel or niclosamide   mebandazole


  Hymenolepis nana                 Praziquantel           niclosamide
Echinococcus granulosus             Albendazole
Drugs For Treatment Nematodes
           Organism                           Drug Of Choice                 Other Drugs

    Entrobius vermocularis           Mebandazole . pyrantel pamoate          Albendazole




Nactor amiericanus. ancyostoma             pyrantel pamoate
                                               Albendazole
                                             Mebandazole

     Wuchereria bancrofti                  diethylcabamazine                invermectin
           Loa loa                         diethylcabamazine                invermectin
        Brugia malayi                      diethylcabamazine                invermectin
      Trichuris trichiura                      Albendazole            oxantel/pyrantel pamoate
                                             Mebandazole



   Strongyloides stercoralis                  invermectin                    Albendazole
                                                                           thiabendazole

     Ascaris lumbricoides                      Albendazole                   piperazine
                                           pyrantel pamoate
                                             Mebandazole
Treatment of Amebiasis

Asymptomatic intestinal infection :
Drug of choice :
Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days .
Iodoquinol , 650 mg 3 times daily for 21 days .
Promomycine , 10 mg /kg 3 times daily for 7 days .




Mild to moderate intestinal infection :
 Drug of choice :
Metronidazol, 750mg 3 times daily (or 500 mg IV every 6 hours) for 10 days
Tinidazole . 2g daily for 3 days .
Other drugs :
Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days .
Tetracycline,250mg 3 times daily for 10 days
Severe intestinal infection :
 Drug of choice :
Metronidazol, 750mg 3 times daily (or 500 mg IV every 6 hours) for 10 days
Tinidazole . 2g daily for 3 days .
Other drugs :
Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days .
Tetracycline,250mg 3 times daily for 10 days




Hepatic abscess . ameboma and lung abscess :
 Drug of choice :
Metronidazol, 750mg 3 times daily (or 500 mg IV every 6 hours) for 10 days
Tinidazole . 2g daily for 3 days .
Other drugs :
Dehydrometine or emerine ,1 mg /kg SC or IM for 8-10 days , followed by ( liver abscess
only ) chloroquine , 500 mg twice daily then 500 mg daily for 21
Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days .
Tetracycline,250mg 3 times daily for 10 days
Gaza strip parasite

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Gaza strip parasite

  • 1. Report about the most common parasite In Gaza Strip Prepared by : Mohammed Adnan Qazzaz
  • 2. Gaza Strip is a narrow zone of land (360 km2) situated on the southeastern corner of the Mediterranean Sea. It is bordered on the south by Egypt, on the west by the Mediterranean, on the east by Negev desert and on the north by the green line. Over one million inhabitants live in Gaza Strip.
  • 3. In order to monitor changes in the frequency of intestinal parasites, the records of 8,417 stool specimens of patients attending the Ahli Arab Hospital in the Gaza city in the period 1995-2000 were reviewed and analyzed. Of these 2,506 (29.77%) were positive.
  • 4. Although 9 different parasites were encountered, the most common pathogenic parasites identified were: Entamoeba histolytica (70.19%), Ascaris lumbricoides (14.64%) , and Giardia lamblia (10.34%). The other parasites present were: Trichuris trichiura , Hymenolepis nana , Enterobius vermicularis, Strongyloides , stercolaris, Taenia saginata , and Echinococcus granulosus. The overall monthly
  • 5. incidence of parasites did not show clear seasonal patterns. The prevalence of intestinal parasites has dropped significantly over the reviewed years from 36.35% in 1995 to 21.20% in 2000. This decline in prevalence reflects the continuing efforts of the public health authorities to improve primary health care, water supply services and sanitation conditions. .
  • 6. The hospital records of 8,417 stool specimens were analyzed. The annual distribution of the specimens and the percentage of specimens containing parasites are presented in Table 1. The overall prevalence of parasites was 29.77%. As can be seen from the table the overall frequency of parasites has decreased from 36.35% in the year 1995 to 21.20% in the year 2000
  • 7. Table 1. Overall distribution of tested stool specimens and positive cases of intestinal parasites at the Ahli Arab hospital
  • 8. The numbers and types of parasites seen over the six years are shown in Table 2. The most common parasites identified were; E. histolytica , A. lumbricoides and G. lamblia . The same table also shows that changes have occurred in the types of parasites over the reviewed years. In general, E.histolytica was the most commonly isolated parasite and represented around three quarters of all parasites throughout the investigated years. Moreover, E. histolytica was the only parasite that showed consistent and significant annual increase.
  • 9. Most of the remaining identified parasites, however, showed a significant decrease. For instance, A. lumbricoides and G. lamblia which were respectively responsible for 14.56% and 12.30% of parasitosis in the year 1995 became numerically less in the year 2000 and represented only 9.22% and 8.53% of the positive specimens, respectively. T. saginata and E. garanulosus remained uncommon parasites in Gaza and only 2 cases of each were recorded in the whole study period.
  • 10. distribution of the recovered parasites over the six years is illustrated in the figure below : Generally the percentage of positive specimens per month did not deviate from the yearly overall percentage. Additionally, there was no apparent seasonal variation for any of the recorded parasites. The monthly
  • 11. The most commone parasite in Gaza Strip : Gardia lamblia Entamoeba hostolytica Oientamoeba fragilis Blastocystic hominis Entamoeba coli Endolimax nana Ascaris lumbricoides Entrobius vermicularis Chilomastix mesuini Trichuris trichiura Cryptosporidium parvum Strongyloides stercoralis Taenia saginata Hymenolopis nana
  • 12. Entamoeba hostolytica and Entamoeba coli: Most physicians in Gaza prescribe medicaments for patient's suffering from Entamoeba histolytica/dispar without parasitologic diagnosis. Additionally, stool analysis performed by the routine methods usually reports the species as E. histolytica without con- firmation. In this study, 92 stool specimens were collected and analyzed by wet mount, iron haematoxylin staining, antigen detection of E. histolytica and polymerase chain reaction (PCR). The total number of E. histolytica identified by PCR was 64
  • 13. (69.6%) that of E. dispar was 21 (22.8%). Mixed infection with both E. histolytica and E. dispar was evident in 7 specimens (7.6%). In the light of these results approximately 30% of suspected clinical amoebiasis cases were negative for E. histolytica. It is recommended to use PCR for diagnosis of stool specimens from patients with E. histolytica/dispar and that treatment should be prescribed for only patients positive for E.
  • 14. Gardia lamblia : Giardia lamblia (synonymous with Lamblia intestinalis and Giardia duodenalis) is a flagellated protozoan parasite that colonises and reproduces in the small intestine, causing giardiasis its most common in Khan Yuins City and it cause 12.30% of parasitic infection in Gaza strip .
  • 15. Dientamoeba fragilis : Some cases are reported in Gaza strip but it's not so common . Blastocystic hominis : Some cases are reported in Gaza strip but it's not so common . this protozoa is not always pathogen .
  • 16. Endolimax nana : Its intestinal protozoa . Originally thought to be non-pathogenic, studies suggest it can cause intermittent or chronic diarrhea.Additionally, it is very significant in medicine because it can provide false positives for other tests, notably the similar species Entamoeba histolytica, the pathogenresponsible for amoebic dysentery, and because its presence indicates the host has consumed fecal material. It forms cysts with four nuclei which excyst in the body and become trophozoites. Endolimax nana nuclei have a large endosome somewhat off-center and small amounts of visible chromatin or none at all.
  • 17. Ascaris lumbricoides : Ascaris lumbricoides is the giant roundworm of humans, belonging to the phylumNematoda. An ascarid nematode, it is responsible for the disease ascariasis in humans, and it is the largest and most common parasitic worm in humans. A quarter of the human population is estimated to be infected by this parasite. Ascariasis is prevalent worldwide and more so in tropical and subtropical countries. Here in Gaza it cause 9.5% of protozoal infestation and its common in children more than the adult and its reported in almost all the cites in Gaza Strip .
  • 18.
  • 19. Entrobius vermicularis : It’s the most common helminthes that infect child in Gaza Strip and its very easy to be diagnosed . any itching in the anus region of a child in Gaza strip is referred to Entrobius worms . and its cause 38.6%, of the parasite infestation in Gaza .
  • 20. Trichuris trichiura : Its common in Gaza valley region and it cause 7.3% of the helminthal infestation in Gaza Strip .
  • 21. Strongyloides stercoralis : It cause 11.0% of helminthal infestation in Gaza strip
  • 22. A study in Gaza valley region shows that : in Gaza Valley, out of 352 children surveyed, 265 (75.28%) were positive for intestinal helminths. Prevalence of Ascaris lumbricoides was 71.87%, followed byTrichuris trichiura (26.42%), Enterobius vermicularis (13.92%) and . Single species infection was seen in 38.63% of the infected children, whereas 36.64% were infected with multiple species of helminth parasites. The prevalence of infection peaked in the age group of 11-15 years (84.91%) followed by the age group of 6-10 years (81.70%) and age group of 0-5 years (50.54%) .The differences in prevalence rates between male, female and rural urban children was insignificant .Water source, defecation site, personal hygiene and maternal education were significant risk factors in predicting the intestinal helminth infection.
  • 23. Conclusion : The present study reveals that intestinal helminths are abundant among schoolchildren of Gaza valley. This situation strongly calls for the institution of control measures, including treatment of infected individuals, improvement of sanitation practices, provision of clean water and further studies on the abundance of intestinal protozoan infections in the children of Gaza valley. The impact of each measure would be maximized through a health education program directed at schoolchildren and their mothers in particular, and to communities in general.
  • 24. Taenia saginata : This is the beef tape worm and it is not so common in Gaza but some cases were reported . produces only mild abdominal symptoms .
  • 25. Hymenolopis nana : Dwarf tapeworm it cause 4.1% of helminthal infestation .
  • 26. Cryptosporidium parvum : This one most of the infections is asymptomatic . however In some people "often immuniocompromised " can cause sever diarrhea . And 6.6% of tested people were positive for it .
  • 27. Final Conclusion : The highest incidence rate in proportion to the total number of investigated samples was recorded in Jabalia area 17.0% followed by Deir el balaharea 16.6%, Beit hanoun 15.6% and Gaza town 14.0%. The infection rate was higher in younger age group (6- 9 years) in which several of pupils reported variable symptoms like abdominal pain, cramps, weight loss, diarrhea, and anorexia. The rate of infection was higher in children from overcrowded areas, rural areas, low income families and it was reported more in male than female pupils.
  • 28. The worst parasite in Gaza and in whole Palestine is the Israeli occupation Freedom for Gaza . Freedom For whole Palestine
  • 29. Treatment of some protozoa and helminthes Drugs for treatment of protozoal infection Organism Drug Of Choice Other Drugs Tetracycline,500mg 4 times Iodoquinol, 650mg 3time daily for 10 days Dientamoeba fragilis daily for 20 days Paromoycin,500 mg 3 times daily for 7 days Nifurtimox Trypanosome Cruzi Or benznidizol Hemolymphatic Suramin Pentamidine Or Eflonithine Trypanosome Brucei Advanced CNS Melarsoprol Eflonithine disease Furazolidone, 100 mg 4 Metronidazol, 250mg3 times daily for 7 days times Gardia Lamblia Or Or Albendazole ,400 mg daily dailyfor 5 days Tinidazole for 5 days Tetracycline , 500 mg 4 Metronidazol 750,mg 3 Blantidium coli times daily for 10 daily times daily for 5 days
  • 30. Paromoycin,500-750 mg 3 times Azithromycin, 500 mg daily for Cryptosporidium species daily for 10 days 21day Metronidazol, 2 gonce or 250 mg 3 times daily for 7days Trichomonas vaginalis Or Tinidazole , 2 g once Visceral Meglumine antimonite Or Sodium stibogluconate , 20 mg IV Pentamidine Mucosal or IM for 28 day Or Amphotericine B Lishmaniasis Meglumine antimonite Or Sodium stibogluconate , 20 mg IV Ctaneous Pentamidine or IM for 20 day Or Ketoconazole
  • 31. Drugs for treatment of helminthic infection : Drugs For Treatment Trematodes Organism Drug Of Choice Other Drugs Haematobium Schistosoma mansoni praziquantel metrifonate japonicum Bithionol Fasciola hepatica triclabendazole Praziquantel or Fasciolopsis buski niclosamide Clonorchis sinensis praziquantel Albendazole Paragonimus westermani praziquantel Bithionol
  • 32. Drugs For Treatment cestodes Organism Drug Of Choice Other Drugs Diphyllobothrium latem Praziquantel or niclosamide Taenia solium Praziquantel or niclosamide Taenia saginata Praziquantel or niclosamide mebandazole Hymenolepis nana Praziquantel niclosamide Echinococcus granulosus Albendazole
  • 33. Drugs For Treatment Nematodes Organism Drug Of Choice Other Drugs Entrobius vermocularis Mebandazole . pyrantel pamoate Albendazole Nactor amiericanus. ancyostoma pyrantel pamoate Albendazole Mebandazole Wuchereria bancrofti diethylcabamazine invermectin Loa loa diethylcabamazine invermectin Brugia malayi diethylcabamazine invermectin Trichuris trichiura Albendazole oxantel/pyrantel pamoate Mebandazole Strongyloides stercoralis invermectin Albendazole thiabendazole Ascaris lumbricoides Albendazole piperazine pyrantel pamoate Mebandazole
  • 34. Treatment of Amebiasis Asymptomatic intestinal infection : Drug of choice : Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days . Iodoquinol , 650 mg 3 times daily for 21 days . Promomycine , 10 mg /kg 3 times daily for 7 days . Mild to moderate intestinal infection : Drug of choice : Metronidazol, 750mg 3 times daily (or 500 mg IV every 6 hours) for 10 days Tinidazole . 2g daily for 3 days . Other drugs : Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days . Tetracycline,250mg 3 times daily for 10 days
  • 35. Severe intestinal infection : Drug of choice : Metronidazol, 750mg 3 times daily (or 500 mg IV every 6 hours) for 10 days Tinidazole . 2g daily for 3 days . Other drugs : Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days . Tetracycline,250mg 3 times daily for 10 days Hepatic abscess . ameboma and lung abscess : Drug of choice : Metronidazol, 750mg 3 times daily (or 500 mg IV every 6 hours) for 10 days Tinidazole . 2g daily for 3 days . Other drugs : Dehydrometine or emerine ,1 mg /kg SC or IM for 8-10 days , followed by ( liver abscess only ) chloroquine , 500 mg twice daily then 500 mg daily for 21 Lumina agent :Diloxanide Furoate 500 mg 3 times daily for 10 days . Tetracycline,250mg 3 times daily for 10 days