title: The prevalence of Giardia infection in dogs and cats, a systematic review and meta-analysis of prevalence studies from stool samples.
abstract: Giardia has a wide range of host species and is a common cause of diarrhoeal disease in humans and animals. Companion animals are able to transmit a range of zoonotic diseases to their owners including giardiasis, but the size of this risk is not well known. The aim of this study was to analyse giardiasis prevalence rates in dogs and cats worldwide using a systematic search approach. Meta-analysis enabled to describe associations between Giardia prevalence and various confounding factors. Pooled prevalence rates were 15.2% (95% CI 13.8-16.7%) for dogs and 12% (95% CI 9.2-15.3%) for cats. However, there was very high heterogeneity between studies. Meta-regression showed that the diagnostic method used had a major impact on reported prevalence with studies using ELISA, IFA and PCR reporting prevalence rates between 2.6 and 3.7 times greater than studies using microscopy. Conditional negative binomial regression found that symptomatic animals had higher prevalence rates ratios (PRR) than asymptomatic animals 1.61 (95% CI 1.33-1.94) in dogs and 1.94 (95% CI 1.47-2.56) in cats. Giardia was much more prevalent in young animals. For cats >6 months, PRR=0.47 (0.42-0.53) and in dogs of the same age group PRR=0.36 (0.32-0.41). Additionally, dogs kept as pets were less likely to be positive (PRR=0.56 (0.41-0.77)) but any difference in cats was not significant. Faecal excretion of Giardia is common in dogs and slightly less so in cats. However, the exact rates depend on the diagnostic method used, the age and origin of the animal. What risk such endemic colonisation poses to human health is still unclear as it will depend not only on prevalence rates but also on what assemblages are excreted and how people interact with their pets.
authors.affiliation: Norwich Medical School, University of East Anglia, NR4 7TJ Norwich, UK. Electronic address: m.bouzid@uea.ac.uk.
authors.forename: Maha
authors.initials: M
authors.lastname: Bouzid
authors.affiliation: Norwich Medical School, University of East Anglia, NR4 7TJ Norwich, UK.
authors.forename: Kapil
authors.initials: K
authors.lastname: Halai
authors.affiliation: Norwich Medical School, University of East Anglia, NR4 7TJ Norwich, UK.
authors.forename: Danielle
authors.initials: D
authors.lastname: Jeffreys
authors.affiliation: Norwich Medical School, University of East Anglia, NR4 7TJ Norwich, UK.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Hunter
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000453:epidemiology*; D002415:Cats; D004283:Dog Diseases / Q000453:epidemiology*; D004285:Dogs; D005243:Feces / Q000469:parasitology; D016829:Giardia lamblia / Q000235:genetics; D005873:Giardiasis / Q000453:epidemiology / Q000662:veterinary*; D006801:Humans; D057805:Pets / Q000469:parasitology; D015995:Prevalence
keywords: Cats; Dogs; Giardia; Meta-analysis; Prevalence; Zoonotic