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Volume 31, Number 6—June 2025
Dispatch
Prevalence of Nitroimidazole-Refractory Giardiasis Acquired in Different World Regions, Sweden, 2008–2020
, Joanna Nederby Öhd, Urban Hellgren, and Hilmir Asgeirsson
Table
Prevalence of giardiasis by country of acquisition and rate of nitroimidazole-refractory cases, Stockholm, Sweden, 2008–2020
| Origin of infection* | Total no. cases | No. (%) nitroimidazole-refractory cases |
|---|---|---|
| Asia | 1,337 | 73 (5.5) |
| India | 545 | 64 (11.7)† |
| Thailand | 168 | 4 (2.4) |
| Pakistan | 94 | 1 (1.1) |
| Iraq | 71 | 0 |
| Turkey | 65 | 0 |
| Afghanistan | 58 | 0 |
| Syria | 45 | 0 |
| China | 36 | 0 |
| Sri Lanka | 33 | 0 |
| Cambodia | 25 | 0 |
| Indonesia | 25 | 0 |
| Bangladesh | 23 | 2 (8.7) |
| Nepal |
7 |
2 (28.6) |
| Africa | 1,115 | 17‡ (1.5) |
| Tanzania | 136 | 3 (2.2) |
| Somalia | 133 | 1 (0.8) |
| Ethiopia | 105 | 1 (0.9) |
| Kenya | 94 | 0 |
| Eritrea | 93 | 0 |
| Uganda | 65 | 2 (3.1) |
| Egypt | 57 | 0 |
| Gambia | 45 | 0 |
| Sudan | 37 | 0 |
| South Africa | 26 | 1 (3.8) |
| Morocco |
23 |
0 |
| Americas | 349 | 1 (0.3) |
| Colombia | 67 | 1 (1.5) |
| Brazil | 55 | 0 |
| Peru | 36 | 0 |
| Mexico | 28 | 0 |
| United States |
23 |
0 |
| Europe | 1,247 | 11§ (0.9) |
| Sweden | 881 | 5 (0.6) |
| Spain | 107 | 2 (1.9) |
| Greece | 36 | 0 |
| France |
29 |
1 (3.4) |
| Oceania |
5 |
0 |
| Unknown |
232 |
0 |
| Total | 4,285 | 102 (2.4) |
*Countries with >20 giardiasis cases in total are shown, as well as countries with >2 treatment refractory cases. †p<0.0001 for India compared with rest of Asia and for India compared with the rest of the world (by χ2 test). ‡In addition, the following countries had 1 case: Angola, Benin, Central African Republic, Democratic Republic of the Congo, Ghana, Madagascar, Sudan, Tchad, and Zimbabwe. §In addition, the following countries had 1 case: Belgium, Italy, and Switzerland.