Spatial distribution of Giardia lamblia infection among general population in Mazandaran Province, north of Iran.

Giardia lamblia is the most prevalent intestinal parasites of humans in Iran and other in the world although information on geographical distribution of giardiasis plays significant role in identifying communities at high risk, little attention has been paid to study human giardiasis using geographical information system. Therefore, the aim of the current study was to determine temporal and spatial patterns of human giardiasis distribution to identify possible high risk areas and seasons in northern Iran. A total of 4788 people referred to health centers in the Mazandaran Province of northern Iran were surveyed January to December 2015. From each person stool sample and questionnaire with socio-demographic data were collected. Giardia infection was diagnosed using direct wet mount, formalin ether concentration and trichrome staining. The results were analyzed using Moran Local Indicators of spatial association and geographically weighted regression. The overall prevalence of Giardia infection was 4.6% (222/4788), and was significantly higher among those aged 5-9 years compared to their older peers (P < 0.0001). Our data showed a significant dependency between the prevalence of G. lamblia and age, job, residence, season and height from the sea (P < 0.0001). The results of this study provided a precise and specific spatial and temporal pattern of human giardiasis distribution in the Mazandaran Province, Iran. These evidences should be considered for proper control of disease decisions and strategies.