Prevalence and Diversity of Parasitic Infections Among Kindergarten Children: A Cross-Sectional Study

Introduction: Intestinal parasitic infections (IPIs) disproportionately affect children in low-resource settings, where poor sanitation and contaminated environments increase transmission risks. Kindergarten-aged children are particularly vulnerable, with IPIs contributing to malnutrition and developmental impairments. While school-aged populations have been well-studied, data on kindergarten children especially urban-rural disparities remain limited. This study assessed IPI prevalence, species distribution, and risk factors in this vulnerable group to inform targeted interventions like deworming and sanitation programs. Methodology: This cross-sectional study assessed the prevalence and risk factors of intestinal parasitic infections (IPIs) among ۱۰,۲۳۷ kindergarten children (aged ۳-۶ years) in urban (n = ۶,۰۰۵) and rural (n = ۴,۲۳۲) settings. Stool samples were analyzed using direct wet mount microscopy (saline/iodine) and the Kato-Katz technique (WHO egg-count thresholds for Ascaris, Trichuris, hookworms). Quality control included re-examination of ۱۰% of slides by an expert parasitologist and daily equipment calibration. Statistical analysis (SPSS v۲۵) employed chi-square tests and logistic regression, reporting adjusted odds ratios (AORs) with ۹۵% confidence intervals (CIs; p < ۰.۰۵). Ethical approval was obtained, with written parental consent and free treatment for infected children. Results: The overall prevalence of IPIs was ۹.۰۲۶% (۹۲۴/۱۰,۲۳۷), with rural areas exhibiting significantly higher rates (۱۱.۲۷%, ۴۷۶/۴,۲۳۲) than urban areas (۷.۴۶%, ۴۴۸/۶,۰۰۵; p < ۰.۰۵). Blastocystis spp. (۳۸۳ cases; ۴۱.۵%), Hymenolepis nana (۲۴۳; ۲۶.۳%), and Enterobius vermicularis (۱۶۴; ۱۷.۷%) were the most prevalent species, respectively. Notably, ۸.۰% of infected children (۷۴ cases) had multi-infections. The diversity of parasites was higher in rural settings, reflecting potential differences in sanitation and access to healthcare. Conclusion: This study highlights the substantial burden of IPIs in kindergarten populations, particularly in rural regions, driven by socioeconomic and hygiene-related factors. Targeted interventions, deworming programs, health education, and improved sanitation are urgently needed to reduce morbidity. Ethics Approval: IR.MAZUMS.REC.۱۴۰۳.۲۴۲۷۱