Impact of COVID-19 restrictions on incidence of gastrointestinal protozoal infections in Mexico and their association with environmental and socioeconomic risk factors.

Abstract

Gastrointestinal infections caused by protozoan parasites remain a significant public health concern worldwide, particularly during the health crisis caused by the COVID-19 pandemic, which led to severe economic and social crisis that highlighted the inadequacy of healthcare services in many countries. In this study, we analyzed changes in the incidence of cases of amebiasis, giardiasis, and other gastrointestinal protozoal infections before (2017-2019) and during (2020-2022) the pandemic. Our findings indicate a decrease in the incidence of these infections, with no significant variations in incidence by gender or age, and a higher incidence during months with elevated temperature and humidity. Sociodemographic factors, including residence in homes with earthen floors, poverty, limited access to healthcare services, inadequate nutrition, unemployment, and overcrowded living conditions, were associated with an increased risk of infection. Additionally, our results highlight the impact of public health policies on disease control, demonstrating that COVID-19 containment measures - such as international travel restrictions, workplace closures, event cancellations, stay-at-home mandates, and enhanced hand hygiene - also contributed to reducing parasitic infections. The persistent prevalence of protozoal infections in both periods underscores the urgent need to improve sanitation, personal hygiene, and public health education, particularly in developing countries, to mitigate their high burden.