Prevalence and associated factors of intestinal parasitic infections in the school children of Sarlahi, Nepal

A large proportion of the global population is affected by intestinal parasitic infections (IPIs) caused by protozoa and helminths. These infections lead to intestinal inflammation, malabsorption, and nutritional deficiencies, ultimately impairing growth and child health. This study aims to fill the knowledge gap regarding the link between nutritional status and IPIs in children over the age of five. It investigates this relationship among schoolchildren aged 6 to 17 years attending public and private schools in the Sarlahi district of Nepal. Data collection included child and adolescent interviews, anthropometric measurements, and stool sample analysis. The microscopic examination was performed using direct wet mount and concentration techniques. The overall parasitic prevalence was 30.8% (74/239), among which more females (35.3%) were infected than male children (25.2%), though this difference did not reach statistical significance (p = 0.06). The prevalence of parasites was found more in public school (35.8%) than private school (24.5%). Ascaris lumbricoides was the most prevalent with a prevalence of 25.0% followed by Giardia lamblia (5%), Entamoeba histolytica and E. coli (i.e., 1.7 to 1.3%, respectively). Helminth parasites were more frequent (i.e., 25.4%) than protozoan (i.e., 8.3%) parasites. Students from public schools had a significantly higher prevalence of G. lamblia infection and co-infections compared to those from private schools (p < 0.05). Barefooted Participants had significantly higher unadjusted odds of infection (cOR = 9.37; 95% CI: 1.03–85.35). Likewise, Janajati and Dalit participants showed increased odds of any IPIs (cOR = 2.10; 95% CI: 1.01–4.34) compared to their reference groups. There was no significant association between IPIs and nutritional status. Despite ongoing mass deworming programs, the relatively high prevalence of IPIs among school-aged children remains concerning. Poor personal hygiene, inadequate sanitation, cohabitation with livestock, and the use of unboiled drinking water may contribute to persistent infections, particularly among females and children from Janajati and Dalit communities with lower socioeconomic status. Targeted school-based health education and hygiene promotion programs are warranted to reduce the infection burden and sustain control efforts.