Parasitological profile and nutritional status of hospitalized children under five years of age in Koudougou, Burkina Faso

Parasitological profile and nutritional status of hospitalized children under five years of age in Koudougou, Burkina Faso | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Parasitological profile and nutritional status of hospitalized children under five years of age in Koudougou, Burkina Faso Jean Axel T. KABORE, Patindoilba Marcel SAWADOGO, P. Jean Yves ZONGO, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7889683/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background Intestinal parasitic infections remain a significant public health concern, particularly in developing countries. This study aimed to assess the impact of intestinal parasitosis on the nutritional status of children under five years of age admitted to the pediatric department of the Koudougou Regional Hospital in Burkina Faso. Methods We conducted a descriptive cross-sectional study between March and September 2023. Each child underwent direct stool examination and concentration techniques using both the Ritchie and Willis methods. Nutritional status and hematological parameters were also evaluated. Result A total of 384 children aged 1 to 58 months participated, with a mean age of 15 months and a male predominance (62.2%). Among them, 67 children tested positive for intestinal parasites, yielding an overall prevalence of 17.4% [13.6–21.2]. The identified species included Giardia intestinalis (28.4%), Entamoeba histolytica (20.9%), Trichomonas intestinalis (19.4%), Entamoeba coli (14.9%), Ancylostoma sp. (10.4%), and Taenia solium (6.0%). Regarding nutritional status, 76.04% [71.7–80.4] of the children were malnourished. No statistically significant association was found between intestinal parasitosis and malnutrition (p > 0.05). The prevalence of anemia was 81.5%, and a strong association was observed between intestinal parasitosis and anemia (p < 0.001). Malaria prevalence was 6.0%, and a statistically significant association was also noted between malaria and intestinal parasitic infections (p < 0.001). Conclusion These findings highlight the importance of improving hygiene practices and strengthening routine deworming strategies to enhance child health outcomes and reduce the burden of intestinal parasitic diseases. intestinal parasitosis nutritional status Koudougou children under five 1. Introduction Intestinal parasitic infections (IPIs) remain a significant public health issue in developing countries, comparable in impact to nutritional disorders. According to the World Health Organization (WHO), these infections are responsible for an estimated 450 million cases of morbidity and approximately 155,000 deaths annually, despite considerable advances in medical science and technology [1]. Although often benign in healthy children, IPIs can lead to a range of complications [2]. They also have serious socioeconomic consequences, including anemia, malnutrition, asthenia, and school absenteeism [3]. In Burkina Faso, the 2021 Statistical Yearbook of the Ministry of Health and Public Hygiene reported 878,830 cases of intestinal parasitic infections, accounting for 2.7% of all outpatient consultations in health facilities. The number of deaths attributed to these infections was estimated at 3,194 [4]. Among children under five years of age, 280,097 cases were recorded, with six deaths out of 987 hospitalized cases [4]. IPIs are strongly associated with age, sex, and nutritional status, particularly in children under five, whose immature immune systems make them especially vulnerable to contaminated environments. While gender-related differences vary by context, several studies indicate a slightly higher prevalence in boys, possibly linked to more frequent engagement in risky behaviors. Moreover, IPIs contribute to nutrient malabsorption, leading to deficiencies, stunted growth, and wasting—conditions that are especially prevalent in settings of nutritional insecurity. In turn, undernutrition weakens the immune system, increasing susceptibility to infections and creating a vicious cycle, as described in the study by Stephenson et al. [5]. In settings with poor hygiene and sanitation—common in low-resource areas—the majority of pediatric cases originate. At the regional hospital of Koudougou, children under five admitted to the pediatric department frequently present with diarrheal illnesses, which may have a parasitic origin and potentially impact their nutritional status. Given the scarcity of studies on the prevalence of intestinal parasitic infections among children under five admitted to the pediatric ward of Koudougou’s regional hospital, and considering the possible impact of these infections on nutritional status, the present study was undertaken to investigate this under-explored issue within this population. 2. Materials and Methods 2.1. Study Area and Population Between March and September 2023, a cross-sectional study was conducted at the Koudougou Regional Hospital, a second-level referral hospital in Burkina Faso's health pyramid. It serves as a referral center for five health districts in the Center-West region, covering a population estimated at 1.55 million. In 2021, the hospital recorded an average of 48,133 visits, including 3,945 children under five. The hospital comprises several clinical departments: general medicine, general surgery, gynecology-obstetrics, and pediatrics, each with emergency and inpatient units [6]. The study sample included children under five years of age presenting with digestive disorders at the pediatric department. 2.2. Sample Size The required sample size was calculated using a standard formula [7]: Due to the absence of recent prevalence data for intestinal parasitic infections in the Center-West region, an estimated prevalence of 50% was used [8]. presentative sample size calculated using the above formula, with an estimated overall prevalence of intestinal parasitic infections of 50%, a confidence interval of 95% (1.96), a standard deviation of 0.5 and a margin of error of 5% (0.05), is 384 children under 5. 2.3. Socio-Demographic, Anthropometric, and Parasitological Data Collection To better characterize the study population and identify potential risk factors for intestinal parasitic infections, data were collected on socio-demographic characteristics, anthropometric measurements, and parasitological status. Socio-demographic information was obtained through interviews conducted with the mothers or accompanying persons after the child's admission and initial medical care. Also, several clinical signs were collected on admission to the pediatric emergency department for better management. All symptoms specific and non-specific to intestinal parasitic infections were collected in the file after admission. This reflected a systematic prescription of the blood count, thick gout and parasitic coprology. Symptoms such as respiratory distress, dyspnea, anorexia and cachexia, fever, cough, constipation and vomiting were collected and reflected a reference reason for paediatric emergencies. These clinical manifestations showed the general state of vulnerability of children referred for better care, often linked to the combination of malnutrition, anaemia and parasitic infections. Informed consent was obtained prior to the collection of additional information from medical records. · Stool Sample Collection for Parasitological Analysis Stool collection was a critical step in diagnosing intestinal parasitosis and was conducted with strict adherence to hygiene protocols to ensure sample quality. Samples were collected using sterile, wide-mouthed containers, avoiding contamination by urine or other substances. Approximately 5 to 10 grams of stool, preferably from areas containing mucus or blood, were collected. Proper labeling and handling procedures were followed, and the samples were sent promptly to the laboratory for analysis. · Anthropometric Measurements -Anthropometric parameters were as follows -Weight was measured using a bathroom scale. -Height was measured using a stadiometer. - The weight-for-height ratio was calculated using WHO reference tables to determine the nutritional status of children under five. · Nutritional status was assessed according to WHO criteria: - Moderate Acute Malnutrition (MAM) : weight-for-height between -3 and -2 Z-scores or < -3 Z-scores, and/or the presence of bilateral edema [9]. - Chronic Malnutrition (CM) : height-for-age index between -3 and -2 Z-scores or < -3 Z-scores. · Additional Medical Tests -Hemoglobin levels: Anemia was defined as a hemoglobin concentration below 12.0 g/dl [10], determined through routine blood counts. - Malaria diagnosis: A thick blood smear was used to detect Plasmodium trophozoites [11]. · Intestinal parasite detection. Each stool sample underwent: - Macroscopic examination: The first step is the macroscopic examination. It allows you to observe the consistency of the stool, the color, the presence of mucus, blood or parasites visible to the naked eye, such as adult worms or Taenia's proglottids. This step also makes it possible to orient microscopic investigations according to the appearance of the stool [12]. - Direct microscopic examination: Direct microscopic examination is usually carried out in two preparations: the first corresponds to physiological saline solution (NaCl 0.9%) to highlight motile trophozoites and eggs, and second to dilute Lugol’s solution to observe protozoan cysts with their internal structures. This type of examination is particularly indicated for fresh stools, especially liquid stools, where the mobile forms of the parasites may still be active [13]. - Enrichment using the simplified Ritchie method (Hawgood and Ridley): Concentration techniques, in particular the Ritchie method, improve detection sensitivity, especially in cases of mild parasitism. It is a centrifugal sedimentation technique using formalin and ether. It concentrates eggs and cysts at the bottom of the tube, making it easier to identify them under a microscope [14,15,16,12,17]. -The Willis method: The Willis technique is based on the flotation principle. The stool is mixed with a saturated solution of sodium chloride (NaCl). Parasite eggs with a lower density than the solution rise to the surface and can be collected under a coverslip for observation. However, this method is less effective for dense eggs such as those of Ascaris lumbricoides or Trichuris trichiura [14,15,16,17,18]. All samples were analyzed at least twice by trained coprologists and results validated by a biologist. 2.4. Statistical analysis Data entry was performed using SPSS version 12. Statistical analyses were carried out using SPSS version 12 and WHO Anthro. Excel was used to generate figures. Categorical variables were expressed as percentages. Continuous variables were tested for normal distribution using Shapiro-wilk test. If following the Gaussian distribution, data were presented as mean ± standard deviation. The continuous variable ‘age’ was transformed into categorical variables in order to facilitate the interpretation of the results specifically for logistic regression analyses. This categorical variable was defined according to the age distribution of the population as a whole, and the relevant thresholds of child development. This is to reflect the main stages of feeding growth. Also, the ‘nutritional status’ from continuous Z-scores (weight/height, height/age, weight/age) was transformed into a categorical according to the WHO criteria in normal, acute malnutrition, chronic malnutrition, overweight/obesity. Parametric tests were applied. Two types of analyses were conducted: -Descriptive analysis: Frequencies, percentages, and means were calculated. -Comparative analysis: Univariate logistic regression was used to evaluate associations between intestinal parasitic infections and independent variables (origin, age, sex, anemia, malaria, and nutritional status). A multivariate logistic regression was then performed to identify independent risk factors while adjusting for potential confounders. 3. Results Study participant characteristics A total of 384 children with symptoms such as respiratory distress, dyspnea, anorexia and cachexia, fever, cough, constipation and vomiting came for better care at the emergency medical services and participated in the study. Among infected children, 33.6% exhibited non-specific symptoms such as respiratory distress, dyspnea, anorexia, and cachexia. Other reported symptoms included constipation (16.6%), fever (16.6%), cough (16.6%), and vomiting (16.6%). Of these, 62.2% (n = 239) were boys and 37.8% (n = 145) were girls, with a sex ratio of 1.65 in favor of boys (Table 2 ). The prevalence of infection among boys was 19.2% (46/239) compared to 14.5% (21/145) among girls. Male sex was associated with an Odds Ratio (OR) of 1.41 (95% CI: 0.81–2.44), p > 0.05. Analysis of the association between sex and intestinal parasitic infection did not reveal a statistically significant difference. (Table 3 ). Table 2 Socio-demographic distribution of children under five years of age admitted to the pediatric department Characteristics of children. Number of children examined. Percentage of children examined (%) CI 95% Age (months). 0–5. 95 24.7 20.6–29.2 6–11. 81 21.1 17.2–25.5 12–17. 85 22.1 18.2–26.5 18–23. 46 12.0 9.0-15.7 24 and above. 77 20.1 16.3–24.4 Gender. Male. 239 62.2 56.7–66.1 Female. 145 37.8 33.2–42.5 Place of origin. Urban area. 148 38.5 33.9–43.2 Rural area. 236 61.5 56.8–66.1 Table 3 Socio-demographic distribution of children under five years of age admitted to the pediatric department: Frequencies and Odds Ratio Analysis Characteristics of children. Number of cases of parasitic infections Percentage of cases of parasitic infections (%) Odds- CI 95% OR-CI 95% OR CI 95% Global p-value. Positive. Negative Positive Negative Age (months). 3.5 [0,63-15.05] p > 0.05 1–5. 6 89 6.3 93.7 0.067 [0.03 ; 0.16] Ref. 6–11. 9 72 11.1 88.9 O.125 [0.06 ; 0.27] 1.86 [0.65 ; 5.36] 12–17. 23 62 27.1 72.9 0.371 [0.23 ; 0.60] 5.51 [2.04 ; 14.87] 18–23. 12 34 26.1 73.9 0.353 [0.18 ; 0.71] 5.21 [1.76 ; 15.43] 24 and above. 17 60 22.1 77.9 0.283 [0.16 ; 0.51] 4.20 [1.53 ; 11.53] Gender. 1.41 [0,8-2.48] p > 0.05 Male. 46 193 19.2 80.8 0.238 [0.11 ; 0.27] 1.41 [0.80 ; 2.48] Female. 21 124 14.5 85.5 0.169 [0.17 ; 0.34] Ref. Place of origin. 0.58 [0,32-1.03] p > 0.05 Urban area. 19 129 12.8 87.2 0.147 [0.11 ; 0.27] Ref. Rural area. 48 188 20.3 79.7 0.255 [0.17 ; 0.34] 1.73 [0.99 ; 3.05] The children's ages ranged from 1 to 58 months, with a mean age of 15 months (95% CI: 13.58–16.42). 3.1. Overall Parasitism Of the 384 stool samples analyzed, 67 tested positive for at least one parasite, giving an overall prevalence of 17.4% (95% CI: 13.7–21.2). The most affected age group was 12–17 months, representing 34.3% of all infected children. All infected children originated from rural areas outside the town of Koudougou. The 1–5 months range was chosen as the reference model. Logistic regression analysis showed a significantly higher risk of infection in this group (OR = 5.14; 95% CI: 1.77–14.9; p = 0.002). Similarly, children aged 18–24 months (OR = 4.91; 95% CI: 1.50–16.00; p = 0.008) and those older than 24 months (OR = 3.94; 95% CI: 1.27–12.20; p = 0.017) also had significantly increased risks. The association observed in children aged 6–11 months (OR = 1.62; 95% CI: 0.55–4.80) was not statistically significant (p > 0.05). Although children from rural areas had a higher prevalence of infection, the association was not statistically significant (OR = 0.58; 95% CI: 0.32–1.03; p > 0.05) (Table 3 ). 3.2. Parasitism in Relation to Nutritional Status, Malaria, and Anemia All parasitized children presented monoparasitism, with protozoa accounting for most cases (94%of all the 67). Six intestinal parasite species were identified: Entamoeba coli (14.9%), Trichomonas intestinalis (19.4%), Ancylostoma sp . (10.4%), Giardia intestinalis (28.4%), Entamoeba histolytica (20.9%), and Taenia solium (6.0%) (Table 1 ). Table 1 Prevalence of intestinal parasite species diagnosed in 384 stool samples. Intestinal parasite species Number of parasites identified. Percentage of parasites identified (%) Entamoeba coli 10 14.9 Trichomonas intestinalis 13 19.4 Ancylostoma sp. 7 10.4 Giardia intestinalis 19 28.4 Entamoeba histolytica 14 20.9 Taenia solium 4 6.0 Among the 384 children, 76.0% were malnourished: 63.8% with acute malnutrition (95% CI: 58.9–68.5), 10.15% with chronic malnutrition (95% CI : 7.1–13.2), and 2.1% overweight (95% CI : 0.6–3.5) (Table 4 ). Malaria was confirmed in 6.0% of cases (95% CI: 3.6–8.4), while 81.5% of children were anemic (95% CI : 77.3–85.1). Table 4 Distribution of parasitized children under five years of age admitted to the pediatric department according to nutritional status Malnutrition. Number of children examined. Percentage of children examined (%) CI 95% Normal status. 92 24.0 [19.7–28.3] Acute malnutrition. 245 63.8 [58.9–68.5] Chronic malnutrition. 39 10.2 [7.1–13.2] Overweight/Obesity. 8 2.0 [0.6–3.5] Among the 67 parasitized children, 5.4% were anemic based on hemoglobin analysis. The odds ratio analysis indicated that acutely malnourished children had a slightly lower likelihood of intestinal parasitic infection compared to well-nourished children (OR = 0.87; 95% CI: 0.46–1.65), but the difference was not statistically significant (Table 5 ). Table 5 Distribution of parasitized children under five years of age admitted to the pediatric department according to nutritional status: Frequencies and Odds Ratio Analysis Malnutrition. Number of cases of parasitic infections. Percentage of cases of parasitic infections (%) Odds- CI 95% OR-CI 95% OR CI 95% Global p-value Positive. Negative. 0.87 [0,5-1.7] p > 0.05 Normal status. 16 76 17.4 82.6 0.211 [0.12 ; 0.38] Ref. Acute malnutrition. 38 207 15.5 84.5 0.184 [0.13 ; 0.26] 0.87 [0.44 ; 1.73] Chronic malnutrition. 13 26 33.3 66.7 0.5 [0.27 ; 0.92] 2.37 [1.05 ; 5.32] Overweight/Obesity. 0 8 0 100 NC NC However, statistical analysis showed that anemic children had a significantly lower probability of parasitic infection compared to non-anemic children (OR = 0.02; 95% CI: 0.01–0.05; p < 0.001) (Table 6 ). Table 6 Distribution of anemia and malaria cases according to intestinal parasitic infections of children under five years of age admitted to the pediatric department Characteristics of children. Number of children examined. Percentage of children examined CI 95% Anaemia Yes. 313 81.5 [77.3–85.1] None 71 18.5 [14.9–22.7] Malaria Positive 23 6.0 [3.6–8.4] Negative 361 94.0 [95% : 91.6–96.4] Of the 23 parasitized children who tested positive for malaria, 56.5% had intestinal parasitic infections. The odds ratio analysis indicated a significantly higher likelihood of intestinal parasitic infection among children with malaria compared to non-malarial children (OR = 7.39; 95% CI: 3.08–17.72; p < 0.001) (Table 7 ). Table 7 Distribution of anemia and malaria cases according to intestinal parasitic infections of children under five years of age admitted to the pediatric department: Frequencies and Odds Ratio Analysis Characteristics of children. Number of cases of parasitic infections. Percentage of cases of parasitic infections (%) Odds- CI 95% OR-CI 95% OR CI 95% Global p-value Positive. Negative. Positive. Negative. Anemia 0.024 [0.01–0.05] P < 0.001 Yes. 17 296 5.4 94.6 0.057 [0.035–0.094] 0.024 [0.012–0.049] None 50 21 70.4 29.6 2.38 [1.430–3.964] Ref. Malaria 7.39 [3.1–17.7] P < 0.001 Positive 13 10 56.5 43.5 1.30 [0.570–2.965] 7.39 [3.085–17.706] Negative 54 307 15.0 85.0 0.176 [0.132–0.235] Ref. 4. Discussion This study investigated the prevalence of malnutrition in its various forms and intestinal parasites among children under five years of age admitted to the pediatric department of the Regional Hospital Center of Koudougou. The intestinal parasites identified were Entamoeba coli , Trichomonas intestinalis , Ancylostoma sp., Giardia intestinalis, Entamoeba histolytica , and Taenia solium. Overall, parasitic infections affected a significant portion of the study population, irrespective of age, gender, or origin. While the prevalence of parasitic infections was observed to be higher in male children than in female children, this difference was not statistically significant (p > 0.05). This finding aligns with Endale et al. (2025) [19], who similarly concluded that parasitism was not sex-related, suggesting that both genders are exposed to similar environmental hygiene conditions and thus face comparable risks of infestation. Our results are also contradicts those of Zemene et al. (2018) [20], whose study reported a similar infection rate in female (52.2%) and male (47.8%) subjects. The overall prevalence of intestinal parasites found in this study is lower compared to previous studies conducted in Burkina Faso, such as Ouemi (2012) [22] (60.82%), Ouattara (2019) [21] (50%), and ProGRES Consortium. (2015) [23] (22.9%), Endale (2025) [19] (19.45%), as well as a study in Algeria by Benouis et al. (2013) [25] (19.96%). These variations in prevalence may be attributed to differences in study area and time. Intestinal parasite prevalence is typically higher in rural areas than in urban ones; our study predominantly included samples from rural backgrounds, which should theoretically lean towards higher prevalence. However, the relatively low prevalence observed in our study could be explained by the impact of national de-worming campaigns targeting children under five. Although our results are higher than those reported by the Ministry of Health in 2022 for the Center-west region (6%) during a parasitological survey, they are still lower than Benouis et al.'s findings (2013) in Algeria (19.96%) [25]. The lower prevalence in our study may also stem from the comprehensive package of interventions for de-worming children aged 6–59 months across the country, and the fact that all children admitted to the pediatric department of the Regional Hospital are referrals for advanced care. In this study, protozoa (94%) were identified more frequently than helminths. This difference might be related to the faster and simpler biological cycles of protozoa compared to the often slower and more complex cycles of helminths, whose intermediate forms may face challenging environmental conditions (e.g., hot and dry climates) for their maturation. The high prevalence of intestinal protozoa points to significant fecal contamination of drinking water and food, coupled with inadequate hygiene practices within the population [26]. Our findings indicate that the 12 to 18-month age group was the most affected. This contrasts with Gebretsadik et al. (2015) [24], who found the most affected age group to be between 36 and 59 months (28.57%). The higher susceptibility in younger children in our study could be attributed to their developmental stage, where increased dietary diversity and more frequent contact with the ground, especially as they begin to walk, elevate their risk of parasitic intestinal infestation. Furthermore, the study revealed a predominance of infected children originating from rural areas outside Koudougou city, suggesting a link between geographical origin and parasite transmission. This is likely due to the continued prevalence of insufficient hygiene awareness and practices in these rural localities. Regarding clinical presentation, the majority of children with parasitic infections exhibited non-specific signs such as respiratory distress, dyspnea, anorexia, and cachexia. These findings are consistent with those reported in other studies conducted by Amoah et al. (2021) in Ghana found that many parasitized children were asymptomatic or had symptoms such as weight loss or asthenia, while the absence of digestive signs (diarrhea, abdominal pain) was often found in chronic carriers [27]. Also, a study in Tanzania conducted by Mrimi et al. (2022) found that Giardia intestinalis and Entamoeba histolytica infections were generally associated with non-specific or absent symptoms. The authors pointed out that the parasite load and nutritional status of the host strongly influenced clinical signs, often masking ordinary signs of infection [28]. This may be because specific acute symptoms like fever, diarrhea, vomiting, and cough are often managed at the initial health facility before referral for more comprehensive treatment. Nutritional indicators, including underweight, obesity, and overweight, were used to assess malnutrition in this study. We found a high overall prevalence of acute malnutrition (63.80%). This figure is considerably higher than the 17.5% underweight rate among children aged 0–5 years reported in a 2021 nutrition survey by the Ministry of Health of Burkina Faso. Similarly, Endale et al . (2025) [19] found a 28.1% underweight rate in Assela Referral Hospital, and Beasley et al . (2002) [30] reported 18.7% underweight prevalence in Chad. Our study also identified subjects with normal status (24.0%), a finding consistent with Endale et al . (2025) [19], who reported only 29.1% of the subjects in our study had a normal nutritional status. The elevated prevalence of acute malnutrition observed could be attributed to the late referral of patients to the regional hospital center, allowing for the progression of acute malnutrition. Univariate logistic regression analysis demonstrated an association between nutritional status and intestinal parasitic infections in our study. While the analysis revealed moderate variation across nutritional categories, the differences were not statistically significant in the univariate analysis (non-significant odds ratios and p > 0.05). Despite the lack of statistical significance, this finding holds epidemiological consistency. For instance, intestinal parasitic infections (by protozoa like Giardia intestinalis or helminths) can lead to intestinal absorption disorders or malabsorption of essential nutrients, along with an increase in energy requirements, thereby contributing to malnutrition [31]. Chatterjee et al . (2014) [32] also showed that impaired staturo-weight growth contributes to the chronic presence of intestinal parasites, particularly in children living in resource-limited countries. Furthermore, an inadequate diet weakens the immune system, especially mucosal immunity, increasing the risk of recurrent or severe infections in children. The absence of obese children with intestinal parasitic infections in our cohort might be due to the small sample size in this category, potentially limiting statistical power. Alternatively, it could reflect different socioeconomic conditions, such as better access to safer food and improved hygiene practices among this group. In the present study, the majority of malnourished subjects (76.11%) were also parasitized. However, this association was not statistically significant (p > 0.05), suggesting that intestinal parasites affect a broad spectrum of the population regardless of their nutritional status. Endale et al . (2025) [19] similarly found a higher prevalence of underweight and parasitized subjects compared to those with normal nutritional status and parasitic infections (70.9%) among patients visiting Assela Referral Hospital. Intestinal parasites can reduce nutrient absorption, cause appetite loss, and consequently lead to undernourished in affected individuals [33, 34, 35, 36]. Finally, the prevalence of children testing positive for malaria (6.0%) via thick blood smear was lower than that reported by Djanou et al . (2004) [37], which was 52%. This difference may arise from patients often receiving antimalarial drugs at their initial contact with a health facility before being referred to the regional hospital for more comprehensive management. In the overall study population, one-third of children with intestinal parasitosis also had a positive blood smear, and this association was statistically significant (p < 0.001). Therefore, parasitism is related to the presence of anemia. However, the results from our multivariate analyses showed an unexpected inverse association between intestinal parasitic infections (IPIs) and anemia. This observation is notable, as IPIs are generally understood to actively contribute to the development of anemia through mechanisms like chronic blood loss, malabsorption, and iron deficiency [38, 39]. Indeed, the WHO classifies helminthic infections as a major cause of anemia in tropical regions [40]. Several hypotheses could explain our inverse findings: Indication or Access to Care Bias, Chronology of Pathologies and Unmeasured Characteristics Despite our findings, it's widely reported that a robust positive association exists between anemia and IPIs, especially in children residing in impoverished rural areas [38, 5]. Our study, therefore, suggests that the relationship between anemia and IPIs may be modulated by specific contextual factors, including the broader health environment, nutritional status, and access to healthcare services in Koudougou, Burkina Faso. 5. Study Limitation The hospital-based design (selection bias toward severe or referred cases), the limited sample size in certain nutritional categories, and the diagnostic approach used (direct microscopy may underestimate some intestinal parasitic infections) were the limitations of our study. 6. Conclusion This study found that the prevalence of intestinal parasitosis among children aged 0–5 years was 17.4%, while malnutrition stood at 76.0%. Giardia intestinalis was identified as the most common parasite, present in 28.4% of cases. Our findings did not reveal a statistically significant link between these intestinal parasites and malnutrition. However, the study did establish a significant association between intestinal parasitosis and age, anemia, and malaria. Declarations Ethics approval: Applicable With the authorization of the primary person in charge of the structure in agreement with the ethical health and scientific committee of the hospital structure. Consent for publication : Applicable Availability of data and material : Study data are available from the corresponding authors upon reasonable request by investigators. Competing interests : The authors declare no conflicts of interest Funding : Not applicable Authors' contributions: Jean Axel T. KABORE, Roselyne OUATTARA, and Siaka KOBEANE conceptualized and designed the study, and participated in data collection, analysis, and interpretation. Jean Axel T. KABORE was responsible for writing the manuscript. Jean Axel T. KABORE, Marcel P. SAWADOGO, Awa GNEME, Moustapha NIKIEMA, Roselyne OUATTARA, Siaka KOBEANE, and Adama ZIDA provided critical revisions to the article. The final manuscript was approved by Awa GNEME. All authors have read and approved the final version of the manuscript. Consent to participate declaration Informed consent was obtained from the mothers of the participating children. The consent process was conducted in a clear, understandable, and culturally appropriate manner, respecting the rights and dignity of both participants and their guardians. Ethical consideration This study was conducted in accordance of Helsinki. The research protocol was reviewed and approved by ethics committee of Koudougou Regional Hospital (Approval No. [2023-800373/MSHP/SG/CHR-KDG/DRH/SRF]. Written informed consent was obtained from all participants prior to inclusion in the study. For illiterate participants, the consent from was read aloud in the presence of an impartial witness, and consent was confirmed by a fingerprint and the witness’s signature. So, informed consent was obtained from parents or legal guardians before participation. Clinical trial number Not applicable Acknowledgements We thank the administration of the Koudougou Regional Hospital for allowing us to carry out this study within one of the health services. We also thank the Joseph KI-ZERBO University and the professors of the Laboratory of Animal Biology and Ecology for their guidance. Finally, we thank the parents or guardians of children who voluntarily participated in this study. References Bourée P. Intestinal parasitosis is still common. Médecine Santé Trop. 2015;25(2):130. Pires C, Renata de CC. Prevalence and epidemiological aspects of enteroparasitosis and its relationship with nutritional status in children living in the Beira Rio neighborhood of Imperatriz, MA in 2011. Rev Cient Multidisc Núcleo Conhecimento. 2020;5(7):51–70. Bourée P. Intestinal amoebiasis. Encycl Méd Chir (Elsevier Paris). 2010;103(27):1–8. Ministry of Health, Global Fund. Statistical Yearbook 2021. April 2022. 397 Stephenson LS, Latham MC, Ottesen EA. Malnutrition and parasitic helminth infections. Parasitology. 2000;121(S1):S23–38. Ministère de la Santé, Fonds Mondial. Annuaire statistique de la santé 2021. 2022. 397 p. Zine S, Karima B, Ahmed BA, Mohamed BO, Réseau PRP2S. Comment calculer la taille d’un échantillon pour une étude observationnelle. Tunisie Méd. 2020;98(1):1–7. Lemeshow S, Hosmer DW, Klar J, Lwanga SK. Adequacy of sample size in health studies . Geneva: World Health Organization; 1990 Ministère de la Santé, OCHA. Protocole national de prise en charge intégrée de la malnutrition aiguë (PCIMA) - Burkina Faso. 2014. 154 p. Ministry of Health and Public Hygiene. Diagnosis of malnutrition. 2017. 66 Guillaume V. Parasitologie sanguine. Bruxelles: De Boeck Supérieur; 2009. Cheesbrough M. District laboratory practice in tropical countries. Part 1. 2nd ed. Cambridge: Cambridge University Press; 2005. p. 196–205. Guillaume V. Fiches de parasitologie. Bruxelles: De Boeck Supérieur; 2007. Houzé S, Delhaes L, eds. Parasitologie et mycologie médicales. Paris: Elsevier Health Sciences; 2022. Marijon A, Hodille E, Jourdy Y, Buffaz C, Louvrier C. Parasitologie et mycologie médicale pratique. Bruxelles: De Boeck Supérieur; 2020. Esch G, Fernandez J. A functional biology of parasitism: ecological and evolutionary implications. Berlin: Springer; 2013. World Health Organization. Basic laboratory methods in medical parasitology. Geneva: WHO; 1991. p. 21–30. Bogitsh BJ, Carter CE, Oeltmann TN. Human parasitology. 5th ed. London: Academic Press; 2018. p. 31–5. Endale T, Birmeka M, Bekele D. Effect of Intestinal Parasitic Infection on Nutritional Status on Under‑five Children Patients Visiting Assela Referral Hospital, East Arsi Zone, Oromia Region, Ethiopia. Acta Parasitologica. 2025;70(1):55 Zemene T, Shiferaw MB. Prevalence of intestinal parasitic infections in children under the age of 5 years attending the Debre Birhan Referral Hospital, North Shoa, Ethiopia. BMC Res Notes. 2018;11:58 Ouattara AK, Zongo A, et al. Gastrointestinal parasitic infections in children aged less than 5 years in Ouagadougou, Burkina Faso. OJ Ped. 2019;317 enfants étudiés Ouermi D, Karou DS, Ouattara I. Prevalence of intestinal parasites at Saint-Camille Medical Center in Ouagadougou (Burkina Faso), 1991–2010. Méd Santé Trop. 2012;22(1):40–4. ProGRES Consortium. Hospital‑based cross‑sectional survey for gastrointestinal parasites in children under five years in Ouagadougou, Burkina Faso. 2018–2019 Gebretsadik D et al. Prevalence of intestinal parasitic infection among children under 5 years of age at Dessie Referral Hospital. BMC Res Notes. 2018;11:771 Benouis A, Bekkouche Z, Benmansour Z. Epidemiological study of human intestinal parasitosis at the University Hospital of Oran (Algeria). Int J Innov Appl Stud. 2013;2(4):613–20. Monjour L, Noel B, Bounkoungou B. Use of drinking water with or without environmental protection in peri-urban areas: Ouagadougou, Burkina Faso. In: Water, agriculture and health in tropical environments. 1998. p. 34. Amoah SA, Darko BA, OwusuAsenso CM, AddoOsafo K, et al. Prevalence and clinical profile of intestinal parasitic infections in school-aged children in rural Ghana. J Parasitol Res. 2021;2021:6645123. doi:10.1155/2021/6645123 Mrimi EC, Palmeirim MS, Minja EG, Long KZ, Keiser J. Malnutrition, anemia, micronutrient deficiency and parasitic infections among schoolchildren in rural Tanzania. PLoS Negl Too Say. 2022; 16(3):E0010261. doi:10.1371/journal.pntd.0010261 Savadogo B, Bengaly MD, Sorgho H, Zongo D, Zeba AN, Lanou H, et al. Nutritional status and parasitosis in school-age children in Burkina Faso: case of schools in Yamtenga, Koubri, and Daguilma. Rev Sci Tech/Santé. 2014;37(1–2):12. Beasley M, Brooker S, Ndinaromtan M. First nationwide survey of the health of schoolchildren in Chad. Trop Med Int Health. 2002;7(7):625–30. Guerrant RL, Oria RB, Moore SR, et al. Malnutrition as an enteric infectious disease with long-term effects on child development. Nutr Rev. 2008;66(9):487–505. Chatterjee N, Banu N, Dey T. Correlation of nutritional status and intestinal parasitic infection in school children. Al Ameen J Med Sci. 2014;7(1):41–4. Kabatereine NB, Brooker S, Koukounari A. Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren. Bull World Health Organ. 2007;85(2):91–9. Kabatereine NB, Tukahebwa E, Kazibwe F, Namwangye H, Zaramba S. Progress towards countrywide control of schistosomiasis and soil-transmitted helminthiasis in Uganda. Trans R Soc Trop Med Hyg. 2006;100(3):208–15. Kabatereine NB, Brooker S, Koukounari A. Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren. Bull World Health Organ. 2007;85(2):91–9. World Health Organization. Working to overcome the global impact of neglected tropical diseases: first WHO report on neglected tropical diseases. Geneva: WHO; 2010. Dianou D, Poda JN, Savadogo LG. Intestinal parasitosis in the Sourou hydroagricultural complex area of Burkina Faso. VertigO. 2004;5(2):1–8. Brooker S, Hotez PJ, Bundy DAP. Hookworm-related anemia among pregnant women: a systematic review. PLoS Negl Trop Dis. 2008;2(9):e291. Hall A, Hewitt G, Tuffrey V, de Silva N. A review and meta-analysis of the impact of intestinal worms on child growth and nutrition. Matern Child Nutr. 2008;4:118–36. World Health Organization. Haemoglobin concentrations for the diagnosis of anemia and assessment of severity. Geneva: WHO; 2011. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 29 Dec, 2025 Reviews received at journal 16 Dec, 2025 Reviewers agreed at journal 16 Dec, 2025 Reviews received at journal 09 Dec, 2025 Reviewers agreed at journal 06 Dec, 2025 Reviewers agreed at journal 04 Dec, 2025 Reviewers invited by journal 04 Dec, 2025 Editor invited by journal 12 Nov, 2025 Editor assigned by journal 22 Oct, 2025 Submission checks completed at journal 22 Oct, 2025 First submitted to journal 17 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7889683","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":556473665,"identity":"757cecc9-2729-4e50-9d76-fc1415a38645","order_by":0,"name":"Jean Axel T. KABORE","email":"data:image/png;base64,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","orcid":"","institution":"Regional Hospital Center of Koudougou","correspondingAuthor":true,"prefix":"","firstName":"Jean","middleName":"Axel T.","lastName":"KABORE","suffix":""},{"id":556473666,"identity":"9b5c3a14-ff0b-4ee4-a510-3842cba6a9ff","order_by":1,"name":"Patindoilba Marcel SAWADOGO","email":"","orcid":"","institution":"Université Joseph Ki-Zerbo","correspondingAuthor":false,"prefix":"","firstName":"Patindoilba","middleName":"Marcel","lastName":"SAWADOGO","suffix":""},{"id":556473667,"identity":"174fcea0-a8f8-4972-bf75-14832a6f781f","order_by":2,"name":"P. Jean Yves ZONGO","email":"","orcid":"","institution":"Université Joseph Ki-Zerbo","correspondingAuthor":false,"prefix":"","firstName":"P.","middleName":"Jean Yves","lastName":"ZONGO","suffix":""},{"id":556473668,"identity":"9e89afc4-855c-4ef1-b9fb-4b3207ed669c","order_by":3,"name":"Awa GNEME","email":"","orcid":"","institution":"Université Joseph Ki-Zerbo","correspondingAuthor":false,"prefix":"","firstName":"Awa","middleName":"","lastName":"GNEME","suffix":""},{"id":556473669,"identity":"4c51ccdb-4997-423c-af2f-25f8c59569cd","order_by":4,"name":"Moustapha NIKIEMA","email":"","orcid":"","institution":"Centre de Recherche en Santé de Nouna","correspondingAuthor":false,"prefix":"","firstName":"Moustapha","middleName":"","lastName":"NIKIEMA","suffix":""},{"id":556473670,"identity":"d8e77efd-0315-4c65-8445-17a01edcdbc6","order_by":5,"name":"Roselyne OUATTARA","email":"","orcid":"","institution":"Regional Hospital Center of Koudougou","correspondingAuthor":false,"prefix":"","firstName":"Roselyne","middleName":"","lastName":"OUATTARA","suffix":""},{"id":556473671,"identity":"b589b815-9757-4992-9e34-54d9ff82aa81","order_by":6,"name":"Siaka KOBEANE","email":"","orcid":"","institution":"Regional Hospital Center of Koudougou","correspondingAuthor":false,"prefix":"","firstName":"Siaka","middleName":"","lastName":"KOBEANE","suffix":""},{"id":556473672,"identity":"958e8b9e-4cf8-491c-b0d5-428036a03ead","order_by":7,"name":"Adama ZIDA","email":"","orcid":"","institution":"Université Joseph Ki-Zerbo","correspondingAuthor":false,"prefix":"","firstName":"Adama","middleName":"","lastName":"ZIDA","suffix":""}],"badges":[],"createdAt":"2025-10-17 21:08:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7889683/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7889683/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":97651200,"identity":"8d8cc33a-6922-4e57-8e08-cff8f7f8ee71","added_by":"auto","created_at":"2025-12-08 06:25:01","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":54270,"visible":true,"origin":"","legend":"","description":"","filename":"parasitologyarticlereviewed2Copy.docx","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/ade08af38414c30b82111b89.docx"},{"id":97674652,"identity":"d800d120-f832-4e75-af9d-f0fffa6d873e","added_by":"auto","created_at":"2025-12-08 09:43:47","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":29523,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/adcffd0a5eab562f9cac21ef.docx"},{"id":97674287,"identity":"508b002d-db72-4751-930e-73073a9ca9d5","added_by":"auto","created_at":"2025-12-08 09:42:54","extension":"json","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":9765,"visible":true,"origin":"","legend":"","description":"","filename":"8c51c89dfa4d4fbcbc0e2c76c0254d6f.json","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/3d5e47c2b8c105081900e3ec.json"},{"id":97651201,"identity":"df5fe011-eac6-4c39-8343-3ce4f43a4e1a","added_by":"auto","created_at":"2025-12-08 06:25:01","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":23774,"visible":true,"origin":"","legend":"","description":"","filename":"Consentementfile.docx","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/4c72d6e010472bef1dccd93e.docx"},{"id":97651206,"identity":"fe8e8a7c-6a8d-4b95-b687-1223562c5b98","added_by":"auto","created_at":"2025-12-08 06:25:01","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":85499,"visible":true,"origin":"","legend":"","description":"","filename":"8c51c89dfa4d4fbcbc0e2c76c0254d6f1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/068c0b3d44c9ccec118ae3fb.xml"},{"id":97651203,"identity":"82074a91-f4dd-4993-9047-0608239f2965","added_by":"auto","created_at":"2025-12-08 06:25:01","extension":"jpeg","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":182654,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/b2f3460de7cb21501f4653aa.jpeg"},{"id":97651205,"identity":"671159c0-b4f8-4a2a-b213-7ca5e866fb82","added_by":"auto","created_at":"2025-12-08 06:25:01","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":36797,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/1e7d2b4fc60a0c9792be2ed0.png"},{"id":97651207,"identity":"1dadc2de-4cb9-4895-9fd1-898c5df9aafb","added_by":"auto","created_at":"2025-12-08 06:25:01","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":84782,"visible":true,"origin":"","legend":"","description":"","filename":"8c51c89dfa4d4fbcbc0e2c76c0254d6f1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/3788fc358c745072bf903a86.xml"},{"id":97651208,"identity":"fcde751e-7141-4d20-b676-896bc8929537","added_by":"auto","created_at":"2025-12-08 06:25:01","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":96069,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/030bb2d7f0ddbd2fccd16a09.html"},{"id":97892545,"identity":"9bb17f0e-8399-4b54-ad19-6eb22430e801","added_by":"auto","created_at":"2025-12-10 15:13:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":977184,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7889683/v1/143a10b0-389f-4b50-aaa0-333ba20b0aac.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Parasitological profile and nutritional status of hospitalized children under five years of age in Koudougou, Burkina Faso","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eIntestinal parasitic infections (IPIs) remain a significant public health issue in developing countries, comparable in impact to nutritional disorders. According to the World Health Organization (WHO), these infections are responsible for an estimated 450\u0026nbsp;million cases of morbidity and approximately 155,000 deaths annually, despite considerable advances in medical science and technology [1]. Although often benign in healthy children, IPIs can lead to a range of complications [2]. They also have serious socioeconomic consequences, including anemia, malnutrition, asthenia, and school absenteeism [3].\u003c/p\u003e\u003cp\u003eIn Burkina Faso, the 2021 Statistical Yearbook of the Ministry of Health and Public Hygiene reported 878,830 cases of intestinal parasitic infections, accounting for 2.7% of all outpatient consultations in health facilities. The number of deaths attributed to these infections was estimated at 3,194 [4]. Among children under five years of age, 280,097 cases were recorded, with six deaths out of 987 hospitalized cases [4].\u003c/p\u003e\u003cp\u003eIPIs are strongly associated with age, sex, and nutritional status, particularly in children under five, whose immature immune systems make them especially vulnerable to contaminated environments. While gender-related differences vary by context, several studies indicate a slightly higher prevalence in boys, possibly linked to more frequent engagement in risky behaviors.\u003c/p\u003e\u003cp\u003eMoreover, IPIs contribute to nutrient malabsorption, leading to deficiencies, stunted growth, and wasting\u0026mdash;conditions that are especially prevalent in settings of nutritional insecurity. In turn, undernutrition weakens the immune system, increasing susceptibility to infections and creating a vicious cycle, as described in the study by Stephenson \u003cem\u003eet al.\u003c/em\u003e [5].\u003c/p\u003e\u003cp\u003eIn settings with poor hygiene and sanitation\u0026mdash;common in low-resource areas\u0026mdash;the majority of pediatric cases originate. At the regional hospital of Koudougou, children under five admitted to the pediatric department frequently present with diarrheal illnesses, which may have a parasitic origin and potentially impact their nutritional status.\u003c/p\u003e\u003cp\u003eGiven the scarcity of studies on the prevalence of intestinal parasitic infections among children under five admitted to the pediatric ward of Koudougou\u0026rsquo;s regional hospital, and considering the possible impact of these infections on nutritional status, the present study was undertaken to investigate this under-explored issue within this population.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cp\u003e2.1. Study Area and Population\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBetween March and September 2023, a cross-sectional study was conducted at the Koudougou Regional Hospital, a second-level referral hospital in Burkina Faso\u0026apos;s health pyramid. It serves as a referral center for five health districts in the Center-West region, covering a population estimated at 1.55 million. In 2021, the hospital recorded an average of 48,133 visits, including 3,945 children under five. The hospital comprises several clinical departments: general medicine, general surgery, gynecology-obstetrics, and pediatrics, each with emergency and inpatient units [6].\u003c/p\u003e\n\u003cp\u003eThe study sample included children under five years of age presenting with digestive disorders at the pediatric department.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2. Sample Size\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe required sample size was calculated using a standard formula [7]:\u003c/p\u003e\n\u003cp\u003eDue to the absence of recent prevalence data for intestinal parasitic infections in the Center-West region, an estimated prevalence of 50% was used [8]. presentative sample size calculated using the above formula, with an estimated overall prevalence of intestinal parasitic infections of 50%, a confidence interval of 95% (1.96), a standard deviation of 0.5 and a margin of error of 5% (0.05), is 384 children under 5.\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3. Socio-Demographic, Anthropometric, and Parasitological Data Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo better characterize the study population and identify potential risk factors for intestinal parasitic infections, data were collected on socio-demographic characteristics, anthropometric measurements, and parasitological status. Socio-demographic information was obtained through interviews conducted with the mothers or accompanying persons after the child\u0026apos;s admission and initial medical care. Also, several clinical signs were collected on admission to the pediatric emergency department for better management. All symptoms specific and non-specific to intestinal parasitic infections were collected in the file after admission. This reflected a systematic prescription of the blood count, thick gout and parasitic coprology. Symptoms such as respiratory distress, dyspnea, anorexia and cachexia, fever, cough, constipation and vomiting were collected and reflected a reference reason for paediatric emergencies. These clinical manifestations showed the general state of vulnerability of children referred for better care, often linked to the combination of malnutrition, anaemia and parasitic infections.\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained prior to the collection of additional information from medical records.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Stool Sample Collection for Parasitological Analysis\u003c/p\u003e\n\u003cp\u003eStool collection was a critical step in diagnosing intestinal parasitosis and was conducted with strict adherence to hygiene protocols to ensure sample quality. Samples were collected using sterile, wide-mouthed containers, avoiding contamination by urine or other substances. Approximately 5 to 10 grams of stool, preferably from areas containing mucus or blood, were collected. Proper labeling and handling procedures were followed, and the samples were sent promptly to the laboratory for analysis.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Anthropometric Measurements\u003c/p\u003e\n\u003cp\u003e-Anthropometric parameters were as follows\u003c/p\u003e\n\u003cp\u003e-Weight was measured using a bathroom scale.\u003c/p\u003e\n\u003cp\u003e-Height was measured using a stadiometer.\u003c/p\u003e\n\u003cp\u003e- The weight-for-height ratio was calculated using WHO reference tables to determine the nutritional status of children under five.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Nutritional status was assessed according to WHO criteria:\u003c/p\u003e\n\u003cp\u003e- Moderate Acute Malnutrition (MAM) : weight-for-height between -3 and -2 Z-scores or \u0026lt; -3 Z-scores, and/or the presence of bilateral edema [9].\u003c/p\u003e\n\u003cp\u003e- Chronic Malnutrition (CM) : height-for-age index between -3 and -2 Z-scores or \u0026lt; -3 Z-scores.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026middot; Additional Medical Tests\u003c/p\u003e\n\u003cp\u003e-Hemoglobin levels: Anemia was defined as a hemoglobin concentration below 12.0 g/dl [10], determined through routine blood counts.\u003c/p\u003e\n\u003cp\u003e- Malaria diagnosis: A thick blood smear was used to detect Plasmodium trophozoites [11].\u003c/p\u003e\n\u003cp\u003e\u0026middot; Intestinal parasite detection.\u003c/p\u003e\n\u003cp\u003eEach stool sample underwent:\u003c/p\u003e\n\u003cp\u003e- Macroscopic examination: The first step is the macroscopic examination. It allows you to observe the consistency of the stool, the color, the presence of mucus, blood or parasites visible to the naked eye, such as adult worms or Taenia\u0026apos;s proglottids. This step also makes it possible to orient microscopic investigations according to the appearance of the stool [12].\u003c/p\u003e\n\u003cp\u003e- Direct microscopic examination: Direct microscopic examination is usually carried out in two preparations: the first corresponds to physiological saline solution (NaCl 0.9%) to highlight motile trophozoites and eggs, and second to dilute Lugol\u0026rsquo;s solution to observe protozoan cysts with their internal structures. This type of examination is particularly indicated for fresh stools, especially liquid stools, where the mobile forms of the parasites may still be active [13].\u003c/p\u003e\n\u003cp\u003e- Enrichment using the simplified Ritchie method (Hawgood and Ridley): Concentration techniques, in particular the Ritchie method, improve detection sensitivity, especially in cases of mild parasitism. It is a centrifugal sedimentation technique using formalin and ether. It concentrates eggs and cysts at the bottom of the tube, making it easier to identify them under a microscope [14,15,16,12,17].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e-The Willis method: The Willis technique is based on the flotation principle. The stool is mixed with a saturated solution of sodium chloride (NaCl). Parasite eggs with a lower density than the solution rise to the surface and can be collected under a coverslip for observation. However, this method is less effective for dense eggs such as those of \u003cem\u003eAscaris\u003c/em\u003e \u003cem\u003elumbricoides\u003c/em\u003e or \u003cem\u003eTrichuris\u003c/em\u003e \u003cem\u003etrichiura\u003c/em\u003e [14,15,16,17,18].\u003c/p\u003e\n\u003cp\u003eAll samples were analyzed at least twice by trained coprologists and results validated by a biologist.\u003c/p\u003e\n\u003ch2\u003e2.4. Statistical analysis\u003c/h2\u003e\n\u003cp\u003eData entry was performed using SPSS version 12. Statistical analyses were carried out using SPSS version 12 and WHO Anthro. Excel was used to generate figures. Categorical variables were expressed as percentages. Continuous variables were tested for normal distribution using Shapiro-wilk test. If following the Gaussian distribution, data were presented as mean \u0026plusmn; standard deviation. The continuous variable \u0026lsquo;age\u0026rsquo; was transformed into categorical variables in order to facilitate the interpretation of the results specifically for logistic regression analyses. This categorical variable was defined according to the age distribution of the population as a whole, and the relevant thresholds of child development. This is to reflect the main stages of feeding growth. Also, the \u0026lsquo;nutritional status\u0026rsquo; from continuous Z-scores (weight/height, height/age, weight/age) was transformed into a categorical according to the WHO criteria in normal, acute malnutrition, chronic malnutrition, overweight/obesity. Parametric tests were applied.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTwo types of analyses were conducted:\u003c/p\u003e\n\u003cp\u003e-Descriptive analysis: Frequencies, percentages, and means were calculated.\u0026nbsp;\u003cbr\u003e\u0026nbsp;-Comparative analysis:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUnivariate logistic regression was used to evaluate associations between intestinal parasitic infections and independent variables (origin, age, sex, anemia, malaria, and nutritional status). A multivariate logistic regression was then performed to identify independent risk factors while adjusting for potential confounders.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cb\u003eStudy participant characteristics\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA total of 384 children with symptoms such as respiratory distress, dyspnea, anorexia and cachexia, fever, cough, constipation and vomiting came for better care at the emergency medical services and participated in the study. Among infected children, 33.6% exhibited non-specific symptoms such as respiratory distress, dyspnea, anorexia, and cachexia. Other reported symptoms included constipation (16.6%), fever (16.6%), cough (16.6%), and vomiting (16.6%).\u003c/p\u003e\u003cp\u003eOf these, 62.2% (n\u0026thinsp;=\u0026thinsp;239) were boys and 37.8% (n\u0026thinsp;=\u0026thinsp;145) were girls, with a sex ratio of 1.65 in favor of boys (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The prevalence of infection among boys was 19.2% (46/239) compared to 14.5% (21/145) among girls. Male sex was associated with an Odds Ratio (OR) of 1.41 (95% CI: 0.81\u0026ndash;2.44), p\u0026thinsp;\u0026gt;\u0026thinsp;0.05. Analysis of the association between sex and intestinal parasitic infection did not reveal a statistically significant difference. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic distribution of children under five years of age admitted to the pediatric department\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics of children.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of children examined.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage of children examined (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCI 95%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge (months).\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u0026ndash;5.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.6\u0026ndash;29.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;11.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.2\u0026ndash;25.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u0026ndash;17.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18.2\u0026ndash;26.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;23.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.0-15.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e24 and above.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.3\u0026ndash;24.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e239\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e62.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.7\u0026ndash;66.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.2\u0026ndash;42.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePlace of origin.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrban area.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e148\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.9\u0026ndash;43.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural area.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.8\u0026ndash;66.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic distribution of children under five years of age admitted to the pediatric department: Frequencies and Odds Ratio Analysis\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCharacteristics of children.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNumber of cases of parasitic infections\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003ePercentage of cases of parasitic infections (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOdds- CI 95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOR-CI 95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOR CI 95% Global\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep-value.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePositive.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNegative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePositive\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNegative\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAge (months).\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003e3.5\u0026nbsp;[0,63-15.05]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003ep\u0026thinsp;\u0026gt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;5.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e93.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.067 [0.03 ; 0.16]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;11.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e88.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eO.125 [0.06 ; 0.27]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.86 [0.65 ; 5.36]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u0026ndash;17.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e72.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.371 [0.23 ; 0.60]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.51 [2.04 ; 14.87]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;23.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e73.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.353 [0.18 ; 0.71]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.21 [1.76 ; 15.43]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e24 and above.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e77.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.283 [0.16 ; 0.51]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4.20 [1.53 ; 11.53]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u003cp\u003e\u003cb\u003eGender.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e1.41\u0026nbsp;[0,8-2.48]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003ep\u0026thinsp;\u0026gt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e193\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e80.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.238 [0.11 ; 0.27]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.41 [0.80 ; 2.48]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e85.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.169 [0.17 ; 0.34]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u003cp\u003e\u003cb\u003ePlace of origin.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.58\u0026nbsp;[0,32-1.03]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003ep\u0026thinsp;\u0026gt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrban area.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e129\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e87.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.147 [0.11 ; 0.27]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural area.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e188\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e79.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.255 [0.17 ; 0.34]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.73 [0.99 ; 3.05]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe children's ages ranged from 1 to 58 months, with a mean age of 15 months (95% CI: 13.58\u0026ndash;16.42).\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e3.1. Overall Parasitism\u003c/h2\u003e\u003cp\u003eOf the 384 stool samples analyzed, 67 tested positive for at least one parasite, giving an overall prevalence of 17.4% (95% CI: 13.7\u0026ndash;21.2). The most affected age group was 12\u0026ndash;17 months, representing 34.3% of all infected children. All infected children originated from rural areas outside the town of Koudougou. The 1\u0026ndash;5 months range was chosen as the reference model. Logistic regression analysis showed a significantly higher risk of infection in this group (OR\u0026thinsp;=\u0026thinsp;5.14; 95% CI: 1.77\u0026ndash;14.9; p\u0026thinsp;=\u0026thinsp;0.002). Similarly, children aged 18\u0026ndash;24 months (OR\u0026thinsp;=\u0026thinsp;4.91; 95% CI: 1.50\u0026ndash;16.00; p\u0026thinsp;=\u0026thinsp;0.008) and those older than 24 months (OR\u0026thinsp;=\u0026thinsp;3.94; 95% CI: 1.27\u0026ndash;12.20; p\u0026thinsp;=\u0026thinsp;0.017) also had significantly increased risks. The association observed in children aged 6\u0026ndash;11 months (OR\u0026thinsp;=\u0026thinsp;1.62; 95% CI: 0.55\u0026ndash;4.80) was not statistically significant (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003eAlthough children from rural areas had a higher prevalence of infection, the association was not statistically significant (OR\u0026thinsp;=\u0026thinsp;0.58; 95% CI: 0.32\u0026ndash;1.03; p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.2. Parasitism in Relation to Nutritional Status, Malaria, and Anemia\u003c/h2\u003e\u003cp\u003eAll parasitized children presented monoparasitism, with protozoa accounting for most cases (94%of all the 67). Six intestinal parasite species were identified: \u003cem\u003eEntamoeba coli\u003c/em\u003e (14.9%), \u003cem\u003eTrichomonas intestinalis\u003c/em\u003e (19.4%), \u003cem\u003eAncylostoma sp\u003c/em\u003e. (10.4%), \u003cem\u003eGiardia intestinalis\u003c/em\u003e (28.4%), \u003cem\u003eEntamoeba histolytica\u003c/em\u003e (20.9%), and \u003cem\u003eTaenia solium\u003c/em\u003e (6.0%) (Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of intestinal parasite species diagnosed in 384 stool samples.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntestinal parasite species\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of parasites identified.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage of parasites identified (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eEntamoeba coli\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eTrichomonas intestinalis\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e19.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eAncylostoma sp.\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eGiardia intestinalis\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eEntamoeba histolytica\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eTaenia solium\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAmong the 384 children, 76.0% were malnourished: 63.8% with acute malnutrition (95% CI: 58.9\u0026ndash;68.5), 10.15% with chronic malnutrition (95% CI : 7.1\u0026ndash;13.2), and 2.1% overweight (95% CI : 0.6\u0026ndash;3.5) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Malaria was confirmed in 6.0% of cases (95% CI: 3.6\u0026ndash;8.4), while 81.5% of children were anemic (95% CI : 77.3\u0026ndash;85.1).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of parasitized children under five years of age admitted to the pediatric department according to nutritional status\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMalnutrition.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of children examined.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage of children examined (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCI 95%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNormal status.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[19.7\u0026ndash;28.3]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcute malnutrition.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e245\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[58.9\u0026ndash;68.5]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic malnutrition.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[7.1\u0026ndash;13.2]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOverweight/Obesity.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e[0.6\u0026ndash;3.5]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAmong the 67 parasitized children, 5.4% were anemic based on hemoglobin analysis.\u003c/p\u003e\u003cp\u003eThe odds ratio analysis indicated that acutely malnourished children had a slightly lower likelihood of intestinal parasitic infection compared to well-nourished children (OR\u0026thinsp;=\u0026thinsp;0.87; 95% CI: 0.46\u0026ndash;1.65), but the difference was not statistically significant (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of parasitized children under five years of age admitted to the pediatric department according to nutritional status: Frequencies and Odds Ratio Analysis\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMalnutrition.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNumber of cases of parasitic infections.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003ePercentage of cases of parasitic infections (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eOdds- CI 95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eOR-CI 95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eOR CI 95% Global\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePositive.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNegative.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.87 [0,5-1.7]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003ep\u0026thinsp;\u0026gt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNormal status.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e82.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.211 [0.12 ; 0.38]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcute malnutrition.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e207\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e84.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.184 [0.13 ; 0.26]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.87 [0.44 ; 1.73]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic malnutrition.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e66.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.5 [0.27 ; 0.92]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.37 [1.05 ; 5.32]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOverweight/Obesity.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eNC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eNC\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eHowever, statistical analysis showed that anemic children had a significantly lower probability of parasitic infection compared to non-anemic children (OR\u0026thinsp;=\u0026thinsp;0.02; 95% CI: 0.01\u0026ndash;0.05; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of anemia and malaria cases according to intestinal parasitic infections of children under five years of age admitted to the pediatric department\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics of children.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of children examined.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage of children examined\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCI 95%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAnaemia\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e313\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e[77.3\u0026ndash;85.1]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e[14.9\u0026ndash;22.7]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMalaria\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003ePositive\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e23\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003e[3.6\u0026ndash;8.4]\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNegative\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e361\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e94.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003e[95%\u0026nbsp;: 91.6\u0026ndash;96.4]\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eOf the 23 parasitized children who tested positive for malaria, 56.5% had intestinal parasitic infections. The odds ratio analysis indicated a significantly higher likelihood of intestinal parasitic infection among children with malaria compared to non-malarial children (OR\u0026thinsp;=\u0026thinsp;7.39; 95% CI: 3.08\u0026ndash;17.72; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of anemia and malaria cases according to intestinal parasitic infections of children under five years of age admitted to the pediatric department: Frequencies and Odds Ratio Analysis\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics of children.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNumber of cases of parasitic infections.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003ePercentage of cases of parasitic infections (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOdds- CI 95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOR-CI 95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOR CI 95% Global\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePositive.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNegative.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePositive.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNegative.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u003cp\u003eAnemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.024 [0.01\u0026ndash;0.05]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e296\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e94.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.057 [0.035\u0026ndash;0.094]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.024 [0.012\u0026ndash;0.049]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e29.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.38 [1.430\u0026ndash;3.964]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u003cp\u003eMalaria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e7.39 [3.1\u0026ndash;17.7]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003ePositive\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e13\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003e10\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e43.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.30 [0.570\u0026ndash;2.965]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7.39 [3.085\u0026ndash;17.706]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cem\u003eNegative\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e54\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003e307\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e85.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.176 [0.132\u0026ndash;0.235]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003e This study investigated the prevalence of malnutrition in its various forms and intestinal parasites among children under five years of age admitted to the pediatric department of the Regional Hospital Center of Koudougou. The intestinal parasites identified were \u003cem\u003eEntamoeba coli\u003c/em\u003e, \u003cem\u003eTrichomonas intestinalis\u003c/em\u003e, \u003cem\u003eAncylostoma sp., Giardia intestinalis, Entamoeba histolytica\u003c/em\u003e, and \u003cem\u003eTaenia solium.\u003c/em\u003e\u003c/p\u003e\u003cp\u003eOverall, parasitic infections affected a significant portion of the study population, irrespective of age, gender, or origin. While the prevalence of parasitic infections was observed to be higher in male children than in female children, this difference was not statistically significant (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). This finding aligns with Endale \u003cem\u003eet al.\u003c/em\u003e (2025) [19], who similarly concluded that parasitism was not sex-related, suggesting that both genders are exposed to similar environmental hygiene conditions and thus face comparable risks of infestation. Our results are also contradicts those of Zemene \u003cem\u003eet al.\u003c/em\u003e (2018) [20], whose study reported a similar infection rate in female (52.2%) and male (47.8%) subjects.\u003c/p\u003e\u003cp\u003eThe overall prevalence of intestinal parasites found in this study is lower compared to previous studies conducted in Burkina Faso, such as Ouemi (2012) [22] (60.82%), Ouattara (2019) [21] (50%), and ProGRES Consortium. (2015) [23] (22.9%), Endale (2025) [19] (19.45%), as well as a study in Algeria by Benouis \u003cem\u003eet al.\u003c/em\u003e (2013) [25] (19.96%). These variations in prevalence may be attributed to differences in study area and time. Intestinal parasite prevalence is typically higher in rural areas than in urban ones; our study predominantly included samples from rural backgrounds, which should theoretically lean towards higher prevalence. However, the relatively low prevalence observed in our study could be explained by the impact of national de-worming campaigns targeting children under five. Although our results are higher than those reported by the Ministry of Health in 2022 for the Center-west region (6%) during a parasitological survey, they are still lower than Benouis et al.'s findings (2013) in Algeria (19.96%) [25]. The lower prevalence in our study may also stem from the comprehensive package of interventions for de-worming children aged 6\u0026ndash;59 months across the country, and the fact that all children admitted to the pediatric department of the Regional Hospital are referrals for advanced care.\u003c/p\u003e\u003cp\u003eIn this study, protozoa (94%) were identified more frequently than helminths. This difference might be related to the faster and simpler biological cycles of protozoa compared to the often slower and more complex cycles of helminths, whose intermediate forms may face challenging environmental conditions (e.g., hot and dry climates) for their maturation. The high prevalence of intestinal protozoa points to significant fecal contamination of drinking water and food, coupled with inadequate hygiene practices within the population [26].\u003c/p\u003e\u003cp\u003eOur findings indicate that the 12 to 18-month age group was the most affected. This contrasts with Gebretsadik \u003cem\u003eet al.\u003c/em\u003e (2015) [24], who found the most affected age group to be between 36 and 59 months (28.57%). The higher susceptibility in younger children in our study could be attributed to their developmental stage, where increased dietary diversity and more frequent contact with the ground, especially as they begin to walk, elevate their risk of parasitic intestinal infestation.\u003c/p\u003e\u003cp\u003eFurthermore, the study revealed a predominance of infected children originating from rural areas outside Koudougou city, suggesting a link between geographical origin and parasite transmission. This is likely due to the continued prevalence of insufficient hygiene awareness and practices in these rural localities. Regarding clinical presentation, the majority of children with parasitic infections exhibited non-specific signs such as respiratory distress, dyspnea, anorexia, and cachexia. These findings are consistent with those reported in other studies conducted by Amoah \u003cem\u003eet al.\u003c/em\u003e (2021) in Ghana found that many parasitized children were asymptomatic or had symptoms such as weight loss or asthenia, while the absence of digestive signs (diarrhea, abdominal pain) was often found in chronic carriers [27]. Also, a study in Tanzania conducted by Mrimi \u003cem\u003eet al.\u003c/em\u003e (2022) found that Giardia intestinalis and Entamoeba histolytica infections were generally associated with non-specific or absent symptoms. The authors pointed out that the parasite load and nutritional status of the host strongly influenced clinical signs, often masking ordinary signs of infection [28]. This may be because specific acute symptoms like fever, diarrhea, vomiting, and cough are often managed at the initial health facility before referral for more comprehensive treatment.\u003c/p\u003e\u003cp\u003eNutritional indicators, including underweight, obesity, and overweight, were used to assess malnutrition in this study. We found a high overall prevalence of acute malnutrition (63.80%). This figure is considerably higher than the 17.5% underweight rate among children aged 0\u0026ndash;5 years reported in a 2021 nutrition survey by the Ministry of Health of Burkina Faso. Similarly, Endale \u003cem\u003eet al\u003c/em\u003e. (2025) [19] found a 28.1% underweight rate in Assela Referral Hospital, and Beasley \u003cem\u003eet al\u003c/em\u003e. (2002) [30] reported 18.7% underweight prevalence in Chad. Our study also identified subjects with normal status (24.0%), a finding consistent with Endale \u003cem\u003eet al\u003c/em\u003e. (2025) [19], who reported only 29.1% of the subjects in our study had a normal nutritional status. The elevated prevalence of acute malnutrition observed could be attributed to the late referral of patients to the regional hospital center, allowing for the progression of acute malnutrition.\u003c/p\u003e\u003cp\u003eUnivariate logistic regression analysis demonstrated an association between nutritional status and intestinal parasitic infections in our study. While the analysis revealed moderate variation across nutritional categories, the differences were not statistically significant in the univariate analysis (non-significant odds ratios and p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Despite the lack of statistical significance, this finding holds epidemiological consistency. For instance, intestinal parasitic infections (by protozoa like \u003cem\u003eGiardia intestinalis\u003c/em\u003e or helminths) can lead to intestinal absorption disorders or malabsorption of essential nutrients, along with an increase in energy requirements, thereby contributing to malnutrition [31]. Chatterjee \u003cem\u003eet al\u003c/em\u003e. (2014) [32] also showed that impaired staturo-weight growth contributes to the chronic presence of intestinal parasites, particularly in children living in resource-limited countries.\u003c/p\u003e\u003cp\u003eFurthermore, an inadequate diet weakens the immune system, especially mucosal immunity, increasing the risk of recurrent or severe infections in children. The absence of obese children with intestinal parasitic infections in our cohort might be due to the small sample size in this category, potentially limiting statistical power. Alternatively, it could reflect different socioeconomic conditions, such as better access to safer food and improved hygiene practices among this group.\u003c/p\u003e\u003cp\u003eIn the present study, the majority of malnourished subjects (76.11%) were also parasitized. However, this association was not statistically significant (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), suggesting that intestinal parasites affect a broad spectrum of the population regardless of their nutritional status. Endale \u003cem\u003eet al\u003c/em\u003e. (2025) [19] similarly found a higher prevalence of underweight and parasitized subjects compared to those with normal nutritional status and parasitic infections (70.9%) among patients visiting Assela Referral Hospital. Intestinal parasites can reduce nutrient absorption, cause appetite loss, and consequently lead to undernourished in affected individuals [33, 34, 35, 36].\u003c/p\u003e\u003cp\u003eFinally, the prevalence of children testing positive for malaria (6.0%) via thick blood smear was lower than that reported by Djanou \u003cem\u003eet al\u003c/em\u003e. (2004) [37], which was 52%. This difference may arise from patients often receiving antimalarial drugs at their initial contact with a health facility before being referred to the regional hospital for more comprehensive management. In the overall study population, one-third of children with intestinal parasitosis also had a positive blood smear, and this association was statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003eTherefore, parasitism is related to the presence of anemia. However, the results from our multivariate analyses showed an unexpected inverse association between intestinal parasitic infections (IPIs) and anemia. This observation is notable, as IPIs are generally understood to actively contribute to the development of anemia through mechanisms like chronic blood loss, malabsorption, and iron deficiency [38, 39]. Indeed, the WHO classifies helminthic infections as a major cause of anemia in tropical regions [40].\u003c/p\u003e\u003cp\u003eSeveral hypotheses could explain our inverse findings:\u003c/p\u003e\u003cp\u003eIndication or Access to Care Bias, Chronology of Pathologies and Unmeasured Characteristics\u003c/p\u003e\u003cp\u003eDespite our findings, it's widely reported that a robust positive association exists between anemia and IPIs, especially in children residing in impoverished rural areas [38, 5]. Our study, therefore, suggests that the relationship between anemia and IPIs may be modulated by specific contextual factors, including the broader health environment, nutritional status, and access to healthcare services in Koudougou, Burkina Faso.\u003c/p\u003e"},{"header":"5. Study Limitation","content":"\u003cp\u003eThe hospital-based design (selection bias toward severe or referred cases), the limited sample size in certain nutritional categories, and the diagnostic approach used (direct microscopy may underestimate some intestinal parasitic infections) were the limitations of our study.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eThis study found that the prevalence of intestinal parasitosis among children aged 0\u0026ndash;5 years was 17.4%, while malnutrition stood at 76.0%. Giardia intestinalis was identified as the most common parasite, present in 28.4% of cases. Our findings did not reveal a statistically significant link between these intestinal parasites and malnutrition. However, the study did establish a significant association between intestinal parasitosis and age, anemia, and malaria.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApplicable With the authorization of the primary person in charge of the structure in agreement with the ethical health and scientific committee of the hospital structure.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApplicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy data are available from the corresponding authors upon reasonable request by investigators.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eJean Axel T. KABORE, Roselyne OUATTARA, and Siaka KOBEANE conceptualized and designed the study, and participated in data collection, analysis, and interpretation. Jean Axel T. KABORE was responsible for writing the manuscript. Jean Axel T. KABORE, Marcel P. SAWADOGO, Awa GNEME, Moustapha NIKIEMA, Roselyne OUATTARA, Siaka KOBEANE, and Adama ZIDA provided critical revisions to the article. The final manuscript was approved by Awa GNEME. All authors have read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from the mothers of the participating children. The consent process was conducted in a clear, understandable, and culturally appropriate manner,\u0026nbsp;respecting the rights and dignity of both participants and their guardians.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance of Helsinki. The research protocol was reviewed and approved by ethics committee of Koudougou Regional Hospital (Approval No. [2023-800373/MSHP/SG/CHR-KDG/DRH/SRF]. Written informed consent was obtained from all participants prior to inclusion in the study. For illiterate participants, the consent from was read aloud in the presence of an impartial witness, and consent was confirmed by a fingerprint and the witness’s signature. So, informed consent was obtained from parents or legal guardians before participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the administration of the Koudougou Regional Hospital for allowing us to carry out this study within one of the health services. We also thank the Joseph KI-ZERBO University and the professors of the Laboratory of Animal Biology and Ecology for their guidance. Finally, we thank the parents or guardians of children who voluntarily participated in this study.\u003c/p\u003e"},{"header":" References","content":"\u003col\u003e\n\u003cli\u003eBour\u0026eacute;e P. Intestinal parasitosis is still common. M\u0026eacute;decine Sant\u0026eacute; Trop. 2015;25(2):130.\u003c/li\u003e\n\u003cli\u003ePires C, Renata de CC. Prevalence and epidemiological aspects of enteroparasitosis and its relationship with nutritional status in children living in the Beira Rio neighborhood of Imperatriz, MA in 2011. Rev Cient Multidisc N\u0026uacute;cleo Conhecimento. 2020;5(7):51\u0026ndash;70.\u003c/li\u003e\n\u003cli\u003eBour\u0026eacute;e P. Intestinal amoebiasis. Encycl M\u0026eacute;d Chir (Elsevier Paris). 2010;103(27):1\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eMinistry of Health, Global Fund. Statistical Yearbook 2021. April 2022. 397\u003c/li\u003e\n\u003cli\u003eStephenson LS, Latham MC, Ottesen EA. Malnutrition and parasitic helminth infections. Parasitology. 2000;121(S1):S23\u0026ndash;38.\u003c/li\u003e\n\u003cli\u003eMinist\u0026egrave;re de la Sant\u0026eacute;, Fonds Mondial. Annuaire statistique de la sant\u0026eacute; 2021. 2022. 397 p.\u003c/li\u003e\n\u003cli\u003eZine S, Karima B, Ahmed BA, Mohamed BO, R\u0026eacute;seau PRP2S. Comment calculer la taille d\u0026rsquo;un \u0026eacute;chantillon pour une \u0026eacute;tude observationnelle. Tunisie M\u0026eacute;d. 2020;98(1):1\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eLemeshow S, Hosmer DW, Klar J, Lwanga SK. \u003cem\u003eAdequacy of sample size in health studies\u003c/em\u003e. Geneva: World Health Organization; 1990\u003c/li\u003e\n\u003cli\u003eMinist\u0026egrave;re de la Sant\u0026eacute;, OCHA. Protocole national de prise en charge int\u0026eacute;gr\u0026eacute;e de la malnutrition aigu\u0026euml; (PCIMA) - Burkina Faso. 2014. 154 p.\u003c/li\u003e\n\u003cli\u003eMinistry of Health and Public Hygiene. Diagnosis of malnutrition. 2017. 66\u003c/li\u003e\n\u003cli\u003eGuillaume V. Parasitologie sanguine. Bruxelles: De Boeck Sup\u0026eacute;rieur; 2009.\u003c/li\u003e\n\u003cli\u003eCheesbrough M. District laboratory practice in tropical countries. Part 1. 2nd ed. Cambridge: Cambridge University Press; 2005. p. 196\u0026ndash;205.\u003c/li\u003e\n\u003cli\u003eGuillaume V. Fiches de parasitologie. Bruxelles: De Boeck Sup\u0026eacute;rieur; 2007.\u003c/li\u003e\n\u003cli\u003eHouz\u0026eacute; S, Delhaes L, eds. Parasitologie et mycologie m\u0026eacute;dicales. Paris: Elsevier Health Sciences; 2022.\u003c/li\u003e\n\u003cli\u003eMarijon A, Hodille E, Jourdy Y, Buffaz C, Louvrier C. Parasitologie et mycologie m\u0026eacute;dicale pratique. Bruxelles: De Boeck Sup\u0026eacute;rieur; 2020.\u003c/li\u003e\n\u003cli\u003eEsch G, Fernandez J. A functional biology of parasitism: ecological and evolutionary implications. Berlin: Springer; 2013.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Basic laboratory methods in medical parasitology. Geneva: WHO; 1991. p. 21\u0026ndash;30.\u003c/li\u003e\n\u003cli\u003eBogitsh BJ, Carter CE, Oeltmann TN. Human parasitology. 5th ed. London: Academic Press; 2018. p. 31\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eEndale T, Birmeka M, Bekele D. Effect of Intestinal Parasitic Infection on Nutritional Status on Under‑five Children Patients Visiting Assela Referral Hospital, East Arsi Zone, Oromia Region, Ethiopia. Acta Parasitologica. 2025;70(1):55\u003c/li\u003e\n\u003cli\u003eZemene T, Shiferaw MB. Prevalence of intestinal parasitic infections in children under the age of 5 years attending the Debre Birhan Referral Hospital, North Shoa, Ethiopia. BMC Res Notes. 2018;11:58\u003c/li\u003e\n\u003cli\u003eOuattara AK, Zongo A, et al. Gastrointestinal parasitic infections in children aged less than 5 years in Ouagadougou, Burkina Faso. OJ Ped. 2019;317 enfants \u0026eacute;tudi\u0026eacute;s\u003c/li\u003e\n\u003cli\u003eOuermi D, Karou DS, Ouattara I. Prevalence of intestinal parasites at Saint-Camille Medical Center in Ouagadougou (Burkina Faso), 1991\u0026ndash;2010. M\u0026eacute;d Sant\u0026eacute; Trop. 2012;22(1):40\u0026ndash;4.\u003c/li\u003e\n\u003cli\u003eProGRES Consortium. Hospital‑based cross‑sectional survey for gastrointestinal parasites in children under five years in Ouagadougou, Burkina Faso. 2018\u0026ndash;2019\u003c/li\u003e\n\u003cli\u003eGebretsadik D et al. Prevalence of intestinal parasitic infection among children under 5 years of age at Dessie Referral Hospital. BMC Res Notes. 2018;11:771\u003c/li\u003e\n\u003cli\u003eBenouis A, Bekkouche Z, Benmansour Z. Epidemiological study of human intestinal parasitosis at the University Hospital of Oran (Algeria). Int J Innov Appl Stud. 2013;2(4):613\u0026ndash;20.\u003c/li\u003e\n\u003cli\u003eMonjour L, Noel B, Bounkoungou B. Use of drinking water with or without environmental protection in peri-urban areas: Ouagadougou, Burkina Faso. In: Water, agriculture and health in tropical environments. 1998. p. 34.\u003c/li\u003e\n\u003cli\u003eAmoah SA, Darko BA, OwusuAsenso CM, AddoOsafo K, et al. Prevalence and clinical profile of intestinal parasitic infections in school-aged children in rural Ghana. J Parasitol Res. 2021;2021:6645123. doi:10.1155/2021/6645123 \u003c/li\u003e\n\u003cli\u003eMrimi EC, Palmeirim MS, Minja EG, Long KZ, Keiser J. Malnutrition, anemia, micronutrient deficiency and parasitic infections among schoolchildren in rural Tanzania. PLoS Negl Too Say. 2022; 16(3):E0010261. doi:10.1371/journal.pntd.0010261\u003c/li\u003e\n\u003cli\u003eSavadogo B, Bengaly MD, Sorgho H, Zongo D, Zeba AN, Lanou H, et al. Nutritional status and parasitosis in school-age children in Burkina Faso: case of schools in Yamtenga, Koubri, and Daguilma. Rev Sci Tech/Sant\u0026eacute;. 2014;37(1\u0026ndash;2):12.\u003c/li\u003e\n\u003cli\u003eBeasley M, Brooker S, Ndinaromtan M. First nationwide survey of the health of schoolchildren in Chad. Trop Med Int Health. 2002;7(7):625\u0026ndash;30.\u003c/li\u003e\n\u003cli\u003eGuerrant RL, Oria RB, Moore SR, et al. Malnutrition as an enteric infectious disease with long-term effects on child development. Nutr Rev. 2008;66(9):487\u0026ndash;505.\u003c/li\u003e\n\u003cli\u003eChatterjee N, Banu N, Dey T. Correlation of nutritional status and intestinal parasitic infection in school children. Al Ameen J Med Sci. 2014;7(1):41\u0026ndash;4.\u003c/li\u003e\n\u003cli\u003eKabatereine NB, Brooker S, Koukounari A. Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren. Bull World Health Organ. 2007;85(2):91\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eKabatereine NB, Tukahebwa E, Kazibwe F, Namwangye H, Zaramba S. Progress towards countrywide control of schistosomiasis and soil-transmitted helminthiasis in Uganda. Trans R Soc Trop Med Hyg. 2006;100(3):208\u0026ndash;15.\u003c/li\u003e\n\u003cli\u003eKabatereine NB, Brooker S, Koukounari A. Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren. Bull World Health Organ. 2007;85(2):91\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Working to overcome the global impact of neglected tropical diseases: first WHO report on neglected tropical diseases. Geneva: WHO; 2010.\u003c/li\u003e\n\u003cli\u003eDianou D, Poda JN, Savadogo LG. Intestinal parasitosis in the Sourou hydroagricultural complex area of Burkina Faso. VertigO. 2004;5(2):1\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eBrooker S, Hotez PJ, Bundy DAP. Hookworm-related anemia among pregnant women: a systematic review. PLoS Negl Trop Dis. 2008;2(9):e291.\u003c/li\u003e\n\u003cli\u003eHall A, Hewitt G, Tuffrey V, de Silva N. A review and meta-analysis of the impact of intestinal worms on child growth and nutrition. Matern Child Nutr. 2008;4:118\u0026ndash;36.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Haemoglobin concentrations for the diagnosis of anemia and assessment of severity. Geneva: WHO; 2011.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"intestinal parasitosis, nutritional status, Koudougou, children under five","lastPublishedDoi":"10.21203/rs.3.rs-7889683/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7889683/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eIntestinal parasitic infections remain a significant public health concern, particularly in developing countries. This study aimed to assess the impact of intestinal parasitosis on the nutritional status of children under five years of age admitted to the pediatric department of the Koudougou Regional Hospital in Burkina Faso.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe conducted a descriptive cross-sectional study between March and September 2023. Each child underwent direct stool examination and concentration techniques using both the Ritchie and Willis methods. Nutritional status and hematological parameters were also evaluated.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cp\u003eA total of 384 children aged 1 to 58 months participated, with a mean age of 15 months and a male predominance (62.2%). Among them, 67 children tested positive for intestinal parasites, yielding an overall prevalence of 17.4% [13.6\u0026ndash;21.2]. The identified species included \u003cem\u003eGiardia intestinalis\u003c/em\u003e (28.4%), \u003cem\u003eEntamoeba histolytica\u003c/em\u003e (20.9%), \u003cem\u003eTrichomonas intestinalis\u003c/em\u003e (19.4%), \u003cem\u003eEntamoeba coli\u003c/em\u003e (14.9%), \u003cem\u003eAncylostoma sp.\u003c/em\u003e (10.4%), and \u003cem\u003eTaenia solium\u003c/em\u003e (6.0%). Regarding nutritional status, 76.04% [71.7\u0026ndash;80.4] of the children were malnourished. No statistically significant association was found between intestinal parasitosis and malnutrition (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The prevalence of anemia was 81.5%, and a strong association was observed between intestinal parasitosis and anemia (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Malaria prevalence was 6.0%, and a statistically significant association was also noted between malaria and intestinal parasitic infections (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThese findings highlight the importance of improving hygiene practices and strengthening routine deworming strategies to enhance child health outcomes and reduce the burden of intestinal parasitic diseases.\u003c/p\u003e","manuscriptTitle":"Parasitological profile and nutritional status of hospitalized children under five years of age in Koudougou, Burkina Faso","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-08 06:24:56","doi":"10.21203/rs.3.rs-7889683/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-29T12:01:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-16T23:10:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"289960328851843666895084481479672773875","date":"2025-12-16T09:20:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-10T04:15:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"228173596787509812550365856957780830910","date":"2025-12-06T14:52:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"231320049771124324326481918362196012961","date":"2025-12-04T21:40:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-04T12:32:32+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-12T05:57:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-22T07:42:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-22T07:40:55+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2025-10-17T20:56:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6a15dc17-012b-4daf-b27c-d71fb73e1ef9","owner":[],"postedDate":"December 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T06:24:57+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-08 06:24:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7889683","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7889683","identity":"rs-7889683","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}