Parasite contamination of soil in distinct Peruvian locations and outside built environments

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Understanding how environmental factors like temperature, humidity, and soil type strongly influence parasite distribution is essential, particularly given how climate change may intensify their impacts, altering parasite habitats and increasing transmission risks. The primary goal of this study was to understand how environmental conditions affect soil parasite prevalence and diversity. Methodology: A total of 198 soil samples from 43 locations across three Peruvian regions—Tingo María (TM) (Amazon rainforest), Andabamba/Marabamba (A/M) (Andean highlands), and Huánuco city parks—were analyzed using multi-parallel quantitative real-time PCR (qPCR) to detect soil-transmitted helminths (STH) and protozoan DNA from entry, patio, and latrine sites. Results Parasites were detected in 93% of locations, with 84% showing polyparasitism. TM houses had a higher odds ratio (OR) of contamination with Ascaris lumbricoides (16.5) and Trichuris trichiura (8.4) compared to those in A/M (p < 0.05). TM also showed significantly higher odds of parasite presence in patios compared to entries, particularly for helminths; patios had an OR of 5.8 relative to entries (p = 0.006). A/M had higher protozoan prevalence with Blastocystis species, with a greater odd of 8.4 (p = 0.042) to TM. A/M had an OR of Acanthamoeba species 8.6 in patios versus entries (p = 0.0327), indicating a niche favoring protozoans in these arid conditions. TM had significantly more parasite species (p = 0.0154), with helminth species significantly higher in the patio vs. entry (p = 0.0029). Conclusions The observed variability in soil parasite prevalence between tropical rainforest and highland regions highlights the influence of environmental niches on parasite distribution, which may shift further due to climate change. This study demonstrates a sensitive approach to monitoring environmental contamination with parasites by leveraging qPCR. The findings underscore the importance of ecological surveillance for assessing parasitic transmission risks, which is crucial for guiding public health interventions, especially as environmental changes accelerate. parasitic DNA soil qPCR Figures Figure 1 Figure 2 Background Soil-transmitted helminths (STH) and protozoan parasites can lead to significant health problems in tropical and subtropical areas worldwide, including malnutrition, anemia, and growth delays in children( 1 , 2 ). These parasitic infections are caused by helminths: Ancylostoma species, Ascaris lumbricoides, Necator americanus, Strongyloides stercoralis , Trichuris trichiura, Toxocara cati, Toxocara canis , Taenia solium , and protozoa: Blastocystis species, Entamoeba histolytica, Giardia intestinalis , and Cryptosporidium species. Other soil-borne organisms, such as Acanthamoeba species, can be opportunistic human pathogens, the most environmentally prevalent free-living protozoa( 3 ). In terms of STH, upwards of 20% of the world's population (1.5 billion people) are infected, leading to an estimated 5.2 million disability-adjusted life years (DALYs)( 1 ). Based upon analysis of results from a standardized multi-parallel real-time quantitative PCR method( 4 – 6 ), risk assessments can be performed based on parasite soil contamination from environmental sites. We aimed to detect soil-transmitted helminth and protozoan parasite DNA in soil collected from two environmentally distinct areas in Peru: (01) Tingo María, in the Selva Alta (“High Forest”) of Peru’s Eastern Piedmont (600m elevation), and (02) Andabamba/Marabamba (mountainous Andean highlands, 1900m elevation) and Huánuco (mountainous basin Andean highlands, 1900m elevation). The area of Tingo María is the gateway to the biodiverse Tingo María National Park, and the city of Tingo María lies in an intermediate geographic zone known as the ceja de selva (“eyebrow of the jungle”). This region has a tropical rainforest climate, typically hot, humid, and wet with no dry season. In contrast, the Andabamba/Marabamba area, including nearby Huánuco, has a semi-arid climate, comprising parts of the Andean highlands and the High Jungle (mountain rim) regions. It has mild weather with an average annual temperature of 20°C (68°F). These sites were selected primarily because of their different soil environments to ascertain similarities and differences between helminth and protozoan soil prevalences and burdens. Climate change leading to soil environmental shifts will likely change these parasitic parameters, leading to consequences for parasite risk monitoring and subsequent health care approaches( 7 ). Methods Altogether, 198 samples were taken from 43 independent locations. At each location, 2–7 soil samples were collected (76 from 14 houses in Tingo María, 77 from 22 houses in Andabamba/Marabamba, and 45 from 7 parks in Huánuco) from entries, patios, and outdoor latrines in the cases of Tingo María and Andabamba/Marabamba. Households were randomly selected after obtaining consent from the owners. Latrines were limited-service latrines on the JMP sanitation ladder about 2 meters from the house's back door( 8 ). Each sample was processed at the Universidad Nacional Hermilio Valdizán (UNHEVAL), Huánuco, Peru. Up to 50g of wet soil was collected and stored at -20ºC until use. Each sample was weighed and resuspended to 45 mL in PBS (Alfa Asesar, Ward Hill, MA) containing 0.05% TWEEN (Sigma-Aldrich, St. Louis, MO) in a conical centrifuge tube. The samples were then shaken and inverted for 5 min and centrifuged at 500 g for 5 min. Supernatants were then decanted and discarded. A total of 10 mL of sugar solution (320 granulated sugar in 620 ml H 2 0, specific gravity of 1.30) was added to the pellets for parasite egg/larvae/cyst flotation. After shaking and inversion for 5 min, samples were centrifuged at 500 g for 5 min. Supernatants were then filtered through an MCE membrane (3.0 µM, MF-Millipore, Merck KGaA, Darmstadt, Germany), and the resultant filtrates were processed using FastDNA SPIN kit for soils (MP Biomedicals, Santa Ana, California, USA) as previously described( 4 – 6 ). An external DNA control, unrelated to the target parasites, was added to each sample before the purification step to allow for the quantification of the isolated DNA using PCR( 9 ). The eluent was spotted on 0.2 µm filter paper (Millipore, Merck KGaA, Darmstadt, Germany) and air-dried before being shipped at ambient temperature to Baylor College of Medicine, Houston, Texas, USA. Once received, DNA was extracted from the filter papers by overnight room temperature elution using 100 µl of elution buffer (MP Biomedicals). Recovered DNA was analyzed by a multi-parallel quantitative polymerase chain reaction (qPCR) as previously described( 4 – 6 ), with the addition of a Taenia solium (TsolR13) primer and probes( 10 ). Samples were run on a QS7 Pro Fast Real-time PCR System (Applied Biosystems, Waltham, Massachusetts, USA), and plasmid samples containing the target sequences were serially diluted to create the standard curve (duplicates) ( 11 ). Only a cycle threshold (Ct) of 38 or lower was considered positive for all parasites based on spiking studies using parasite egg/larvae/cyst and detection using qPCR 6,7 (Supplemental Table 1) . Parasite copy numbers of DNA were calculated by linear regression, including those outside the dynamic range of the standard curve (Design and Analysis Software: 2.6.0, Thermo Fisher Scientific, USA) (Supplemental Table 2) . The exogenous internal DNA control was used to assess the quality of DNA extraction and inhibition efficiency in all samples( 9 ). To minimize the risk of cross-contamination during DNA extraction and qPCR, all reagents and samples were prepared in a Cleanprep Station (Mystaire, Creedmoor, NC). Singleplex qPCR was used on all samples to detect only one parasite in each 96-well plate. Each sample plate was validated with a positive (parasite DNA) and a negative (no DNA) control. A built environment was considered contaminated with a parasite if at least one sample from a given environmental build location/house or park was qPCR positive. Statistical methods used for this study include the Mann-Whitney t-test and the Kruskal-Wallis ANOVA test to compare locations and parasite concentrations. Odds ratios were calculated by Logistic Regression, Fisher exact, or Firth's Bias-Reduced Logistic Regression when the sample size of one cell was less than five. Values were considered significant if p < 0.05. Results Prevalence among all 3 sample areas (43 locations) Of the three sample areas, 93.0% (40/43) of houses and parks tested positive for at least one parasite, with 83.7% (36/43) showing polyparasitism. Up to seven different parasites were detected in an individual house or park site (range 0–7). For STH, 53.5% (23/43) of houses and parks were positive with 14% of the sites (6/43) positive for Ancylostoma species, 16.3% (7/43) for Ascaris lumbricoides , 7 % (3/43) for Necator americanus , 16.3% (7/43) for Strongyloides stercoralis , 2.3% (1/43 ) for Taenia solium , 4.7 % (2/43) for Toxocara canis and 16.3% (7/43) for Trichuris trichiura . No Toxocara cati -positive sample was found. For protozoa, 88.4% (38/43) of houses and parks were contaminated. Among these, 58.1% (25/43) were positive for Acanthamoeba species, 81.4% (35/43) were positive for Blastocystis species, and 16.3% (7/43) were positive for Giardia intestinalis. No Cryptosporidium species or Entamoeba histolytica detection were observed ( Table 1 ) (Supplemental Fig. 1, 2) . Considering the 198 samples taken in the 43 independent locations, 58.6% (116/198) tested positive for the presence of DNA from at least one parasite, 24.7% (49/198) showed polyparasitism and 41.4% (82/198) were negative for any tested parasite. Up to 6 different parasites were detected in a single sample (range 0–6). Among STH, 19.2% (38/198) tested positive with 3.5% (7/198) positive for Ancylostoma species, 6.6% (13/198) for Ascaris lumbricoides , 1.5% (3/198) for Necator americanus , 5.6% (11/198) for Strongyloides stercoralis , 0.5% (1/198) for Taenia solium , 1% (2/198) for Toxocara canis , and 3.5% (7/198) for Trichuris trichiura. No Toxocara cati was observed. Among protozoa, 52.5% (104/198) of samples were positive, 24% (47/198) for Acanthamoeba species, 38% (76/198) for Blastocystis species, and 6% (12/198) for Giardia intestinalis. No Cryptosporidium species or Entamoeba histolytica were detected ( Table 1 ) . Table 1 Prevalence of parasites and DNA concentrations in the soil Parasite/Location Contamination Rate by Samples Contamination Rates by Sites DNA concentration in kg of soil (fg/µl), mean (range) HELMINTHS Ancylostoma species Overall 3.5% (7/198) 14.0% (6/43) 7.61 (0.249 to 36.7) Tingo María 2.6% (2/76) 14.3% (2/14) 18.5 (0.249 to 36.7) Andabamba/Marabamba 6.5% (5/77) 18.2% (4/22) 3.26 (0.442 to 12.5) Huánuco 0% (0/45) 0% (0/7) 0 Ascaris lumbricoides Overall 6.6% (13/198) 16.3% 7/43) 18.58 (0.156 to 152.7) Tingo María 15.8% (12/76) 42.9% (6/14) 20.12 (0.179 to 152.7) Andabamba/Marabamba 1.3% (1/77) 4.5% (1/22) 0.116 Huánuco 0% (0/45) 0% (0/7) 0 Necator americanus Overall 1.5% (3/198) 7.0% (3/43) 0.125 (0.0634 to 0.227) Tingo María 0% (0/76) 0% (0/14) 0 Andabamba/Marabamba 2.6% (2/77) 9.1% (2/22) 0.156 (0.0858 to 0.227) Huánuco 2.2% (1/45) 14.3% (1/7) 0.0634 Strongyloides stercoralis Overall 5.6% (11/198) 16.3% (7/43) 0.736 (0.0164 to 3.52) Tingo María 14.5% (11/76) 50% (7/14) 0.736 (0.0164 to 3.52) Andabamba/Marabamba 0% (0/77) 0% (0/22) 0 Huánuco 0% (0/45) 0% (0/7) 0 Taenia solium Overall 0.5% (1/198) 2.3%. (1/43) 235.6 Tingo María 0% (0/76) 0% (0/14) 0 Andabamba/Marabamba 0% (0/77) 0% (0/22) 0 Huánuco 2.2% (1/45) 14.3% (1/7) 235.6 Toxocara canis Overall 1% (2/198) 4.7% (2/43) 133.8 (0.3841 to 267.2) Tingo María 1.3% (1/76) 7.1% (1/14) 267.2 Andabamba/Marabamba 1.3% (1/77) 4.5% (1/22) 0.3841 Huánuco 0% (0/45) 0% (0/7) 0 Trichuris trichiura Overall 3.5% (7/198) 16.3% (7/43) 21.25 (0.01627 to 104.1) Tingo María 5.3% (4/76) 28.6% (4/14) 11.16 (0.6382 to 41.58) Andabamba/Marabamba 1.3% (1/77) 4.5% (1/22) 104.1 Huánuco 4.4% (2/45) 28.6% (2/7) 0.01921 (0.01627 to 0.0222) PROTOZOA Acanthamoeba species Overall 23.7% (47/198) 58.1% (25/43) 0.2037 (0.00688 to 4.721) Tingo María 18.4% (14/76) 50% (7/14) 11.16 (0.0098 to 4.721) Andabamba/Marabamba 41.6% (32/77) 77.3% (17/22) 0.1343 (0.00688 to 1.523) Huánuco 2.2% (1/45) 14.3% (1/7) 0.03401 Blastocystis species Overall 38.4% (76/198) 81.4% (35/43) 19.99 (0.01424 to 719.0) Tingo María 28.9% (22/76) 71.4% (10/14) 49.02 (5.705 to 719.0) Andabamba/Marabamba 64.9% (50/77) 95.6% (21/22) 7.175 (0.0558 to 91.34) Huánuco 8.9% (4/45) 57.1% (4/7) 20.41 (0.01424 to 81.52) Giardia intestinalis Overall 6.1% (12/198) 18.6% (8/43) 12.87 (1.276 to 50.92) Tingo María 5.3 (4/76) 21.4% (3/14) 3.985 (2.589 to 5.510) Andabamba/Marabamba 9.1% (7/77) 18.2% (4/22) 19.26 (1.276 to 50.92) Huánuco 2.2% (1/45) 14.3% (1/7) 3.628 Parasite Prevalence in Tingo María Of the 14 houses sampled in Tingo Maria, 92.9% (13/14) were positive for at least one parasite, and 85.7% (12/14) were polyparasitic. Up to seven different parasites were observed in a single house (range 0–7). 58% (44/76) of samples were positive for the DNA presence of at least one parasite, and 25% (19/76) of the samples had more than one parasite detected. Up to 6 different parasites were detected in a single sample (range 0–6). Regarding STH, 85.7% (12/14) of houses were positive for at least one species. Specifically, 14% (2/14) were positive for Ancylostoma species, 42.9% (6/14) fo r Ascaris lumbricoides , 50% (7/14) for Strongyloides stercoralis , 7.1% (1/14) for Toxocara canis , and 28.6% (4/14) for Trichuris trichiura . For protozoans, 78.6% (11/14) houses tested positive, with 50% (7/14) for Acanthamoeba species , 71.4% (10/14) for Blastocystis species , and 21.4% (3/14) for Giardia intestinalis ( Table 1 ) . Regarding the 76 individual samples, 32.9% (25/76) were positive for STH: 2.6% (2/76) for Ancylostoma species, 15.8% (12/76) fo r Ascaris lumbricoides , 14.5% (11/76) for Strongyloides stercoralis , 1.3% (1/76) for Toxocara canis and 5.3% (4/76) for Trichuris trichiura. Among protozoans, 47.4% (36/76) of samples were positive: 18.4% (14/76) for Acanthamoeba species, 28.9% (22/76) for Blastocystis species, and 5.3% (4/76) for Giardia intestinalis. No Necator americanus, Taenia solium , Toxocara canis, Toxocara cati, Cryptosporidium species, or Entamoeba histolytica was detected ( Table 1 ) . Parasite Prevalence in Andabamba/Marabamba Regarding the 22 houses sampled in A/M, 100% (22/22) were positive for at least one parasite; 95.5% (21/22) were polyparasitic. For the 77 samples from 22 houses, 83.1% (64/77) were positive for at least one parasite, and 36.4% (28/77) had more than one parasite detected. No parasites were detected in 16.8% (13/77) of the samples. Up to 4 different parasites were detected in a single house (range 1–4) and up to 3 in a single sample (range 0–3). Among STH, 36.4% (8/22) of houses were positive, with 18.2% (4/22) positive for Ancylostoma species, 4.5% (1/22) fo r Ascaris lumbricoides , 9.1% (2/22) for Necator americanus , 4.5% (1/22) for Toxocara canis and 4.5% (1/22) for Trichuris trichiura. Among protozoa, 100% (22/22) of the houses were positive, with 77.3% (17/22) positive for Acanthamoeba species, 95.6% (21/22) for Blastocystis species, and 18.2% (4/22) for Giardia intestinalis ( Table 1 ) . Among the 77 samples in A/M, 11.7% (9/77) were positive for STH, and 80.5% (62/77) were positive for protozoa. Among the STH, 6.5% (5/77) were positive for Ancylostoma species, 1% (1/77) for Ascaris lumbricoides , 2.6% (2/77) for Necator americanus , 1% (1/77) for Toxocara canis and 1.3% ( 1/77) Trichuris trichiura. In terms of protozoa, 41.6% (32/77) of samples were positive for Acanthamoeba species , 64.9% (50/77) for Blastocystis species , and 9.1% (7/77 ) for Giardia intestinalis . No Cryptosporidium species, Entamoeba histolytica, Taenia solium, Toxocara cati, or Strongyloides stercoralis were detected ( Table 1 ) . Parasite Prevalence in Huánuco A total of 45 samples were taken from 7 city parks in Huánuco. 71.4% (5/7) of parks were positive for at least one parasite, 42.9% (3/7) showed polyparasitism, and up to 3 different parasites were detected in a single house (range 0–3). 17.8% (8/45) of the samples were positive for at least one parasite; in 82.2% (37/45), no parasites were detected. 4.4% (2/45) of the samples showed polyparasitism. A maximum of 2 different parasites were observed in a sample (range 0–2). Regarding STH, 42.9% (3/7) of parks and 8.9% (4/45) samples were positive. 14.3% (1/7) of parks and 2.2% (1/45) of the samples were positive for Necator americanus , 14.3% (1/7) parks) with 2% (1/45) samples positive for Taenia solium and 28.6% (2/7) parks with 4.4% (2/45) positive for Trichuris trichiura. Among protozoans, 71.4% (5/7) of parks and 13.3% (6/45) of the samples were positive. For Acanthamoeba species, 14.3% (1/7) of the parks were positive, with 2.2% (1/45) samples being positive. For Blastocystis species, 57.1% (4/7) of parks and 8.9% (4/45) samples were positive for Giardia intestinalis , 14.3% (1/7) parks with 2.2% (1/45) samples were positive. No positive samples were observed for Ancylostoma species, Ascaris lumbricoides , Strongyloides stercoralis, Toxocara canis, Toxocara cati, Cryptosporidium species, or Entamoeba histolytica. Table 1 also presents the mean (range) parasite abundance regarding DNA concentration in kg of soil (fg/µl) across the three sites. In Tingo María, the highest DNA concentration of STH parasites was observed for Ancylostoma species and Ascaris lumbricoides and among protozoans. Blastocystis species had higher concentrations in Tingo María versus Andabamba/Marabamba and Huánuco (14.66 vs. 0.4312 vs. 0.2159 (fg/µl)/ kg soil, respectively, P < 0.0001) ( Fig. 1 ) . In Andabamba/Marabamba, the highest STH copy numbers were observed for Trichuris trichiura with Giardia intestinalis , the highest among protozoans. Differences in presence and abundance were observed between Tingo María and Andabamba/Marabamba for Ancylostoma species, Toxocara canis, Trichuris trichiura , and all tested protozoans. The odds of encountering a parasite in Tingo María versus Andabamba/Marabamba houses Using odd ratio analysis, comparisons between houses in Tingo María and Andabamba/Marabamba revealed a significant difference for all helminths (p = 0.0037) and protozoans (p = 0.023) ( Table 2 ) . Significant differences were found for helminths for Ascaris (p = 0.0037) and Trichuris (p = 0.042), which were more prevalent in Tingo María. Among protozoans, a positive association was observed only for Blastocystis (p = 0.0421), which was more prevalent in Andabamba/Marabamba. City parks and playgrounds of Huánuco were not included in this comparison. Table 2 The odds ratio for finding a parasite in Tingo María versus Andabamba/Marabamba houses. * Indicates a significant difference (p < 0.05). Parasite Tingo María Houses # Andabamba Marabamba Houses # Odds Ratio P-value Helminths 12* 8 10.50 (1.791 to 52.59) *0.0037 Ancylostoma species 2 4 0.75 (0.1281 to 3.859) 0.7598 Ascaris lumbricoides 6* 1 16.50 (1.829 to 195.7) *0.0037 Necator americanus 0 2 N/A N/A Strongyloides stercoralis 7 0 N/A N/A Taenia solium 0 0 N/A N/A Toxocara canis 1 1 1.615 (0.07940 to 31.97) 0.7401 Toxocara cati 0 0 N/A N/A Trichuris trichiura 4* 1 8.4 (1.046 to 106.6) *0.0421 All Protozoan 11 22* 0 (0.00 to 0.6723) *0.0233 Protozoan not Acanthamoeba 11 21 0.1746 (0.01295 to 1.354) 0.1161 Acanthamoeba species 7 17 0.2941 (0.06318 to 1.184) 0.0906 Blastocystis species 10 21* 8.4 (1.046 to 106.6) *0.0421 Giardia Intestinalis 3 5 N/A N/A Total parasites 14 22 N/A N/A Total parasites not Acanthamoeba 13 22 0 (0.00 to 5.727) 0.2036 Parasites in specific locations of outside built environments Soil from around the entries, patios, and latrines was collected outside each built environment/house in both Tingo María and Andabamba/Marabamba. The odds of detecting any parasite were 3.297 times higher in the patios of Tingo María houses compared to the entries (p = 0.0397). For any helminth, there was a 5.85 times higher contamination in the patios vs entries (p = 0.0065), with the patios having Ascaris lumbricoides 6.7 times higher (p = 0.0469) than the entries ( Table 3 ) . In Andabamba/Marabamba, Acanthamoeba species increased 8.648 times in the patios versus the entries for houses (p = 0.0327). Table 3 The odds ratio for finding a parasite in specific locations outside built environments in Tingo María versus Andabamba/Marabamba houses. * Indicates a significant result Tingo María Parasite Entry Latrine Patio Odds Ratio P - value Any parasites 13 11 20 Latrine vs. Entry 1.41 (0.446–4.464) 0.5587 Patio vs Entry 3.297 (1.058–10.276) *0.0397 Latrine vs Patio 0.428 (0.125–1.466) 0.1766 Any parasite not including Acanthamoeba 10 8 16 Latrine vs. Entry 1.2 (0.368–3.914) 0.7625 Patio vs Entry 2.618 (0.881–7.783) 0.0834 Latrine vs Patio 0.458 (0.141–1.49) 0.1946 Helminths 4 7 14 Latrine vs. Entry 3.025 (0.767–11.932) 0.1139 Patio vs Entry 5.849 (1.64-20.858) *0.0065 Latrine vs Patio 0.517 (0.158–1.693) 0.2758 Protozoa 11 11 14 Latrine vs. Entry 1.889 (0.591–6.04) 0.2836 Patio vs Entry 1.664 (0.571–4.853) 0.3508 Latrine vs Patio 1.135 (0.356–3.621) 0.8307 Protozoa not including Acanthamoeba 8 7 10 Latrine vs. Entry 1.346 (0.393–4.612) 0.6362 Patio vs Entry 1.471 (0.474–4.563) 0.5045 Latrine vs Patio 0.915 (0.274–3.057) 0.8857 Acanthamoeba species 4 6 4 Latrine vs. Entry 2.571(0.617–10.708) 0.1944 Patio vs Entry 1.043(0.233–4.673) 0.9556 Ancylostoma species 0 1 1 N/A Ascaris lumbricoides 1 4 7 Latrine vs Entry 5.002(0.687–36.395) 0.1119 Patio vs Entry 6.710(1.027–43.844) *0.0469 Latrine vs Patio 0.745 (0.190–2.922) 0.6734 Blastocystis species 6 6 10 Latrine vs. Entry 1.552(0.423–5.688) 0.5074 Patio vs Entry 2.077(0.637–6.769) 0.2253 Latrine vs Patio 0.747(0.219–2.549) 0.6414 Cryptosporidium 0 0 0 N/A Entamoeba histolytica 0 0 0 N/A Giardia Intestinalis 2 2 0 Latrine vs. Entry 5.002(0.687–36.395) 0.1119 Patio vs Entry 0.193(0.008–4.449) 0.3039 Latrine vs Patio 0.745 (0.190–2.922) 0.6734 Necator americanus 0 0 0 N/A Strongyloides stercoralis 1 4 5 Latrine vs Entry 2.891(0.529–15.793) 0.2203 Patio vs Entry 2.591(0.510–13.170) 0.251 Latrine vs Patio 1.116(0.267–4.658) 0.8806 Taenia solium 0 0 0 N/A Toxocara canis 0 0 1 N/A Trichuris trichiura 1 1 2 Latrine vs Entry 1.410(0.130-15.329) 0.7777 Patio vs Entry 1.797(0.213–15.160) 0.5899 Latrine vs Patio 0.785 (0.091–6.772) 0.8254 Andabamba/Marabamba Parasite Entry Latrine Patio Odds Ratio P - value Any parasites 11 8 13 Latrine vs Entry 0.95 (0.17–5.305) 0.9536 Patio vs Entry 1.174 (0.244–5.656) 0.8415 Latrine vs Patio 0.809 (0.148–4.438) 0.8076 Any parasite not including Acanthamoeba 11 8 9 Latrine vs. Entry 0.95 (0.17–5.306) 0.9538 Patio vs Entry 0.437 (0.1–1.91) 0.2714 Latrine vs Patio 2.174 (0.434–10.891) 0.3451 Helminths 2 0 1 Latrine vs. Entry 0.235 (0.009–6.173) 0.3849 Patio vs Entry 0.491 (0.054–4.491) 0.5287 Latrine vs Patio 0.478 (0.016–14.637) 0.6725 Protozoa 11 8 13 Latrine vs. Entry 0.95 (0.17–5.305) 0.9536 Patio vs Entry 1.174 (0.244–5.656) 0.8415 Latrine vs Patio 0.809 (0.148–4.438) 0.8076 Protozoa not including Acanthamoeba 10 8 9 Latrine vs. Entry 1.346 (0.393–4.612) 0.6362 Patio vs Entry 1.471 (0.474–4.563) 0.5045 Latrine vs Patio 2.173 (0.434–10.89) 0.3451 Acanthamoeba species 1 4 8 Latrine vs. Entry 5.799 (0.695–48.424) 0.1045 Patio vs Entry 8.648 (1.194–62.639) *0.0327 Latrine vs Patio 0.671 (0.143–3.154) 0.6129 Ancylostoma species 0 0 1 N/A Ascaris lumbricoides 1 0 0 N/A Blastocystis species 10 8 9 Latrine vs Entry 1.272 (0.237–6.833) 0.7789 Patio vs Entry 0.585 (0.140–2.443) 0.4626 Latrine vs Patio 2.173 (0.434–10.890) 0.3451 Cryptosporidium 0 0 0 N/A Entamoeba histolytica 0 0 0 N/A Giardia Intestinalis 1 1 1 Latrine vs. Entry 1.381 (0.114–16.679) 0.7996 Patio vs Entry 0.879 (0.076–10.121) 0.9175 Latrine vs Patio 1.571 (0.132–18.767) 0.721 Necator americanus 0 0 0 N/A Strongyloides stercoralis 0 0 0 N/A Taenia solium 0 0 0 N/A Toxocara canis 1 0 0 N/A Trichuris trichiura 1 0 0 N/A The patios in Tingo María had significantly more species of all parasites than the entries (p = 0.0154). The patios also had significantly more species of all parasites, not including Acanthamoeba (p = 0.0273). Similar findings were seen in all helminth species (p = 0.0029) (Fig. 2). No significant parasite differences existed for specific locations in Andabamba/Marabamba (Supplemental Fig. 1) . Figure 2. In Tingo María: (A) The total number of different parasite species per outside built environment samples was significantly higher in the patios versus the entries (mean 0.571 vs. 1.11, p = 0.0154). (B) Not including Acanthamoeba , all parasite species were higher in the patios than the entries (mean 0.429 vs. 0.963, p 0.0273). (C) Helminths were the leading group of parasites in the patios versus the entries (mean 0.143 vs. 0.592, p = 0.0029) and significantly differed across entries, patios, and latrines (mean 0.5, p = 0.0128). There were no significant differences in the DNA concentrations of each parasite near the entries, patios, or latrines, respectively (Supplemental Table 2). Discussion The findings of this study reveal significant differences in soil parasite prevalence across distinct environmental and climatic conditions within the Peruvian regions of Tingo María, Andabamba/Marabamba, and Huánuco. This spatial variation in parasitic contamination underscores the role of environmental factors, such as climate and soil type, in shaping the distribution and density of STH and protozoan pathogens. Such environmental specificity has implications for parasitic risk assessments, especially as global climate change could further influence these distributions( 12 ). The odds ratio analysis revealed that Tingo María, characterized by a humid rainforest climate, showed higher contamination rates for helminths, particularly Ascaris lumbricoides and Trichuris trichiura , compared to the drier Andabamba/Marabamba region. This outcome aligns with previous literature, suggesting that moist and warm conditions are more conducive to the survival and transmission of STHs, as they favor the development and longevity of parasite eggs and larvae( 13 , 14 ). In contrast, protozoan species, specifically Blastocystis , were more prevalent in the arid Andabamba/Marabamba region, suggesting that certain protozoans may thrive in less humid environments or persist in humid microclimates( 15 , 16 ). Parasite prevalence and burden differed significantly within specific outdoor locations (patio, entry, and latrine) around homes, with the odds of encountering parasites being notably higher in patios compared to entries, especially helminths in the more humid Tingo María. Conversely, protozoa in the drier Andabamba/Marabamba region suggest that arid conditions may create distinct microenvironments that selectively favor certain protozoans( 17 , 18 ). This spatial distribution suggests that patios may provide more favorable conditions for certain parasites, likely due to increased exposure to soil, water retention, and organic debris, which can support the persistence and infectivity of helminth eggs and larvae, including the patio being a high traffic area at each outside built environment. These findings emphasize the importance of spatial considerations in parasitic risk assessments, as different outdoor areas around homes can have varying levels of contamination; this has important implications for targeted intervention strategies in high-risk zones. The study’s use of quantitative real-time PCR (qPCR) methodology contributed to the sensitivity and specificity of parasite detection, highlighting the presence of low parasite burdens that might be undetectable by traditional microscopy in stool samples ( 19 , 20 ). This increased sensitivity of qPCR is particularly valuable for assessing low-level environmental contamination, allowing for a more comprehensive understanding of parasitic presence and distribution across different microenvironments within households and parks( 11 , 21 ). This study also emphasizes the significance of cumulative parasite burdens in environmental reservoirs for public health by identifying multiple parasites within single samples and documenting polyparasitism( 5 ). While the high prevalence of parasitic DNA in soil samples from Tingo María and Andabamba/Marabamba suggests potential health risks for residents, especially in settings with inadequate sanitation, the findings also indicate that public health interventions must be tailored to the specific environmental characteristics of each region( 22 ). For instance, interventions in tropical, humid areas may need to prioritize STH control measures, whereas protozoan monitoring may be more critical in drier, highland environments. Furthermore, longitudinal studies could assess how ongoing climatic shifts—such as increasing temperatures, altered rainfall patterns, and extreme weather events—affect the dynamics of soil parasite communities over time( 23 ). This study is limited by its relatively small sample size, which, while providing valuable initial insights, may not fully capture the breadth of environmental variation in parasitic prevalence across Peru. Future studies with larger sample sizes and additional sites across varied ecosystems are needed to build a more comprehensive parasitic risk map. Also, the qPCR was initially developed for stool studies, and while the highest specificity was attempted by the primer/probe DNA combinations, many animal and non-pathogenic-to-human parasites have similar DNA sequences and may give a false positive result. In summary, the findings highlight the utility of qPCR as a diagnostic tool for environmental surveillance of parasites, offering a robust approach for monitoring contamination levels and assessing potential public health risks in diverse ecological contexts. This study supports the need for continued monitoring and adaptive public health strategies that consider environmental niches and changing climatic conditions to mitigate soil-transmitted parasite transmission effectively. Declarations Ethics approval and consent to participate. Residents of homes were invited to join the study and granted permission to collect soil. Consent for publication. Not applicable. Availability of data and materials. All data generated or analyzed during this study are included in this published article [and its supplementary information files]. Competing interests. The authors do not declare any competing interests. Authors’ contributions. CP, EJW, RM designed the study. ERM collected soil samples and cataloged sample sites. MDCR, EMS, LPPA, JJM, FEV, POH, EPP collected dirt samples and extracted parasite DNA. LEM, KEK, ASDO, MJVM, RM performed qPCR. ZZ performed statistical analysis. BS, RM wrote the initial manuscript, and all authors reviewed, revised, and accepted the final manuscript. Acknowledgments. The authors would like to thank the people of Peru for welcoming us into their homes. Also, thanks to Carlos Alberto Del Aguila and the Global Health Initiative in Peru (GHI-Peru) Association for helping coordinate field work and sampling. Funding declaration. This work had no declared financial support. References Organization WH. Soil-transmitted helminth infections. Mofid LS, Casapia M, Aguilar E, Silva H, Montresor A, Rahme E, et al. A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon. PLoS Negl Trop Dis. 2017;11(1):e0005098. Geisen S, Mitchell EAD, Adl S, Bonkowski M, Dunthorn M, Ekelund F, et al. Soil protists: a fertile frontier in soil biology research. FEMS Microbiol Rev. 2018;42(3):293-323. Mejia R, Vicuña Y, Broncano N, Sandoval C, Vaca M, Chico M, et al. A novel, multi-parallel, real-time polymerase chain reaction approach for eight gastrointestinal parasites provides improved diagnostic capabilities to resource-limited at-risk populations. Am J Trop Med Hyg. 2013;88(6):1041-7. Mejia R, Seco-Hidalgo V, Garcia-Ramon D, Calderon E, Lopez A, Cooper PJ. Detection of enteric parasite DNA in household and bed dust samples: potential for infection transmission. Parasit Vectors. 2020;13(1):141. Naceanceno KS, Matamoros G, Gabrie JA, Bottazzi ME, Sanchez A, Mejia R. 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O'Connell EM, Harrison S, Dahlstrom E, Nash T, Nutman TB. A Novel, Highly Sensitive Quantitative Polymerase Chain Reaction Assay for the Diagnosis of Subarachnoid and Ventricular Neurocysticercosis and for Assessing Responses to Treatment. Clin Infect Dis. 2020;70(9):1875-81. Crudo Blackburn C, Yan SM, McCormick D, Herrera LN, Iordanov RB, Bailey MD, et al. Parasitic Contamination of Soil in the Southern United States. Am J Trop Med Hyg. 2024;111(3):506-14. Al Noman Z, Tasnim S, Masud RI, Anika TT, Islam MS, Rahman A, et al. A systematic review on reverse-zoonosis: Global impact and changes in transmission patterns. J Adv Vet Anim Res. 2024;11(3):601-17. Munoz-Antoli C, Perez P, Pavon A, Toledo R, Esteban JG. High intestinal parasite infection detected in children from Region Autonoma Atlantico Norte (R.A.A.N.) of Nicaragua. Sci Rep. 2022;12(1):5872. Machicado JD, Marcos LA, Tello R, Canales M, Terashima A, Gotuzzo E. Diagnosis of soil-transmitted helminthiasis in an Amazonic community of Peru using multiple diagnostic techniques. Trans R Soc Trop Med Hyg. 2012;106(6):333-9. Ascuna-Durand K, Salazar-Sanchez RS, Castillo-Neyra R, Ballon-Echegaray J. Relative Frequency of Blastocystis Subtypes 1, 2, and 3 in Urban and Periurban Human Populations of Arequipa, Peru. Trop Med Infect Dis. 2020;5(4). Salazar-Sanchez RS, Ascuna-Durand K, Ballon-Echegaray J, Vasquez-Huerta V, Martinez-Barrios E, Castillo-Neyra R. Socio-Demographic Determinants Associated with Blastocystis Infection in Arequipa, Peru. Am J Trop Med Hyg. 2020;104(2):700-7. Ake-Canche B, Rodriguez-Bataz E, Esquivel-Pina JY, Tolentino-Loreto A, Arroyo-Escalante S, Martinez-Ocana J, et al. Can the genetic variability of Blastocystis sp. be associated with the climatic region of its human carriers? Infect Genet Evol. 2022;106:105383. Villegas-Gomez I, Martinez-Hernandez F, Urrea-Quezada A, Gonzalez-Diaz M, Durazo M, Hernandez J, et al. Comparison of the genetic variability of Blastocystis subtypes between human carriers from two contrasting climatic regions of Mexico. Infect Genet Evol. 2016;44:334-40. Cimino RO, Jeun R, Juarez M, Cajal PS, Vargas P, Echazu A, et al. Identification of human intestinal parasites affecting an asymptomatic peri-urban Argentinian population using multi-parallel quantitative real-time polymerase chain reaction. Parasit Vectors. 2015;8:380. Mejia R, Vicuna Y, Broncano N, Sandoval C, Vaca M, Chico M, et al. A novel, multi-parallel, real-time polymerase chain reaction approach for eight gastrointestinal parasites provides improved diagnostic capabilities to resource-limited at-risk populations. Am J Trop Med Hyg. 2013;88(6):1041-7. McKim S, Kopystynsky K, Wolf N, Akbar FA, Bottazzi ME, Hotez PJ, et al. Environmental Detection of Parasites in the Marginalized Paiute Reservations Compared to a Nearby Area. Am J Trop Med Hyg. 2024;110(3):457-9. McKenna ML, McAtee S, Bryan PE, Jeun R, Ward T, Kraus J, et al. Human Intestinal Parasite Burden and Poor Sanitation in Rural Alabama. Am J Trop Med Hyg. 2017;97(5):1623-8. Cuervo PF, Bargues MD, Artigas P, Buchon P, Angles R, Mas-Coma S. Global warming induced spread of the highest human fascioliasis hyperendemic area. Parasit Vectors. 2024;17(1):434. Additional Declarations No competing interests reported. Supplementary Files SupplementalSection.docx Cite Share Download PDF Status: Published Journal Publication published 05 Apr, 2025 Read the published version in Parasites & Vectors → Version 1 posted Editorial decision: Revision requested 04 Feb, 2025 Reviews received at journal 03 Feb, 2025 Reviews received at journal 10 Jan, 2025 Reviewers agreed at journal 15 Dec, 2024 Reviewers agreed at journal 15 Dec, 2024 Reviewers invited by journal 11 Dec, 2024 Editor assigned by journal 07 Dec, 2024 Submission checks completed at journal 07 Dec, 2024 First submitted to journal 05 Dec, 2024 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. 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Wetzel","email":"","orcid":"","institution":"Wabash College","correspondingAuthor":false,"prefix":"","firstName":"Eric","middleName":"J.","lastName":"Wetzel","suffix":""},{"id":391787119,"identity":"1d11689a-1f73-4ee2-95c7-47f14a28967c","order_by":16,"name":"Rojelio Mejia","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAq0lEQVRIiWNgGAWjYJACgwQGmwQwi4cELWkkagGCwyRoMZ92+EDBg5rzefzTDjA+eNtGhBaZ22kJBgnHbhdL3E5gNpxLjBYJ6RwDgwS224kbpBPYpHmJ05L/wSDh3zmQFvbfRGrJYTBIbDsAtoWZSC1pBgaJfclAvyQ2S845R5SW5GeGP77Z5fHPTj744U0ZEVqAgM0AQjM2EKceCJgfEK10FIyCUTAKRiYAAGLbNC0bB9mpAAAAAElFTkSuQmCC","orcid":"","institution":"Baylor College of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Rojelio","middleName":"","lastName":"Mejia","suffix":""}],"badges":[],"createdAt":"2024-12-06 02:08:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5590053/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5590053/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13071-025-06762-7","type":"published","date":"2025-04-05T15:57:53+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":73285336,"identity":"467b74f9-5dd3-447f-a906-27420dbe08d4","added_by":"auto","created_at":"2025-01-08 13:17:58","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":16860,"visible":true,"origin":"","legend":"\u003cp\u003eThe concentration of \u003cem\u003eBlastocystis\u003c/em\u003e DNA was significantly higher in Tingo María than in Andabamba/Marabamba, and there was a difference between all three sites (p \u0026lt; 0.0001).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5590053/v1/b015765f0886ea6f3ef7991b.png"},{"id":73285335,"identity":"9cf9140e-fe75-4d54-941e-219b0824714e","added_by":"auto","created_at":"2025-01-08 13:17:58","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":23751,"visible":true,"origin":"","legend":"\u003cp\u003eIn Tingo María: (A) The total number of different parasite species per outside built environment samples was significantly higher in the patios versus the entries (mean 0.571 vs. 1.11, p = 0.0154). (B) Not including \u003cem\u003eAcanthamoeba,\u003c/em\u003eall parasite species were higher in the patios than the entries (mean 0.429 vs. 0.963, p 0.0273). (C) Helminths were the leading group of parasites in the patios versus the entries (mean 0.143 vs. 0.592, p = 0.0029) and significantly differed across entries, patios, and latrines (mean 0.5, p = 0.0128).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5590053/v1/a747dfbf257faeabacc27fd3.png"},{"id":80082693,"identity":"4cbca304-f3f3-4c78-bed8-45465fdd8a0a","added_by":"auto","created_at":"2025-04-07 16:09:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1817445,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5590053/v1/d038239e-0fec-4d47-850f-fd831c7c72b3.pdf"},{"id":73285339,"identity":"081caa39-cd38-410a-a5b8-e5b14b64880a","added_by":"auto","created_at":"2025-01-08 13:17:59","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":131059,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementalSection.docx","url":"https://assets-eu.researchsquare.com/files/rs-5590053/v1/bdd8ac0e2e3dfce49ad0ff0d.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Parasite contamination of soil in distinct Peruvian locations and outside built environments","fulltext":[{"header":"Background","content":"\u003cp\u003eSoil-transmitted helminths (STH) and protozoan parasites can lead to significant health problems in tropical and subtropical areas worldwide, including malnutrition, anemia, and growth delays in children(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). These parasitic infections are caused by helminths: \u003cem\u003eAncylostoma\u003c/em\u003e species, \u003cem\u003eAscaris lumbricoides, Necator americanus, Strongyloides stercoralis\u003c/em\u003e, \u003cem\u003eTrichuris trichiura, Toxocara cati, Toxocara canis\u003c/em\u003e, \u003cem\u003eTaenia solium\u003c/em\u003e, and protozoa: \u003cem\u003eBlastocystis\u003c/em\u003e species, \u003cem\u003eEntamoeba histolytica, Giardia intestinalis\u003c/em\u003e, and \u003cem\u003eCryptosporidium\u003c/em\u003e species. Other soil-borne organisms, such as Acanthamoeba species, can be opportunistic human pathogens, the most environmentally prevalent free-living protozoa(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In terms of STH, upwards of 20% of the world's population (1.5\u0026nbsp;billion people) are infected, leading to an estimated 5.2\u0026nbsp;million disability-adjusted life years (DALYs)(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBased upon analysis of results from a standardized multi-parallel real-time quantitative PCR method(\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), risk assessments can be performed based on parasite soil contamination from environmental sites. We aimed to detect soil-transmitted helminth and protozoan parasite DNA in soil collected from two environmentally distinct areas in Peru: (01) Tingo Mar\u0026iacute;a, in the Selva Alta (\u0026ldquo;High Forest\u0026rdquo;) of Peru\u0026rsquo;s Eastern Piedmont (600m elevation), and (02) Andabamba/Marabamba (mountainous Andean highlands, 1900m elevation) and Hu\u0026aacute;nuco (mountainous basin Andean highlands, 1900m elevation). The area of Tingo Mar\u0026iacute;a is the gateway to the biodiverse Tingo Mar\u0026iacute;a National Park, and the city of Tingo Mar\u0026iacute;a lies in an intermediate geographic zone known as the \u003cem\u003eceja de selva\u003c/em\u003e (\u0026ldquo;eyebrow of the jungle\u0026rdquo;). This region has a tropical rainforest climate, typically hot, humid, and wet with no dry season. In contrast, the Andabamba/Marabamba area, including nearby Hu\u0026aacute;nuco, has a semi-arid climate, comprising parts of the Andean highlands and the High Jungle (mountain rim) regions. It has mild weather with an average annual temperature of 20\u0026deg;C (68\u0026deg;F). These sites were selected primarily because of their different soil environments to ascertain similarities and differences between helminth and protozoan soil prevalences and burdens. Climate change leading to soil environmental shifts will likely change these parasitic parameters, leading to consequences for parasite risk monitoring and subsequent health care approaches(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eAltogether, 198 samples were taken from 43 independent locations. At each location, 2\u0026ndash;7 soil samples were collected (76 from 14 houses in Tingo Mar\u0026iacute;a, 77 from 22 houses in Andabamba/Marabamba, and 45 from 7 parks in Hu\u0026aacute;nuco) from entries, patios, and outdoor latrines in the cases of Tingo Mar\u0026iacute;a and Andabamba/Marabamba. Households were randomly selected after obtaining consent from the owners. Latrines were limited-service latrines on the JMP sanitation ladder about 2 meters from the house's back door(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEach sample was processed at the Universidad Nacional Hermilio Valdiz\u0026aacute;n (UNHEVAL), Hu\u0026aacute;nuco, Peru. Up to 50g of wet soil was collected and stored at -20\u0026ordm;C until use. Each sample was weighed and resuspended to 45 mL in PBS (Alfa Asesar, Ward Hill, MA) containing 0.05% TWEEN (Sigma-Aldrich, St. Louis, MO) in a conical centrifuge tube. The samples were then shaken and inverted for 5 min and centrifuged at 500 g for 5 min. Supernatants were then decanted and discarded. A total of 10 mL of sugar solution (320 granulated sugar in 620 ml H\u003csub\u003e2\u003c/sub\u003e0, specific gravity of 1.30) was added to the pellets for parasite egg/larvae/cyst flotation. After shaking and inversion for 5 min, samples were centrifuged at 500 g for 5 min. Supernatants were then filtered through an MCE membrane (3.0 \u0026micro;M, MF-Millipore, Merck KGaA, Darmstadt, Germany), and the resultant filtrates were processed using FastDNA SPIN kit for soils (MP Biomedicals, Santa Ana, California, USA) as previously described(\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). An external DNA control, unrelated to the target parasites, was added to each sample before the purification step to allow for the quantification of the isolated DNA using PCR(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The eluent was spotted on 0.2 \u0026micro;m filter paper (Millipore, Merck KGaA, Darmstadt, Germany) and air-dried before being shipped at ambient temperature to Baylor College of Medicine, Houston, Texas, USA. Once received, DNA was extracted from the filter papers by overnight room temperature elution using 100 \u0026micro;l of elution buffer (MP Biomedicals).\u003c/p\u003e \u003cp\u003eRecovered DNA was analyzed by a multi-parallel quantitative polymerase chain reaction (qPCR) as previously described(\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), with the addition of a \u003cem\u003eTaenia solium\u003c/em\u003e (TsolR13) primer and probes(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Samples were run on a QS7 Pro Fast Real-time PCR System (Applied Biosystems, Waltham, Massachusetts, USA), and plasmid samples containing the target sequences were serially diluted to create the standard curve (duplicates) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Only a cycle threshold (Ct) of 38 or lower was considered positive for all parasites based on spiking studies using parasite egg/larvae/cyst and detection using qPCR\u003csup\u003e6,7\u003c/sup\u003e \u003cb\u003e(Supplemental Table\u0026nbsp;1)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eParasite copy numbers of DNA were calculated by linear regression, including those outside the dynamic range of the standard curve (Design and Analysis Software: 2.6.0, Thermo Fisher Scientific, USA) \u003cb\u003e(Supplemental Table\u0026nbsp;2)\u003c/b\u003e. The exogenous internal DNA control was used to assess the quality of DNA extraction and inhibition efficiency in all samples(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). To minimize the risk of cross-contamination during DNA extraction and qPCR, all reagents and samples were prepared in a Cleanprep Station (Mystaire, Creedmoor, NC). Singleplex qPCR was used on all samples to detect only one parasite in each 96-well plate. Each sample plate was validated with a positive (parasite DNA) and a negative (no DNA) control. A built environment was considered contaminated with a parasite if at least one sample from a given environmental build location/house or park was qPCR positive.\u003c/p\u003e \u003cp\u003eStatistical methods used for this study include the Mann-Whitney t-test and the Kruskal-Wallis ANOVA test to compare locations and parasite concentrations. Odds ratios were calculated by Logistic Regression, Fisher exact, or Firth's Bias-Reduced Logistic Regression when the sample size of one cell was less than five. Values were considered significant if p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence among all 3 sample areas (43 locations)\u003c/h2\u003e \u003cp\u003eOf the three sample areas, 93.0% (40/43) of houses and parks tested positive for at least one parasite, with 83.7% (36/43) showing polyparasitism. Up to seven different parasites were detected in an individual house or park site (range 0\u0026ndash;7). For STH, 53.5% (23/43) of houses and parks were positive with 14% of the sites (6/43) positive for \u003cem\u003eAncylostoma\u003c/em\u003e species, 16.3% (7/43) for \u003cem\u003eAscaris lumbricoides\u003c/em\u003e, 7\u003cem\u003e%\u003c/em\u003e (3/43) for \u003cem\u003eNecator americanus\u003c/em\u003e, 16.3% (7/43) for \u003cem\u003eStrongyloides stercoralis\u003c/em\u003e, 2.3% (1/43\u003cem\u003e) for Taenia solium\u003c/em\u003e, 4.7\u003cem\u003e%\u003c/em\u003e (2/43) for \u003cem\u003eToxocara canis\u003c/em\u003e and 16.3% (7/43) for \u003cem\u003eTrichuris trichiura\u003c/em\u003e. No \u003cem\u003eToxocara cati\u003c/em\u003e-positive sample was found. For protozoa, 88.4% (38/43) of houses and parks were contaminated. Among these, 58.1% (25/43) were positive for \u003cem\u003eAcanthamoeba\u003c/em\u003e species, 81.4% (35/43) were positive for \u003cem\u003eBlastocystis\u003c/em\u003e species, and 16.3% (7/43) were positive for \u003cem\u003eGiardia intestinalis.\u003c/em\u003e No \u003cem\u003eCryptosporidium\u003c/em\u003e species or \u003cem\u003eEntamoeba histolytica detection\u003c/em\u003e were observed \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e) (Supplemental Fig.\u0026nbsp;1, 2)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eConsidering the 198 samples taken in the 43 independent locations, 58.6% (116/198) tested positive for the presence of DNA from at least one parasite, 24.7% (49/198) showed polyparasitism and 41.4% (82/198) were negative for any tested parasite. Up to 6 different parasites were detected in a single sample (range 0\u0026ndash;6). Among STH, 19.2% (38/198) tested positive with 3.5% (7/198) positive for \u003cem\u003eAncylostoma\u003c/em\u003e species, 6.6% (13/198) for \u003cem\u003eAscaris lumbricoides\u003c/em\u003e, 1.5% (3/198) for \u003cem\u003eNecator americanus\u003c/em\u003e, 5.6% (11/198) for \u003cem\u003eStrongyloides stercoralis\u003c/em\u003e, 0.5% (1/198) for \u003cem\u003eTaenia solium\u003c/em\u003e, 1% (2/198) for \u003cem\u003eToxocara canis\u003c/em\u003e, and 3.5% (7/198) for \u003cem\u003eTrichuris trichiura.\u003c/em\u003e No \u003cem\u003eToxocara cati\u003c/em\u003e was observed. Among protozoa, 52.5% (104/198) of samples were positive, 24% (47/198) for \u003cem\u003eAcanthamoeba\u003c/em\u003e species, 38% (76/198) for \u003cem\u003eBlastocystis\u003c/em\u003e species, and 6% (12/198) for \u003cem\u003eGiardia intestinalis.\u003c/em\u003e No \u003cem\u003eCryptosporidium\u003c/em\u003e species or \u003cem\u003eEntamoeba histolytica\u003c/em\u003e were detected \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\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 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of parasites and DNA concentrations in the soil\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\u003eParasite/Location\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContamination Rate by Samples\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eContamination Rates by Sites\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDNA concentration in kg of soil (fg/\u0026micro;l), mean (range)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHELMINTHS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAncylostoma\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.5% (7/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0% (6/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.61 (0.249 to 36.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.6% (2/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.3% (2/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.5 (0.249 to 36.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.5% (5/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.2% (4/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.26 (0.442 to 12.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.6% (13/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.3% 7/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.58 (0.156 to 152.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.8% (12/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.9% (6/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.12 (0.179 to 152.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.3% (1/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.5% (1/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.116\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNecator americanus\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.5% (3/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0% (3/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.125 (0.0634 to 0.227)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.6% (2/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.1% (2/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.156 (0.0858 to 0.227)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.2% (1/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.3% (1/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0634\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eStrongyloides stercoralis\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.6% (11/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.3% (7/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.736 (0.0164 to 3.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.5% (11/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50% (7/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.736 (0.0164 to 3.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\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=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.5% (1/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.3%. (1/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e235.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.2% (1/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.3% (1/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e235.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eToxocara canis\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1% (2/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7% (2/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e133.8 (0.3841 to 267.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.3% (1/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1% (1/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e267.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.3% (1/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.5% (1/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.3841\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0% (0/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0% (0/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.5% (7/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.3% (7/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.25 (0.01627 to 104.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.3% (4/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.6% (4/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.16 (0.6382 to 41.58)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.3% (1/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.5% (1/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e104.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.4% (2/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.6% (2/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.01921 (0.01627 to 0.0222)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePROTOZOA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAcanthamoeba species\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.7% (47/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.1% (25/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2037 (0.00688 to 4.721)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.4% (14/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50% (7/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.16 (0.0098 to 4.721)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41.6% (32/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77.3% (17/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.1343 (0.00688 to 1.523)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.2% (1/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.3% (1/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.03401\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eBlastocystis\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38.4% (76/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.4% (35/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.99 (0.01424 to 719.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28.9% (22/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71.4% (10/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.02 (5.705 to 719.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.9% (50/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95.6% (21/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.175 (0.0558 to 91.34)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.9% (4/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.1% (4/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.41 (0.01424 to 81.52)\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=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.1% (12/198)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.6% (8/43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.87 (1.276 to 50.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.3 (4/76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.4% (3/14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.985 (2.589 to 5.510)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndabamba/Marabamba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.1% (7/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.2% (4/22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.26 (1.276 to 50.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHu\u0026aacute;nuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.2% (1/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.3% (1/7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.628\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\n\u003ch3\u003eParasite Prevalence in Tingo María\u003c/h3\u003e\n\u003cp\u003eOf the 14 houses sampled in Tingo Maria, 92.9% (13/14) were positive for at least one parasite, and 85.7% (12/14) were polyparasitic. Up to seven different parasites were observed in a single house (range 0\u0026ndash;7). 58% (44/76) of samples were positive for the DNA presence of at least one parasite, and 25% (19/76) of the samples had more than one parasite detected. Up to 6 different parasites were detected in a single sample (range 0\u0026ndash;6). Regarding STH, 85.7% (12/14) of houses were positive for at least one species. Specifically, 14% (2/14) were positive for \u003cem\u003eAncylostoma\u003c/em\u003e species, 42.9% (6/14) fo\u003cem\u003er Ascaris lumbricoides\u003c/em\u003e, 50% (7/14) for \u003cem\u003eStrongyloides stercoralis\u003c/em\u003e, 7.1% (1/14) for \u003cem\u003eToxocara canis\u003c/em\u003e, and 28.6% (4/14) for \u003cem\u003eTrichuris trichiura\u003c/em\u003e. For protozoans, 78.6% (11/14) houses tested positive, with 50% (7/14) for \u003cem\u003eAcanthamoeba species\u003c/em\u003e, 71.4% (10/14) for \u003cem\u003eBlastocystis species\u003c/em\u003e, and 21.4% (3/14) for \u003cem\u003eGiardia intestinalis\u003c/em\u003e \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eRegarding the 76 individual samples, 32.9% (25/76) were positive for STH: 2.6% (2/76) for \u003cem\u003eAncylostoma\u003c/em\u003e species, 15.8% (12/76) fo\u003cem\u003er Ascaris lumbricoides\u003c/em\u003e, 14.5% (11/76) for \u003cem\u003eStrongyloides stercoralis\u003c/em\u003e, 1.3% (1/76) for \u003cem\u003eToxocara canis\u003c/em\u003e and 5.3% (4/76) for \u003cem\u003eTrichuris trichiura.\u003c/em\u003e Among protozoans, 47.4% (36/76) of samples were positive: 18.4% (14/76) for \u003cem\u003eAcanthamoeba\u003c/em\u003e species, 28.9% (22/76) for \u003cem\u003eBlastocystis\u003c/em\u003e species, and 5.3% (4/76) for \u003cem\u003eGiardia intestinalis.\u003c/em\u003e No \u003cem\u003eNecator americanus, Taenia solium\u003c/em\u003e, \u003cem\u003eToxocara canis, Toxocara cati, Cryptosporidium\u003c/em\u003e species, or \u003cem\u003eEntamoeba histolytica\u003c/em\u003e was detected \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e\n\u003ch3\u003eParasite Prevalence in Andabamba/Marabamba\u003c/h3\u003e\n\u003cp\u003eRegarding the 22 houses sampled in A/M, 100% (22/22) were positive for at least one parasite; 95.5% (21/22) were polyparasitic. For the 77 samples from 22 houses, 83.1% (64/77) were positive for at least one parasite, and 36.4% (28/77) had more than one parasite detected. No parasites were detected in 16.8% (13/77) of the samples. Up to 4 different parasites were detected in a single house (range 1\u0026ndash;4) and up to 3 in a single sample (range 0\u0026ndash;3).\u003c/p\u003e \u003cp\u003eAmong STH, 36.4% (8/22) of houses were positive, with 18.2% (4/22) positive for \u003cem\u003eAncylostoma\u003c/em\u003e species, 4.5% (1/22) fo\u003cem\u003er Ascaris lumbricoides\u003c/em\u003e, 9.1% (2/22) for \u003cem\u003eNecator americanus\u003c/em\u003e, 4.5% (1/22) \u003cem\u003efor Toxocara canis\u003c/em\u003e and 4.5% (1/22) for \u003cem\u003eTrichuris trichiura.\u003c/em\u003e Among protozoa, 100% (22/22) of the houses were positive, with 77.3% (17/22) positive for \u003cem\u003eAcanthamoeba\u003c/em\u003e species, 95.6% (21/22) for \u003cem\u003eBlastocystis\u003c/em\u003e species, and 18.2% (4/22) for \u003cem\u003eGiardia intestinalis\u003c/em\u003e \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eAmong the 77 samples in A/M, 11.7% (9/77) were positive for STH, and 80.5% (62/77) were positive for protozoa. Among the STH, 6.5% (5/77) were positive for \u003cem\u003eAncylostoma\u003c/em\u003e species, 1% (1/77) for \u003cem\u003eAscaris lumbricoides\u003c/em\u003e, 2.6% (2/77) for \u003cem\u003eNecator americanus\u003c/em\u003e, 1% (1/77) for \u003cem\u003eToxocara canis\u003c/em\u003e and 1.3% \u003cem\u003e(\u003c/em\u003e1/77) \u003cem\u003eTrichuris trichiura.\u003c/em\u003e In terms of protozoa, 41.6% (32/77) of samples were positive for \u003cem\u003eAcanthamoeba species\u003c/em\u003e, 64.9% (50/77) for \u003cem\u003eBlastocystis species\u003c/em\u003e, and 9.1% (7/77\u003cem\u003e)\u003c/em\u003e for \u003cem\u003eGiardia intestinalis\u003c/em\u003e. No \u003cem\u003eCryptosporidium\u003c/em\u003e species, \u003cem\u003eEntamoeba histolytica, Taenia solium, Toxocara cati, or Strongyloides stercoralis\u003c/em\u003e were detected \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e\n\u003ch3\u003eParasite Prevalence in Huánuco\u003c/h3\u003e\n\u003cp\u003eA total of 45 samples were taken from 7 city parks in Hu\u0026aacute;nuco. 71.4% (5/7) of parks were positive for at least one parasite, 42.9% (3/7) showed polyparasitism, and up to 3 different parasites were detected in a single house (range 0\u0026ndash;3). 17.8% (8/45) of the samples were positive for at least one parasite; in 82.2% (37/45), no parasites were detected. 4.4% (2/45) of the samples showed polyparasitism. A maximum of 2 different parasites were observed in a sample (range 0\u0026ndash;2).\u003c/p\u003e \u003cp\u003eRegarding STH, 42.9% (3/7) of parks and 8.9% (4/45) samples were positive. 14.3% (1/7) of parks and 2.2% (1/45) of the samples were positive for \u003cem\u003eNecator americanus\u003c/em\u003e, 14.3% (1/7) parks) with 2% (1/45) samples positive for \u003cem\u003eTaenia solium\u003c/em\u003e and 28.6% (2/7) parks with 4.4% (2/45) positive for \u003cem\u003eTrichuris trichiura.\u003c/em\u003e Among protozoans, 71.4% (5/7) of parks and 13.3% (6/45) of the samples were positive. For \u003cem\u003eAcanthamoeba\u003c/em\u003e species, 14.3% (1/7) of the parks were positive, with 2.2% (1/45) samples being positive. For \u003cem\u003eBlastocystis\u003c/em\u003e species, 57.1% (4/7) of parks and 8.9% (4/45) samples were positive for \u003cem\u003eGiardia intestinalis\u003c/em\u003e, 14.3% (1/7) parks with 2.2% (1/45) samples were positive. No positive samples were observed for \u003cem\u003eAncylostoma\u003c/em\u003e species, \u003cem\u003eAscaris lumbricoides\u003c/em\u003e, \u003cem\u003eStrongyloides stercoralis, Toxocara canis, Toxocara cati, Cryptosporidium\u003c/em\u003e species, or \u003cem\u003eEntamoeba histolytica.\u003c/em\u003e\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e also presents the mean (range) parasite abundance regarding DNA concentration in kg of soil (fg/\u0026micro;l) across the three sites. In Tingo Mar\u0026iacute;a, the highest DNA concentration of STH parasites was observed for \u003cem\u003eAncylostoma\u003c/em\u003e species and \u003cem\u003eAscaris lumbricoides\u003c/em\u003e and among protozoans. \u003cem\u003eBlastocystis\u003c/em\u003e species had higher concentrations in Tingo Mar\u0026iacute;a versus Andabamba/Marabamba and Hu\u0026aacute;nuco (14.66 vs. 0.4312 vs. 0.2159 (fg/\u0026micro;l)/ kg soil, respectively, P\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. In Andabamba/Marabamba, the highest STH copy numbers were observed for \u003cem\u003eTrichuris trichiura\u003c/em\u003e with \u003cem\u003eGiardia intestinalis\u003c/em\u003e, the highest among protozoans. Differences in presence and abundance were observed between Tingo Mar\u0026iacute;a and Andabamba/Marabamba for \u003cem\u003eAncylostoma\u003c/em\u003e species, \u003cem\u003eToxocara canis, Trichuris trichiura\u003c/em\u003e, and all tested protozoans.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eThe odds of encountering a parasite in Tingo Mar\u0026iacute;a versus Andabamba/Marabamba houses\u003c/h2\u003e \u003cp\u003eUsing odd ratio analysis, comparisons between houses in Tingo Mar\u0026iacute;a and Andabamba/Marabamba revealed a significant difference for all helminths (p\u0026thinsp;=\u0026thinsp;0.0037) and protozoans (p\u0026thinsp;=\u0026thinsp;0.023) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Significant differences were found for helminths for \u003cem\u003eAscaris\u003c/em\u003e (p\u0026thinsp;=\u0026thinsp;0.0037) and \u003cem\u003eTrichuris\u003c/em\u003e (p\u0026thinsp;=\u0026thinsp;0.042), which were more prevalent in Tingo Mar\u0026iacute;a. Among protozoans, a positive association was observed only for \u003cem\u003eBlastocystis\u003c/em\u003e (p\u0026thinsp;=\u0026thinsp;0.0421), which was more prevalent in Andabamba/Marabamba. City parks and playgrounds of Hu\u0026aacute;nuco were not included in this comparison.\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 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe odds ratio for finding a parasite in Tingo Mar\u0026iacute;a versus Andabamba/Marabamba houses. * Indicates a significant difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParasite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTingo\u003c/p\u003e \u003cp\u003eMar\u0026iacute;a\u003c/p\u003e \u003cp\u003eHouses #\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAndabamba\u003c/p\u003e \u003cp\u003eMarabamba\u003c/p\u003e \u003cp\u003eHouses #\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOdds Ratio\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHelminths\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\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.50\u003c/p\u003e \u003cp\u003e(1.791 to 52.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.0037\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAncylostoma\u003c/em\u003e\u003c/p\u003e \u003cp\u003especies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003cp\u003e(0.1281 to 3.859)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.7598\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003elumbricoides\u003c/em\u003e\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\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.50\u003c/p\u003e \u003cp\u003e(1.829 to 195.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.0037\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNecator\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eamericanus\u003c/em\u003e\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\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eStrongyloides\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003estercoralis\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTaenia\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003esolium\u003c/em\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eToxocara\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003ecanis\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.615\u003c/p\u003e \u003cp\u003e(0.07940 to 31.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.7401\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eToxocara\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003ecati\u003c/em\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003etrichiura\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.4\u003c/p\u003e \u003cp\u003e(1.046 to 106.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.0421\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll Protozoan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0.00 to 0.6723)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.0233\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProtozoan not \u003cem\u003eAcanthamoeba\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\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\u003e0.1746\u003c/p\u003e \u003cp\u003e(0.01295 to 1.354)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.1161\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAcanthamoeba\u003c/em\u003e\u003c/p\u003e \u003cp\u003especies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2941\u003c/p\u003e \u003cp\u003e(0.06318 to 1.184)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0906\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eBlastocystis\u003c/em\u003e\u003c/p\u003e \u003cp\u003especies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\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\u003e8.4\u003c/p\u003e \u003cp\u003e(1.046 to 106.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*0.0421\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eGiardia\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eIntestinalis\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal parasites\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal parasites not \u003cem\u003eAcanthamoeba\u003c/em\u003e\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\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0.00 to 5.727)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.2036\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\n\u003ch3\u003eParasites in specific locations of outside built environments\u003c/h3\u003e\n\u003cp\u003eSoil from around the entries, patios, and latrines was collected outside each built environment/house in both Tingo Mar\u0026iacute;a and Andabamba/Marabamba. The odds of detecting any parasite were 3.297 times higher in the patios of Tingo Mar\u0026iacute;a houses compared to the entries (p\u0026thinsp;=\u0026thinsp;0.0397). For any helminth, there was a 5.85 times higher contamination in the patios vs entries (p\u0026thinsp;=\u0026thinsp;0.0065), with the patios having \u003cem\u003eAscaris lumbricoides\u003c/em\u003e 6.7 times higher (p\u0026thinsp;=\u0026thinsp;0.0469) than the entries \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. In Andabamba/Marabamba, \u003cem\u003eAcanthamoeba\u003c/em\u003e species increased 8.648 times in the patios versus the entries for houses (p\u0026thinsp;=\u0026thinsp;0.0327).\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 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe odds ratio for finding a parasite in specific locations outside built environments in Tingo Mar\u0026iacute;a versus Andabamba/Marabamba houses. * Indicates a significant result\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eTingo Mar\u0026iacute;a\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParasite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEntry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLatrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePatio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eOdds Ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP - value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAny parasites\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.41 (0.446\u0026ndash;4.464)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5587\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.297 (1.058\u0026ndash;10.276)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e*0.0397\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.428 (0.125\u0026ndash;1.466)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1766\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAny parasite not including\u003c/b\u003e \u003cb\u003eAcanthamoeba\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.2 (0.368\u0026ndash;3.914)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.7625\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.618 (0.881\u0026ndash;7.783)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0834\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.458 (0.141\u0026ndash;1.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1946\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eHelminths\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.025 (0.767\u0026ndash;11.932)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.849 (1.64-20.858)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e*0.0065\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.517 (0.158\u0026ndash;1.693)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.2758\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eProtozoa\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.889 (0.591\u0026ndash;6.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.2836\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.664 (0.571\u0026ndash;4.853)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.3508\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.135 (0.356\u0026ndash;3.621)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8307\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eProtozoa not including\u003c/b\u003e \u003cb\u003eAcanthamoeba\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.346 (0.393\u0026ndash;4.612)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.6362\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.471 (0.474\u0026ndash;4.563)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.915 (0.274\u0026ndash;3.057)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8857\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eAcanthamoeba species\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.571(0.617\u0026ndash;10.708)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1944\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.043(0.233\u0026ndash;4.673)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9556\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAncylostoma species\u003c/b\u003e\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\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAscaris lumbricoides\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.002(0.687\u0026ndash;36.395)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1119\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.710(1.027\u0026ndash;43.844)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e*0.0469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.745 (0.190\u0026ndash;2.922)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.6734\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eBlastocystis species\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.552(0.423\u0026ndash;5.688)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.077(0.637\u0026ndash;6.769)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.2253\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.747(0.219\u0026ndash;2.549)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.6414\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCryptosporidium\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEntamoeba histolytica\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eGiardia\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eIntestinalis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.002(0.687\u0026ndash;36.395)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1119\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.193(0.008\u0026ndash;4.449)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.3039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.745 (0.190\u0026ndash;2.922)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.6734\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNecator\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eamericanus\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eStrongyloides\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003estercoralis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.891(0.529\u0026ndash;15.793)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.2203\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.591(0.510\u0026ndash;13.170)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.116(0.267\u0026ndash;4.658)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8806\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTaenia\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003esolium\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eToxocara \u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ecanis\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eTrichuris\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003etrichiura\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.410(0.130-15.329)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.7777\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.797(0.213\u0026ndash;15.160)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5899\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.785 (0.091\u0026ndash;6.772)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8254\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAndabamba/Marabamba\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParasite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEntry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLatrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePatio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eOdds Ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP - value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAny parasites\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.95 (0.17\u0026ndash;5.305)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9536\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.174 (0.244\u0026ndash;5.656)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8415\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.809 (0.148\u0026ndash;4.438)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8076\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAny parasite not including\u003c/b\u003e \u003cb\u003eAcanthamoeba\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.95 (0.17\u0026ndash;5.306)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9538\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.437 (0.1\u0026ndash;1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.2714\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.174 (0.434\u0026ndash;10.891)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.3451\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eHelminths\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.235 (0.009\u0026ndash;6.173)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.3849\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.491 (0.054\u0026ndash;4.491)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5287\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.478 (0.016\u0026ndash;14.637)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.6725\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eProtozoa\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.95 (0.17\u0026ndash;5.305)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9536\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.174 (0.244\u0026ndash;5.656)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8415\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.809 (0.148\u0026ndash;4.438)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8076\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eProtozoa not including\u003c/b\u003e \u003cb\u003eAcanthamoeba\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.346 (0.393\u0026ndash;4.612)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.6362\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.471 (0.474\u0026ndash;4.563)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.173 (0.434\u0026ndash;10.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.3451\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAcanthamoeba\u003c/b\u003e \u003cb\u003especies\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.799 (0.695\u0026ndash;48.424)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.648 (1.194\u0026ndash;62.639)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e*0.0327\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.671 (0.143\u0026ndash;3.154)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.6129\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAncylostoma species\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAscaris lumbricoides\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eBlastocystis species\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.272 (0.237\u0026ndash;6.833)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.7789\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.585 (0.140\u0026ndash;2.443)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.4626\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.173 (0.434\u0026ndash;10.890)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.3451\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCryptosporidium\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEntamoeba histolytica\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eGiardia\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eIntestinalis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs. Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.381 (0.114\u0026ndash;16.679)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.7996\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatio vs Entry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.879 (0.076\u0026ndash;10.121)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9175\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLatrine vs Patio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.571 (0.132\u0026ndash;18.767)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.721\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNecator\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eamericanus\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStrongyloides\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003estercoralis\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTaenia\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003esolium\u003c/b\u003e\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\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eToxocara \u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ecanis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTrichuris\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003etrichiura\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eN/A\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 patios in Tingo Mar\u0026iacute;a had significantly more species of all parasites than the entries (p\u0026thinsp;=\u0026thinsp;0.0154). The patios also had significantly more species of all parasites, not including \u003cem\u003eAcanthamoeba\u003c/em\u003e (p\u0026thinsp;=\u0026thinsp;0.0273). Similar findings were seen in all helminth species (p\u0026thinsp;=\u0026thinsp;0.0029) \u003cb\u003e(Fig.\u0026nbsp;2).\u003c/b\u003e No significant parasite differences existed for specific locations in Andabamba/Marabamba \u003cb\u003e(Supplemental Fig.\u0026nbsp;1)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 2.\u003c/b\u003e In Tingo Mar\u0026iacute;a: (A) The total number of different parasite species per outside built environment samples was significantly higher in the patios versus the entries (mean 0.571 vs. 1.11, p\u0026thinsp;=\u0026thinsp;0.0154). (B) Not including \u003cem\u003eAcanthamoeba\u003c/em\u003e, all parasite species were higher in the patios than the entries (mean 0.429 vs. 0.963, p 0.0273). (C) Helminths were the leading group of parasites in the patios versus the entries (mean 0.143 vs. 0.592, p\u0026thinsp;=\u0026thinsp;0.0029) and significantly differed across entries, patios, and latrines (mean 0.5, p\u0026thinsp;=\u0026thinsp;0.0128).\u003c/p\u003e \u003cp\u003eThere were no significant differences in the DNA concentrations of each parasite near the entries, patios, or latrines, respectively \u003cb\u003e(Supplemental Table\u0026nbsp;2).\u003c/b\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings of this study reveal significant differences in soil parasite prevalence across distinct environmental and climatic conditions within the Peruvian regions of Tingo Mar\u0026iacute;a, Andabamba/Marabamba, and Hu\u0026aacute;nuco. This spatial variation in parasitic contamination underscores the role of environmental factors, such as climate and soil type, in shaping the distribution and density of STH and protozoan pathogens. Such environmental specificity has implications for parasitic risk assessments, especially as global climate change could further influence these distributions(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe odds ratio analysis revealed that Tingo Mar\u0026iacute;a, characterized by a humid rainforest climate, showed higher contamination rates for helminths, particularly \u003cem\u003eAscaris lumbricoides\u003c/em\u003e and \u003cem\u003eTrichuris trichiura\u003c/em\u003e, compared to the drier Andabamba/Marabamba region. This outcome aligns with previous literature, suggesting that moist and warm conditions are more conducive to the survival and transmission of STHs, as they favor the development and longevity of parasite eggs and larvae(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). In contrast, protozoan species, specifically \u003cem\u003eBlastocystis\u003c/em\u003e, were more prevalent in the arid Andabamba/Marabamba region, suggesting that certain protozoans may thrive in less humid environments or persist in humid microclimates(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Parasite prevalence and burden differed significantly within specific outdoor locations (patio, entry, and latrine) around homes, with the odds of encountering parasites being notably higher in patios compared to entries, especially helminths in the more humid Tingo Mar\u0026iacute;a. Conversely, protozoa in the drier Andabamba/Marabamba region suggest that arid conditions may create distinct microenvironments that selectively favor certain protozoans(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This spatial distribution suggests that patios may provide more favorable conditions for certain parasites, likely due to increased exposure to soil, water retention, and organic debris, which can support the persistence and infectivity of helminth eggs and larvae, including the patio being a high traffic area at each outside built environment. These findings emphasize the importance of spatial considerations in parasitic risk assessments, as different outdoor areas around homes can have varying levels of contamination; this has important implications for targeted intervention strategies in high-risk zones.\u003c/p\u003e \u003cp\u003eThe study\u0026rsquo;s use of quantitative real-time PCR (qPCR) methodology contributed to the sensitivity and specificity of parasite detection, highlighting the presence of low parasite burdens that might be undetectable by traditional microscopy in stool samples (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). This increased sensitivity of qPCR is particularly valuable for assessing low-level environmental contamination, allowing for a more comprehensive understanding of parasitic presence and distribution across different microenvironments within households and parks(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). This study also emphasizes the significance of cumulative parasite burdens in environmental reservoirs for public health by identifying multiple parasites within single samples and documenting polyparasitism(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile the high prevalence of parasitic DNA in soil samples from Tingo Mar\u0026iacute;a and Andabamba/Marabamba suggests potential health risks for residents, especially in settings with inadequate sanitation, the findings also indicate that public health interventions must be tailored to the specific environmental characteristics of each region(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). For instance, interventions in tropical, humid areas may need to prioritize STH control measures, whereas protozoan monitoring may be more critical in drier, highland environments. Furthermore, longitudinal studies could assess how ongoing climatic shifts\u0026mdash;such as increasing temperatures, altered rainfall patterns, and extreme weather events\u0026mdash;affect the dynamics of soil parasite communities over time(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study is limited by its relatively small sample size, which, while providing valuable initial insights, may not fully capture the breadth of environmental variation in parasitic prevalence across Peru. Future studies with larger sample sizes and additional sites across varied ecosystems are needed to build a more comprehensive parasitic risk map. Also, the qPCR was initially developed for stool studies, and while the highest specificity was attempted by the primer/probe DNA combinations, many animal and non-pathogenic-to-human parasites have similar DNA sequences and may give a false positive result.\u003c/p\u003e \u003cp\u003eIn summary, the findings highlight the utility of qPCR as a diagnostic tool for environmental surveillance of parasites, offering a robust approach for monitoring contamination levels and assessing potential public health risks in diverse ecological contexts. This study supports the need for continued monitoring and adaptive public health strategies that consider environmental niches and changing climatic conditions to mitigate soil-transmitted parasite transmission effectively.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate.\u0026nbsp;\u003c/strong\u003eResidents of homes were invited to join the study and granted permission to collect soil.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication.\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials.\u0026nbsp;\u003c/strong\u003eAll data generated or analyzed during this study are included in this published article [and its supplementary information files].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests.\u0026nbsp;\u003c/strong\u003eThe authors do not declare any competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions.\u0026nbsp;\u003c/strong\u003eCP, EJW, RM designed the study. ERM collected soil samples and cataloged sample sites. MDCR, EMS, LPPA, JJM, FEV, POH, EPP collected dirt samples and extracted parasite DNA. LEM, KEK, ASDO, MJVM, RM performed qPCR. ZZ performed statistical analysis. BS, RM wrote the initial manuscript, and all authors reviewed, revised, and accepted the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments.\u0026nbsp;\u003c/strong\u003eThe authors would like to thank the people of Peru for welcoming us into their homes. Also, thanks to Carlos Alberto Del Aguila and the Global Health Initiative in Peru (GHI-Peru) Association for helping coordinate field work and sampling.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding declaration.\u0026nbsp;\u003c/strong\u003eThis work had no declared financial support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOrganization WH. Soil-transmitted helminth infections.\u003c/li\u003e\n\u003cli\u003eMofid LS, Casapia M, Aguilar E, Silva H, Montresor A, Rahme E, et al. A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon. PLoS Negl Trop Dis. 2017;11(1):e0005098.\u003c/li\u003e\n\u003cli\u003eGeisen S, Mitchell EAD, Adl S, Bonkowski M, Dunthorn M, Ekelund F, et al. Soil protists: a fertile frontier in soil biology research. FEMS Microbiol Rev. 2018;42(3):293-323.\u003c/li\u003e\n\u003cli\u003eMejia R, Vicu\u0026ntilde;a Y, Broncano N, Sandoval C, Vaca M, Chico M, et al. A novel, multi-parallel, real-time polymerase chain reaction approach for eight gastrointestinal parasites provides improved diagnostic capabilities to resource-limited at-risk populations. Am J Trop Med Hyg. 2013;88(6):1041-7.\u003c/li\u003e\n\u003cli\u003eMejia R, Seco-Hidalgo V, Garcia-Ramon D, Calderon E, Lopez A, Cooper PJ. Detection of enteric parasite DNA in household and bed dust samples: potential for infection transmission. Parasit Vectors. 2020;13(1):141.\u003c/li\u003e\n\u003cli\u003eNaceanceno KS, Matamoros G, Gabrie JA, Bottazzi ME, Sanchez A, Mejia R. Use of Multi-Parallel Real-Time Quantitative PCR to Determine Blastocystis Prevalence and Association with Other Gastrointestinal Parasite Infection in a Rural Honduran Location. Am J Trop Med Hyg. 2020;102(6):1373-5.\u003c/li\u003e\n\u003cli\u003eMejia R, Slatko B, Almazan C, Cimino R, Krolewiecki A, Duran NM, et al. Molecular Testing of Environmental Samples as a Potential Source to Estimate Parasite Infection. Trop Med Infect Dis. 2024;9(10).\u003c/li\u003e\n\u003cli\u003eGirmay AM, Weldetinsae A, Mengesha SD, Adugna EA, Alemu ZA, Wagari B, et al. Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study. BMJ Open. 2023;13(7):e071296.\u003c/li\u003e\n\u003cli\u003eDeer DM, Lampel KA, Gonzalez-Escalona N. A versatile internal control for use as DNA in real-time PCR and as RNA in real-time reverse transcription PCR assays. Lett Appl Microbiol. 2010;50(4):366-72.\u003c/li\u003e\n\u003cli\u003eO\u0026apos;Connell EM, Harrison S, Dahlstrom E, Nash T, Nutman TB. A Novel, Highly Sensitive Quantitative Polymerase Chain Reaction Assay for the Diagnosis of Subarachnoid and Ventricular Neurocysticercosis and for Assessing Responses to Treatment. Clin Infect Dis. 2020;70(9):1875-81.\u003c/li\u003e\n\u003cli\u003eCrudo Blackburn C, Yan SM, McCormick D, Herrera LN, Iordanov RB, Bailey MD, et al. Parasitic Contamination of Soil in the Southern United States. Am J Trop Med Hyg. 2024;111(3):506-14.\u003c/li\u003e\n\u003cli\u003eAl Noman Z, Tasnim S, Masud RI, Anika TT, Islam MS, Rahman A, et al. A systematic review on reverse-zoonosis: Global impact and changes in transmission patterns. J Adv Vet Anim Res. 2024;11(3):601-17.\u003c/li\u003e\n\u003cli\u003eMunoz-Antoli C, Perez P, Pavon A, Toledo R, Esteban JG. High intestinal parasite infection detected in children from Region Autonoma Atlantico Norte (R.A.A.N.) of Nicaragua. Sci Rep. 2022;12(1):5872.\u003c/li\u003e\n\u003cli\u003eMachicado JD, Marcos LA, Tello R, Canales M, Terashima A, Gotuzzo E. Diagnosis of soil-transmitted helminthiasis in an Amazonic community of Peru using multiple diagnostic techniques. Trans R Soc Trop Med Hyg. 2012;106(6):333-9.\u003c/li\u003e\n\u003cli\u003eAscuna-Durand K, Salazar-Sanchez RS, Castillo-Neyra R, Ballon-Echegaray J. Relative Frequency of Blastocystis Subtypes 1, 2, and 3 in Urban and Periurban Human Populations of Arequipa, Peru. Trop Med Infect Dis. 2020;5(4).\u003c/li\u003e\n\u003cli\u003eSalazar-Sanchez RS, Ascuna-Durand K, Ballon-Echegaray J, Vasquez-Huerta V, Martinez-Barrios E, Castillo-Neyra R. Socio-Demographic Determinants Associated with Blastocystis Infection in Arequipa, Peru. Am J Trop Med Hyg. 2020;104(2):700-7.\u003c/li\u003e\n\u003cli\u003eAke-Canche B, Rodriguez-Bataz E, Esquivel-Pina JY, Tolentino-Loreto A, Arroyo-Escalante S, Martinez-Ocana J, et al. Can the genetic variability of Blastocystis sp. be associated with the climatic region of its human carriers? Infect Genet Evol. 2022;106:105383.\u003c/li\u003e\n\u003cli\u003eVillegas-Gomez I, Martinez-Hernandez F, Urrea-Quezada A, Gonzalez-Diaz M, Durazo M, Hernandez J, et al. Comparison of the genetic variability of Blastocystis subtypes between human carriers from two contrasting climatic regions of Mexico. Infect Genet Evol. 2016;44:334-40.\u003c/li\u003e\n\u003cli\u003eCimino RO, Jeun R, Juarez M, Cajal PS, Vargas P, Echazu A, et al. Identification of human intestinal parasites affecting an asymptomatic peri-urban Argentinian population using multi-parallel quantitative real-time polymerase chain reaction. Parasit Vectors. 2015;8:380.\u003c/li\u003e\n\u003cli\u003eMejia R, Vicuna Y, Broncano N, Sandoval C, Vaca M, Chico M, et al. A novel, multi-parallel, real-time polymerase chain reaction approach for eight gastrointestinal parasites provides improved diagnostic capabilities to resource-limited at-risk populations. Am J Trop Med Hyg. 2013;88(6):1041-7.\u003c/li\u003e\n\u003cli\u003eMcKim S, Kopystynsky K, Wolf N, Akbar FA, Bottazzi ME, Hotez PJ, et al. Environmental Detection of Parasites in the Marginalized Paiute Reservations Compared to a Nearby Area. Am J Trop Med Hyg. 2024;110(3):457-9.\u003c/li\u003e\n\u003cli\u003eMcKenna ML, McAtee S, Bryan PE, Jeun R, Ward T, Kraus J, et al. Human Intestinal Parasite Burden and Poor Sanitation in Rural Alabama. Am J Trop Med Hyg. 2017;97(5):1623-8.\u003c/li\u003e\n\u003cli\u003eCuervo PF, Bargues MD, Artigas P, Buchon P, Angles R, Mas-Coma S. Global warming induced spread of the highest human fascioliasis hyperendemic area. Parasit Vectors. 2024;17(1):434.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"parasites-and-vectors","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"parv","sideBox":"Learn more about [Parasites \u0026 Vectors](http://parasitesandvectors.biomedcentral.com/)","snPcode":"13071","submissionUrl":"https://submission.nature.com/new-submission/13071/3","title":"Parasites \u0026 Vectors","twitterHandle":"@bugbittentweets","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"parasitic DNA, soil, qPCR","lastPublishedDoi":"10.21203/rs.3.rs-5590053/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5590053/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSoil is a reservoir for parasites that can affect human and animal health, especially in tropical regions where soil-transmitted helminths and protozoa thrive. Understanding how environmental factors like temperature, humidity, and soil type strongly influence parasite distribution is essential, particularly given how climate change may intensify their impacts, altering parasite habitats and increasing transmission risks. The primary goal of this study was to understand how environmental conditions affect soil parasite prevalence and diversity.\u003c/p\u003e\u003ch2\u003eMethodology:\u003c/h2\u003e \u003cp\u003eA total of 198 soil samples from 43 locations across three Peruvian regions\u0026mdash;Tingo Mar\u0026iacute;a (TM) (Amazon rainforest), Andabamba/Marabamba (A/M) (Andean highlands), and Hu\u0026aacute;nuco city parks\u0026mdash;were analyzed using multi-parallel quantitative real-time PCR (qPCR) to detect soil-transmitted helminths (STH) and protozoan DNA from entry, patio, and latrine sites.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eParasites were detected in 93% of locations, with 84% showing polyparasitism. TM houses had a higher odds ratio (OR) of contamination with \u003cem\u003eAscaris lumbricoides\u003c/em\u003e (16.5) and \u003cem\u003eTrichuris trichiura\u003c/em\u003e (8.4) compared to those in A/M (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). TM also showed significantly higher odds of parasite presence in patios compared to entries, particularly for helminths; patios had an OR of 5.8 relative to entries (p\u0026thinsp;=\u0026thinsp;0.006). A/M had higher protozoan prevalence with \u003cem\u003eBlastocystis\u003c/em\u003e species, with a greater odd of 8.4 (p\u0026thinsp;=\u0026thinsp;0.042) to TM. A/M had an OR of \u003cem\u003eAcanthamoeba species\u003c/em\u003e 8.6 in patios versus entries (p\u0026thinsp;=\u0026thinsp;0.0327), indicating a niche favoring protozoans in these arid conditions. TM had significantly more parasite species (p\u0026thinsp;=\u0026thinsp;0.0154), with helminth species significantly higher in the patio vs. entry (p\u0026thinsp;=\u0026thinsp;0.0029).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe observed variability in soil parasite prevalence between tropical rainforest and highland regions highlights the influence of environmental niches on parasite distribution, which may shift further due to climate change. This study demonstrates a sensitive approach to monitoring environmental contamination with parasites by leveraging qPCR. The findings underscore the importance of ecological surveillance for assessing parasitic transmission risks, which is crucial for guiding public health interventions, especially as environmental changes accelerate.\u003c/p\u003e","manuscriptTitle":"Parasite contamination of soil in distinct Peruvian locations and outside built environments","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-08 13:17:54","doi":"10.21203/rs.3.rs-5590053/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-02-05T03:27:09+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-03T08:15:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-11T00:04:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"40251200035925429386069353920834840232","date":"2024-12-16T01:05:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"6635694570809519483822296988568168482","date":"2024-12-15T23:17:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-12-11T15:44:24+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-12-07T07:41:54+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-12-07T07:37:12+00:00","index":"","fulltext":""},{"type":"submitted","content":"Parasites \u0026 Vectors","date":"2024-12-06T01:56:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"parasites-and-vectors","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"parv","sideBox":"Learn more about [Parasites \u0026 Vectors](http://parasitesandvectors.biomedcentral.com/)","snPcode":"13071","submissionUrl":"https://submission.nature.com/new-submission/13071/3","title":"Parasites \u0026 Vectors","twitterHandle":"@bugbittentweets","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"25931078-d488-4f57-bc00-7bd97527bd40","owner":[],"postedDate":"January 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-04-07T16:08:05+00:00","versionOfRecord":{"articleIdentity":"rs-5590053","link":"https://doi.org/10.1186/s13071-025-06762-7","journal":{"identity":"parasites-and-vectors","isVorOnly":false,"title":"Parasites \u0026 Vectors"},"publishedOn":"2025-04-05 15:57:53","publishedOnDateReadable":"April 5th, 2025"},"versionCreatedAt":"2025-01-08 13:17:54","video":"","vorDoi":"10.1186/s13071-025-06762-7","vorDoiUrl":"https://doi.org/10.1186/s13071-025-06762-7","workflowStages":[]},"version":"v1","identity":"rs-5590053","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5590053","identity":"rs-5590053","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}