Prevalence of Intestinal Parasitism and Associated Risk Factors in Rural and Urban Areas of Southern Algeria: a Four-year Community Based Study

Abstract Background: Intestinal parasitic infections are amongst the most common infections worldwide and have been identified as one of the most significant causes of morbidity and mortality among disadvantaged populations. This community based study was conducted to assess the magnitude and pattern of intestinal parasitism and to identify the key risk factors associated with intestinal parasitic infections in Laghouat province, south Algeria.Methods: Stool samples were collected from 2277 symptomatic and asymptomatic patients aged 1-89 years old. Structured questionnaire were used to identify environmental, socio demographic and behavioral factors. Stool specimens were collected and examined for intestinal parasitic infection. Results: More than 33% of participants were found to be infected for at least one protozoan and/or helminth parasite. Of these, the most common parasites were Blastocystis spp. (17.79%), followed by Entamoeba histolytica/dispar (8.78%), Giardia intestinalis (4.22%), Entamoeba coli (4.08%) and more rarely Endolimax nana, Cryptosporidium spp, Trichomonas intestinalis, Enterobius vermicularis, Taenia spp., and a single case of Trichuris trichiura. Multivariate analysis revealed significant associations between prevalence and species richness of combined protozoan parasites and contact with animal, living in rural areas and relying primarily on tap water, particularly in young individuals. Analysis of temporal consistency showed a high rate of infection in rural locations in the spring of 2018 and a firm relationship between school children and tap water was also detected. Conclusions: The high prevalence of intestinal parasitic infections among the Laghouat population, with identification of several risk factors indicates that parasitic infections are important public health problems. Therefore, several strategies are recommended in order to effectively reduce these infections including good animal husbandry practices, health education focused on good personal hygiene practices especially for school children, availability of safe drinking water and adequate sanitation.