Abstract
BACKGROUND: Intestinal parasitic infections (IPIs) remain a major public health concern in low-income settings where sanitation and hygiene are inadequate. Schoolchildren are among the most vulnerable groups, yet limited data exist on the prevalence and determinants of IPIs in Afghanistan. This study aimed to assess the prevalence of IPIs and identify associated factors among schoolchildren in Jalalabad city. METHODS: A cross-sectional study was conducted between May and October 2023 among 603 students aged 6-15 years from eight randomly selected schools in Jalalabad. Stool samples were examined using direct microscopy and the formalin-ether concentration technique. Demographic and behavioral data were collected using structured questionnaires. Logistic regression analyses were performed to identify factors associated with IPIs. RESULTS: The prevalence of IPIs was 48.8% (294/603). The most frequently detected parasites were Giardia lamblia (35.8%), Entamoeba histolytica (34.3%), Hymenolepis nana (22.5%), Ascaris lumbricoides (5.3%), Enterobius vermicularis (1.8%), and Trichuris trichiura (0.3%). Multivariable analysis identified significant associations with older age (13-15 years) (AOR: 3.22; 95% CI: 1.70-6.10), frequent street food consumption (AOR: 2.45; 95% CI: 1.30-4.58), poor handwashing after toilet use (AOR: 5.37; 95% CI: 2.34-12.31), poor handwashing before eating (AOR: 6.65; 95% CI: 3.89-11.37), never washing hands upon returning home (AOR: 4.52; 95% CI: 2.66-7.67), consumption of unwashed raw vegetables and fruits (AOR: 28.83; 95% CI: 5.50-151.03), and poor nail hygiene (AOR: 5.11; 95% CI: 2.16-12.11). CONCLUSIONS: Nearly half of the schoolchildren in Jalalabad were infected with intestinal parasites, indicating a substantial public health burden. Targeted interventions-including hygiene education, improved sanitation, and regular school-based deworming programs-are urgently needed to reduce the risk of infection in this population.