Prevalence and Risk Factors of Intestinal Parasitic Infection in Under-Five Children With Malnutrition: A Hospital Based Cross-Sectional Study

Background: Intestinal parasitic infections (IPIs) and malnutrition in under-five children contribute substantially to developing countries' childhood morbidity and mortality. This study assessed the prevalence and profile of IPI in under-five children and compared them with nutritional status and other socioeconomic factors. Methods: Anthropometric indices were used for checking the nutritional status of under-five children. Malnutrition was graded into four grades (I-IV) based on the Indian Academy of Pediatrics advocated Weight-for-Age criteria. Children whose Height-for-Age and Weight-for-Height were <-2, standard deviations were regarded as stunted and wasted, respectively. Stool samples were examined by direct wet mount (normal saline and iodine) and formol-ethyl acetate concentration technique to detect parasitic cyst and ova. Stool smears were made directly from the specimen and after concentration and stained by kinyoun's stain. Subsequently, the association of undernutrition was assessed with intestinal IPI using the Chi-square test. Results: The overall prevalence of Grade I, II, III, and IV malnutrition was 52%, 31.7%, 12.2%, and 4.1% while stunting and wasting !Pis were present in 60.2% and 36.6%, respectively. !Pis were present in 47.2%, and 11.4% showed polyparasitism. Soil-transmitted helminths were found to be the commonest (Ascaris lumbricoldes: 21.1%; Trichuris trichiura: 13.0%; and hookworms: 8.1%) followed by the intestinal protozoa (Enterobius vermicularis: 7.3, Giardia lamblia: 6.5, and Cryptosporidium spp.: 2.4%). Increasing age upto 5 years. improper excreta disposal, low level of maternal education, and a higher number of childrenin the family were predictors of IPIs. The prevalence of IPI was significantly associated with Grade II and III undernutrition, stunting, and wasting. Individually, Ascaris and hookworms contributed significantly to stunting and cryptosporidium spp. to wasting. Conclusion: Prevalence of IPI in malnourished under-five children is high. Joint nutritional interventional strategies, early diagnosis/treatment of under-five children, and increased awareness among masses are imperative to break the vicious cycle of malnutrition and parasitic diseases.