# Prevalence of Intestinal Parasitic Infections and Associated Factors Among Rural Ghanaian School Children: A Cross‐Sectional Study in Tokuroano, Krachi East Municipality

## TL;DR

Over 60% of rural Ghanaian schoolchildren had intestinal parasites, with poor sanitation and hygiene as main risk factors, highlighting the need for better health programs.

## Contribution

The study identifies specific parasitic infections and their associated risk factors in rural Ghanaian children, emphasizing the need for integrated deworming and sanitation initiatives.

## Key findings

- 63.23% of schoolchildren had intestinal parasitic infections, with Ascaris lumbricoides and Hookworm being most common.
- Polyparasitism was prevalent, with protozoan–helminth and helminth–helminth co-infections observed.
- Home-cooked meals and health awareness reduced infection odds, while certain sanitation practices increased Giardia risk.

## Abstract

Intestinal parasitic infections (IPIs) pose a significant public health burden in developing regions, disproportionately affecting children. This study investigated the prevalence, determinants, and co‐occurrence patterns of IPIs among schoolchildren in rural Krachi East Municipality, Oti Region, Ghana.

A cross‐sectional study (March–August 2024) enrolled 204 schoolchildren (aged 4–15 years) via simple random sampling. Sociodemographic and risk factor data were collected, using standardized questionnaires. Single fresh stool specimens were microscopically examined using direct wet mount, sedimentation, and Kato–Katz techniques. Data were analyzed with STATA version 18.

Overall IPI prevalence was 63.23% (n = 129), with monoparasitism at 33.3% (n = 68). Key parasites included Ascaris lumbricoides (57.4%), Hookworm (38.7%), and Giardia duodenalis (21.6%), Entamoeba dispar/histolytica (14.2%), and Trichuris trichiura (11.3%). Polyparasitism was common, with protozoan–helminth (19.38%) and helminth–helminth (27.13%) co‐infections. A. lumbricoides and Hookworm were predominant in co‐infections. Home‐cooked meals and awareness of IPIs reduced the odds of infection. Conversely, Kumasi Ventilated Improved Pit (KVIP) and pit latrines at school paradoxically increased G. duodenalis infection risk, whereas fingernail‐biting showed a counterintuitive protective association against G. duodenalis infections.

A high IPI burden, including significant polyparasitism, exists among the schoolchildren in the study area. The findings underscore the urgent need for integrated deworming programs, improved sanitation, and targeted health education to reduce morbidity in this vulnerable population, directly contributing to SDG 3 (Good Health and Well‐being) by addressing preventable diseases and promoting health, and SDG 4 (Quality Education) by improving the health and educational outcomes of schoolchildren.

Over 63% of schoolchildren in rural Ghana's Tokuroano area had intestinal parasitic infections, mainly Ascaris, Hookworm, and Giardia. Poor sanitation, unsafe water, and poor hygiene were key risks. Protective factors included home‐cooked meals and health education. Integrated deworming, sanitation, and education programs are urgently needed to address this public health issue.