{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:23:17Z","timestamp":1785284597701,"version":"3.55.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":52,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006396","name":"Qazvin University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006396","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intestinal parasitic infections (IPIs) remain a significant public health concern worldwide, particularly affecting children under five years old. These infections contribute to malnutrition, impaired growth, diarrhea, and increased morbidity and mortality, disproportionately impacting low- and middle-income countries. This systematic review and meta-analysis aims to estimate the global prevalence of IPIs in children under five and examine the influence of socioeconomic, environmental, and diagnostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across multiple databases (PubMed, Web of Science, Scopus, ScienceDirect, and Google Scholar) for cross-sectional studies reporting the prevalence of IPIs in children under five years old, up to November 2025. The pooled prevalence was estimated using a random-effects meta-analysis, and subgroup analyses were performed by region, human development index (HDI), income level, climate, diagnostic method, and parasite species. Methodological quality was assessed using an adapted Newcastle\u2013Ottawa Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-one studies, involving a total of 15,109 children under five, met the inclusion criteria. The study population was drawn from multiple regions worldwide. The overall pooled prevalence of IPIs in children under five was 31.60% (95% CI: 26.04\u201337.44). Prevalence was highest in lower-middle-income countries (37.45%) and low-HDI regions (35.17%), and lowest in high-income countries (6.25%) and very high-HDI regions (19.41%). South Asia (35.47%) and Eastern sub-Saharan Africa (35.24%) were identified as major hotspots. Helminth infections were most commonly caused by\n                      <jats:italic>Ascaris lumbricoides<\/jats:italic>\n                      (11.93%), while\n                      <jats:italic>Giardia lamblia<\/jats:italic>\n                      (10.37%) was the predominant protozoan. Studies using more sensitive diagnostic methods reported substantially higher prevalence. Environmental factors such as tropical savanna climates, moderate rainfall, and high humidity were associated with increased infection rates. Gender differences in prevalence were negligible.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IPIs continue to pose a substantial global health burden on children under five, with socioeconomic and environmental disparities strongly influencing prevalence. The findings highlight the need for targeted public health interventions, including deworming programs, improved sanitation, and clinical surveillance, particularly in high-burden regions. Enhanced diagnostic strategies are essential to accurately capture infection rates and guide effective prevention and treatment efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-026-27787-2","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T03:54:57Z","timestamp":1779076497000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Global prevalence and public health impact of intestinal parasitic infections in children under five: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Hassan","family":"Taherahmadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meysam","family":"Olfatifar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayed Hussain","family":"Mosawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morteza","family":"Habibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abouzar","family":"Babaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Adamopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Samiee-Rad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Gharibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kareem","family":"Hatam-Nahavandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida Vafae","family":"Eslahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milad","family":"Badri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"27787_CR1","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1186\/s12884-021-03908-0","volume":"21","author":"Z Animaw","year":"2021","unstructured":"Animaw Z, Melese A, Demelash H, Seyoum G, Abebe A. Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2021;21:474.","journal-title":"BMC Pregnancy Childbirth"},{"key":"27787_CR2","first-page":"175","volume":"2","author":"T Ahmed","year":"2016","unstructured":"Ahmed T, Khanum H, Uddin MS, Barua P, Arju T, Kabir M, et al. Entamoeba histolytica, Giardia lamblia and Cryptosporidium spp. infection in children in an urban slum area of Bangladesh. Bioresearch Commun. 2016;2:175\u201381.","journal-title":"Bioresearch Commun."},{"key":"27787_CR3","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s40249-024-01238-9","volume":"13","author":"J Chen","year":"2024","unstructured":"Chen J, Gong Y, Chen Q, Li S, Zhou Y. Global burden of soil-transmitted helminth infections, 1990-2021. Infect Dis Poverty. 2024;13:68\u201377.","journal-title":"Infect Dis Poverty"},{"key":"27787_CR4","doi-asserted-by":"publisher","first-page":"S253","DOI":"10.1093\/cid\/ciy002","volume":"66 suppl_4","author":"SH Farrell","year":"2018","unstructured":"Farrell SH, Coffeng LE, Truscott JE, Werkman M, Toor J, De Vlas SJ, et al. Investigating the effectiveness of current and modified World Health Organization guidelines for the control of soil-transmitted helminth infections. Clin Infect Dis. 2018;66 suppl_4:S253\u20139.","journal-title":"Clin Infect Dis."},{"key":"27787_CR5","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1186\/s13104-018-3888-2","volume":"11","author":"D Gebretsadik","year":"2018","unstructured":"Gebretsadik D, Metaferia Y, Seid A, Fenta GM, Gedefie A. Prevalence of intestinal parasitic infection among children under 5 years of age at Dessie Referral Hospital: cross sectional study. BMC Res Notes. 2018;11:771.","journal-title":"BMC Res Notes"},{"key":"27787_CR6","doi-asserted-by":"publisher","first-page":"2794","DOI":"10.4103\/jfmpc.jfmpc_1742_21","volume":"11","author":"S Deka","year":"2022","unstructured":"Deka S, Kalita D, Hazarika NK. Prevalence and risk factors of intestinal parasitic infection in under-five children with malnutrition: a hospital based cross-sectional study. J Fam Med Prim Care. 2022;11:2794\u2013801.","journal-title":"J Fam Med Prim Care"},{"key":"27787_CR7","doi-asserted-by":"crossref","unstructured":"Taylor-Robinson DC, Maayan N, Donegan S, Chaplin M, Garner P. Public health deworming programmes for soil-transmitted helminths in children living in endemic areas. Cochrane Database Syst Rev. 2019;2019.","DOI":"10.1002\/14651858.CD000371.pub7"},{"key":"27787_CR8","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1186\/s12889-020-09642-0","volume":"20","author":"S Murarkar","year":"2020","unstructured":"Murarkar S, Gothankar J, Doke P, Pore P, Lalwani S, Dhumale G, et al. Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study. BMC Public Health. 2020;20:1559.","journal-title":"BMC Public Health"},{"key":"27787_CR9","doi-asserted-by":"publisher","first-page":"127","DOI":"10.14740\/gr1622","volume":"16","author":"M Ahmed","year":"2023","unstructured":"Ahmed M. Intestinal parasitic infections in 2023. Gastroenterol Res. 2023;16:127.","journal-title":"Gastroenterol Res"},{"key":"27787_CR10","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1007\/s00436-020-06608-4","volume":"119","author":"JA Herrick","year":"2020","unstructured":"Herrick JA, Nordstrom M, Maloney P, Rodriguez M, Naceanceno K, Gallo G, et al. Parasitic infections represent a significant health threat among recent immigrants in Chicago. Parasitol Res. 2020;119:1139\u201348.","journal-title":"Parasitol Res"},{"key":"27787_CR11","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1186\/s13071-016-1906-6","volume":"9","author":"MA Abu-Madi","year":"2016","unstructured":"Abu-Madi MA, Behnke JM, Ismail A, Boughattas S. Assessing the burden of intestinal parasites affecting newly arrived immigrants in Qatar. Parasit Vectors. 2016;9:619.","journal-title":"Parasit Vectors"},{"key":"27787_CR12","doi-asserted-by":"publisher","first-page":"e00368","DOI":"10.1016\/j.parepi.2024.e00368","volume":"26","author":"A Girma","year":"2024","unstructured":"Girma A, Genet A. Prevalence and factors associated with intestinal parasitic infections among preschool-aged children in Ethiopia: a systematic review and meta-analysis. Parasite Epidemiol Control. 2024;26:e00368.","journal-title":"Parasite Epidemiol Control"},{"key":"27787_CR13","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1080\/15513815.2023.2284920","volume":"43","author":"A Girma","year":"2024","unstructured":"Girma A, Genet A. Magnitude and determinants of intestinal parasites among children under five in Ethiopia during 2010--2023: a systematic review and meta-analysis. Fetal Pediatr Pathol. 2024;43:47\u201365.","journal-title":"Fetal Pediatr Pathol"},{"key":"27787_CR14","doi-asserted-by":"crossref","unstructured":"Abdoli A, Olfatifar M, Eslahi AV, Moghadamizad Z, Nowak O, Pirestani M, et al. Prevalence of intestinal protozoan parasites among Asian schoolchildren: a systematic review and meta-analysis. Infection. 2024:1-37.","DOI":"10.1007\/s15010-024-02339-1"},{"key":"27787_CR15","doi-asserted-by":"publisher","first-page":"105906","DOI":"10.1016\/j.ijsu.2021.105906","volume":"88","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906.","journal-title":"Int J Surg"},{"key":"27787_CR16","doi-asserted-by":"crossref","unstructured":"Badri M, Olfatifar M, Sabzi S, Asghari A, Zaki L, Hatam-Nahavandi K, et al. The role of cockroaches as mechanical carriers of helminth infections: a systematic review and meta-analysis of environmental and climatic impacts on public health. Int J Environ Health Res. 2025:1-18.","DOI":"10.1080\/09603123.2025.2571146"},{"key":"27787_CR17","doi-asserted-by":"publisher","first-page":"2852","DOI":"10.1186\/s12889-025-23958-9","volume":"25","author":"M Badri","year":"2025","unstructured":"Badri M, Olfatifar M, Gharibi Z, Pal M, Hatam-Nahavandi K, Asghari A, et al. A systematic review and meta-analysis on the global prevalence of helminthic parasites among schoolchildren: a public health concern. BMC Public Health. 2025;25:2852.","journal-title":"BMC Public Health"},{"key":"27787_CR18","doi-asserted-by":"crossref","unstructured":"Badri M, Olfatifar M, Wandra T, Budke CM, Mahmoudi R, Abdoli A, et al. The prevalence of human trichuriasis in Asia: a systematic review and meta-analysis. Parasitol Res. 2022:1-10.","DOI":"10.1007\/s00436-021-07365-8"},{"key":"27787_CR19","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/s12889-020-8222-y","volume":"20","author":"L Chelkeba","year":"2020","unstructured":"Chelkeba L, Mekonnen Z, Alemu Y, Emana D. Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: a systematic review and meta-analysis. BMC Public Health. 2020;20:117.","journal-title":"BMC Public Health"},{"key":"27787_CR20","doi-asserted-by":"publisher","first-page":"e0006322","DOI":"10.1371\/journal.pntd.0006322","volume":"12","author":"S Kang","year":"2018","unstructured":"Kang S, Damania A, Majid MF, Hotez PJ. Extending the global worm index and its links to human development and child education. PLoS Negl Trop Dis. 2018;12:e0006322.","journal-title":"PLoS Negl Trop Dis"},{"key":"27787_CR21","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1111\/j.1467-8624.2011.01674.x","volume":"83","author":"RH Bradley","year":"2012","unstructured":"Bradley RH, Putnick DL. Housing quality and access to material and learning resources within the home environment in developing countries. Child Dev. 2012;83:76\u201391.","journal-title":"Child Dev"},{"key":"27787_CR22","doi-asserted-by":"publisher","first-page":"216","DOI":"10.21608\/puj.2022.147176.1173","volume":"15","author":"H Abou-Seri","year":"2022","unstructured":"Abou-Seri H, Abdalgaber M, Zahran F. Enteric parasitic infections: From environmental enteric dysfunction to gut microbiota and childhood malnutrition. Parasitol United J. 2022;15:216\u201323.","journal-title":"Parasitol United J"},{"key":"27787_CR23","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s40249-017-0288-0","volume":"6","author":"M Bangert","year":"2017","unstructured":"Bangert M, Molyneux DH, Lindsay SW, Fitzpatrick C, Engels D. The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals. Infect Dis poverty. 2017;6:73.","journal-title":"Infect Dis poverty"},{"key":"27787_CR24","doi-asserted-by":"crossref","unstructured":"Eslahi AV, Olfatifar M, Zaki L, Pirestani M, Sotoodeh S, Farahvash MA, et al. The worldwide prevalence of intestinal helminthic parasites among food handlers: A systematic review and meta-analysis. Food Control. 2023:109658.","DOI":"10.1016\/j.foodcont.2023.109658"},{"key":"27787_CR25","doi-asserted-by":"crossref","unstructured":"Eslahi AV, Olfatifar M, Zaki L, Saryazdi AK, Barikbin F, Maleki A, et al. Global prevalence of intestinal protozoan parasites among food handlers: A systematic review and meta-analysis. Food Control. 2022:109466.","DOI":"10.1016\/j.foodcont.2022.109466"},{"key":"27787_CR26","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/1756-3305-7-37","volume":"7","author":"RL Pullan","year":"2014","unstructured":"Pullan RL, Smith JL, Jasrasaria R, Brooker SJ. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasit Vectors. 2014;7:37.","journal-title":"Parasit Vectors"},{"key":"27787_CR27","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1016\/j.ijheh.2017.05.007","volume":"220","author":"MC Freeman","year":"2017","unstructured":"Freeman MC, Garn JV, Sclar GD, Boisson S, Medlicott K, Alexander KT, et al. The impact of sanitation on infectious disease and nutritional status: a systematic review and meta-analysis. Int J Hyg Environ Health. 2017;220:928\u201349.","journal-title":"Int J Hyg Environ Health"},{"key":"27787_CR28","unstructured":"Downey AS. Prevention and control of enteric protozoan infections: Public health applications of environmental surveillance and drug treatment studies. The Johns Hopkins University; 2009."},{"key":"27787_CR29","doi-asserted-by":"crossref","unstructured":"Djawadi B, Parvizi N, Vazini H, Badri M, Eslahi AV, Adamopoulos I, et al. Genotyping and molecular profiling of intestinal microsporidiosis and cryptosporidiosis in HIV-infected patients in Alborz Province, Iran. Gut Pathog. 2025.","DOI":"10.1186\/s13099-025-00785-2"},{"key":"27787_CR30","first-page":"93","volume":"5","author":"M Mbong Ngwese","year":"2020","unstructured":"Mbong Ngwese M, Prince Manouana G, Nguema Moure PA, Ramharter M, Esen M, Ad\u00e9gnika AA. Diagnostic techniques of soil-transmitted helminths: impact on control measures. Trop Med Infect Dis. 2020;5:93.","journal-title":"Trop Med Infect Dis"},{"key":"27787_CR31","first-page":"1","volume":"18","author":"AAB D\u2019Alessandro","year":"2024","unstructured":"D\u2019Alessandro AAB, Pedreira LE, Farias GS, Almeida SMM, Nery NDA, Paiva MJM, et al. prevalence and diversity of intestinal parasites in children around the world. Rev Gest\u00e3o Soc e Ambient. 2024;18:1\u201312.","journal-title":"Rev Gest\u00e3o Soc e Ambient"},{"key":"27787_CR32","doi-asserted-by":"crossref","unstructured":"Dogan N. Intestinal parasites from past to present: taxonomy, paleoparasitology, geographic distribution, prevention and control strategies. In: Intestinal Parasites-New Developments in Diagnosis, Treatment, Prevention and Future Directions. IntechOpen; 2024.","DOI":"10.5772\/intechopen.1005750"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-026-27787-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-27787-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-27787-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T01:36:06Z","timestamp":1783560966000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-026-27787-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["27787"],"URL":"https:\/\/doi.org\/10.1186\/s12889-026-27787-2","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"assertion":[{"value":"16 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received approval from the Institutional Review Board of Qazvin University of Medical Sciences, Qazvin, Iran, as recorded in the ethics documentation (no.IR.QUMS.REC.1404.231).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"2095"}}