Epidemiological Study of Intestinal Protozoan Infections: A Cross-sectional Study in Zakho, Kurdistan, Iraq, during 2018-2022.

Intestinal protozoan parasitic infections are considered one of the most frequent types of infection caused by these parasites and remain a major health problem for communities. This study aims to detect the frequency of intestinal protozoan infections infection among Zakho general population from October 2018 to June 2022. This cross-sectional study was performed on 2,118 patients referring to private medical diagnostic laboratories in Zakho, Kurdistan Region, Iraq. Samples of fecal matter were collected and subjected to analysis using two different techniques: direct observation under the microscope (wet mount) and formalin-ether concentration methods. Morphological characteristics of trophozoites and cysts were used to identify E. histolytica using microscopical examination. Out of 2,118 recruited samples, 1,155 (54.53%) were male, and 963 (45.47%) were female. The mean age of participants was 20.41 (±19.12), with ages ranging from 1 to 63 years. The overall prevalence of protozoan infections was 395/2118 (18.65%). Out of these, Entamoeba histolytica was the predominant pathogenic protozoa infection 271 (68.61%), followed by Giardia lamblia 100 (25.31%). A significant association was seen between Entamoeba histolytica and age groups (P=0.003) and gender (P=0.004). The highest infection rate was reported among the age group <15 years (55.72%). We also found a higher rate of Giardia infection among age group < 15 years (46%) with significant differences (P=0.002) and a higher rate of Giardia seen in females (55%) with significant association (P=0.014). The frequency of Giardia lamblia and E. histolytica infections in our study was higher than other studies reported in Iraq and other countries, and these infections continue to pose a difficult public health issue and necessitate the implementation of stronger and more effective preventative measures.