Persistent high burden and determinants of intestinal parasitic infections in schoolchildren from vulnerable communities in Costa Rica: an epidemiological analysis of 12 years of data (2008-19).

OBJECTIVES: Intestinal parasites have higher prevalences in poor tropical countries. In Costa Rica, the problem in vulnerable zones has not been epidemiologically characterized over the last two decades. This study aimed to characterize the intestinal parasitic infections among schoolchildren in vulnerable zones of Costa Rica and to explore their multidimensional determinants. METHODS: Data from faecal tests results from schoolchildren living in vulnerable zones of Costa Rica (2008-2019) was compiled with social, climatic and other environmental variables to perform descriptive epidemiological and comparative analyses. Prevalence calculations and maps of protozoan and helminth infections were generated. RESULTS: Intestinal protozoan and soil-transmitted helminth infections affected 46.7% and 26.2% of children, respectively. Prevalence was highest in the Caribbean region: Limoncito and Chirripó led for both soil transmitted helminths (38.1% and 36.6%) and intestinal protozoans (62.8% and 59.5%), with Telire reaching 62.8% for intestinal protozoans. The 7-9-year age group had the highest burden for both infection types. Logistic regression identified geographic inaccessibility, composite socioeconomic-educational-housing scores, and climatic conditions as significant predictors for parasite infections risk. CONCLUSION: Data demonstrate the persistence of high rates of intestinal parasitic infections in vulnerable communities of Costa Rica, highlighting potential associations that reflect the multidimensional nature of the problem.