Prevalence of Cryptosporidium, Giardia, and Entamoeba histolytica in the School-Aged Children of Forcibly Displaced Myanmar Nationals in Bangladesh

ABSTRACT. Intestinal protozoan infections, including Giardia lamblia (G. lamblia), Cryptosporidium spp., and Entamoeba histolytica (E. histolytica), are major contributors to global gastrointestinal morbidity and mortality, particularly among children in resource-limited settings. With this study, we aimed to determine the prevalence of protozoan infections among forcibly displaced Myanmar national children aged 6–16 years by using a multiplex real-time quantitative polymerase chain reaction method. Among 419 participants, the overall prevalence of protozoan infections was 49.4%, with G. lamblia being the most prevalent species (47.0%), followed by Cryptosporidium spp. (4.3%) and E. histolytica (1.2%). The most frequent coinfection involved G. lamblia and Cryptosporidium (2.1%). Male children were marginally more likely to be infected with any protozoan (odds ratio [OR] = 0.086; P = 0.047); however, sex was not a significant predictor when exclusively analyzing Giardia-, Cryptosporidium-, or E. histolytica-positive children. Nutrition status was a significant predictor of being infected with any protozoan (OR = 1.67; P = 0.012), and increased nutrition was additionally associated with lower levels of fecal myeloperoxidase (estimate = −0.31; P = 0.030) and alpha-1-antitrypsin (estimate = −63.41; P = 0.026). Age was significantly predictive of infection status, with younger children exhibiting increased odds of positivity for protozoan parasites (OR = 0.87; P ≤0.001). Increasing age was associated with reduced myeloperoxidase (estimate = −0.17; P = 0.015) but was not associated with alpha-1-antitrypsin. This study underscores the substantial prevalence of intestinal protozoan infections among displaced children and highlights the need for targeted public health interventions.