Identification of intestinal parasite infections and associated risk factors in indigenous Tsáchilas communities of Ecuador

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Background/Aim: Tsachilas are an indigenous group living in a rural tropical rain forest of Western Ecuador. Few studies have been conducted in Ecuador where intestinal parasite infections (IPIs) and associated risk factors have been examined. Hence, the aim of this study was to examine the prevalence of IPIs and identify the associated risk factors in Tsachilas populations. Subjects and Methods: A cross-sectional survey was conducted from August to October 2013 in seven Tsachilas communities. The study consisted of 586 participants, and stool samples were examined microscopically using the formalin-ether concentration technique. Results: Protozoa infections were more common than helminth infections (54.9% vs. 34.1%), and 68.1% of samples were found to contain one or more parasites. Ascaris lumbricoides was the most prevalent (29.4%), with Giardia duodenalis, Blastocystis hominis, and Entamoeba histolytica/dispar showing a prevalence of 3.9%, 19.6%, and 12.5%, respectively. Ova of Amphimerus and Paragonimus, two unexpected liver and lung flukes, respectively, were also found. A logistic model with forward selection showed the following variables to predict parasite infection: age (6–10 years) (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5–5.1, P = 0.001), unclean water supply (OR = 1.16, 95% CI = 1.14–2.4, P = 0.01), handwashing practice (OR = 2.5, 95% CI = 1.27–4.97, P = 0.01), and not washing food before eating (OR = 1.6, 95% CI = 1.09–2.21, P = 0.01). Conclusions: The study shows that IPIs are highly prevalent among the Tsachilas, which might be attributed to their low socioeconomic standards and poor hygienic habits. Educating the communities on risk factors which pose the highest risk of infection, in combination with a mandatory treatment program, would significantly lower the parasitic burden. The following Graduate Medical Education core competencies were addressed: Medical knowledge, Practice-based learning, Communication skills.