ArticleFrontiers in public health2026
Household deprivation score demonstrates graded association with intestinal parasitic infections among schoolchildren in a conflict-affected setting: a cross-sectional study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Intestinal parasitic infections (IPIs) remain highly prevalent in conflict-affected settings where water, sanitation, and health systems are disrupted. Simple, scalable tools for identifying high-risk populations are urgently needed. Methods: We conducted a cross-sectional study of 1,200 schoolchildren aged 5-15 years across nine districts in Al-Dhalea Governorate, Yemen (April-October 2025). Stool samples were analyzed using direct microscopy and formalin-ether concentration. A novel Household Deprivation Score (HDS; range 0-3) was constructed from three indicators of socioeconomic and spatial disadvantage. Multilevel mixed-effects logistic regression was used to assess statistical associations with IPI positivity. All associations are correlational; causal inference is precluded by the cross-sectional design. Results: Overall, the IPI prevalence was 46.2% (95% CI: 43.4 to 49.0%). The Interpretation: The HDS showed a graded association with IPI prevalence (AUC = 0.63), indicating modest discriminative ability suitable for risk stratification rather than diagnosis. Species-stratified analyses excluding Entamoeba cases (29.4% of positives) attenuated the HDS-pathogen association, with the AOR for HDS = 3 decreasing from 2.95 to 2.18 and HDS = 1 losing significance. These findings suggest partial influence of non-pathogenic carriage. The HDS may support resource allocation but should not replace diagnostic testing. Molecular confirmation (PCR) and external validation in other conflict-affected settings are needed before broader implementation.
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