Abstract:
Background: The distribution and prevalence of various species of intestinal parasites differ from region
to region because of several environmental, social and geographical and other factors. Children below the
age of five years were more susceptible to intestinal parasite infection. However, there is paucity of
information about intestinal parasitosis and associated factors among these vulnerable groups (under-five
children) in Borama Town, Somaliland.
Objective: the aim of this study was to determine the prevalence of intestinal parasite infection and
associated factors among under-five children at Sheikh Osman area, Borama Town, Somaliland from
March 15 to June 30, 2025
Method: A community-based cross-sectional study was conducted among 385 systematically selected
children under five years in the Sheekh Osaman area of Borama Town. Data were collected using a
structured questionnaire, and fresh stool samples were examined using direct wet mount and formol-ether
concentration techniques. Data were entered in EpiData 3.1 and analyzed in SPSS 27. Bivariate and
multivariable logistic regression were used to assess associations, with variables having p < 0.25 in the
bivariate analysis included in the final model. Statistical significance was set at p < 0.05.
Result: The overall prevalence of intestinal parasite among under five children was 56.4% (95%CI:
51.3%-61.4%)). The predominant identified parasite was E. histolytica, 130 (33.8%) followed by Giardia
lambia 53 (13.8%), Enterbius vermicularis 25(6.5%) and Hymenolepias nana 9 (2.3%). Recent changes in
appetite or weight loss (AOR=0.484; 95% CI: 0.261, 0.739), itching or discomfort around the anal region
(AOR=2.464; 95% CI: 1.437, 4.227) and notice worm or segments in their child stool (AOR = 0.41; 95%
CI: 0.23 – 0.74) were identified as factors significantly associated with intestinal parasite.
Conclusion: The study found a high prevalence of intestinal parasitic infections among under-five
children, with protozoa being the predominant pathogens. E. histolytica/dispar and G. lamblia were the
most common species. Anal itching, recent appetite or weight changes, and observing worms in stool
were significantly associated with infection. Key recommendations include strengthening deworming and
routine screening programs, improving WASH infrastructure, and expanding community health
education. Health workers should conduct regular stool examinations and ensure timely treatment. NGOs
are encouraged to support hygiene promotion and community-based screening, while caregivers should
practice consistent hygiene and seek timely care. Future research should examine behavioral and
environmental determinants, seasonal trends, intervention effectiveness, and emerging parasitic species.
Subtle signs. Community support, hygiene promotion, and further research on predictive
symptoms are essential to strengthen parasite control efforts.