Unmasking the hidden culprits in the gut: a narrative review on the intestinal parasites Unravelling India’s parasitic paradox

Abstract

Background: Intestinal parasitic infections remain a major public health concern, particularly in low- and middle-income countries, where they contribute substantially to diarrhoeal disease, malnutrition, anaemia, impaired growth, and reduced quality of life. This review summarizes the epidemiology, clinical manifestations, diagnostic approaches, treatment strategies, and preventive measures for common intestinal parasitic infections.

Methods: Relevant literature, international guidelines, and recent evidence on protozoan and helminthic intestinal parasites were synthesized, with emphasis on conventional and emerging diagnostic techniques and current therapeutic recommendations.

Results: Soil-transmitted helminths and intestinal protozoa continue to affect more than one billion individuals worldwide, with children and socioeconomically disadvantaged populations bearing the greatest burden. Stool microscopy remains the cornerstone of diagnosis, while concentration techniques, permanent stains, antigen detection assays, and molecular methods, including polymerase chain reaction and loop-mediated isothermal amplification, provide improved sensitivity and specificity, particularly in low-intensity infections. Appropriate antiparasitic therapy, combined with nutritional support, sanitation, access to safe water, and health education, significantly reduces disease burden and transmission.

Conclusion: Early recognition, accurate laboratory diagnosis, prompt treatment, and integrated public health interventions are essential for controlling intestinal parasitic infections. Continued surveillance and expanded access to sensitive diagnostic technologies are critical for reducing morbidity and supporting global control efforts.