Impact of the COVID-19 Pandemic on Intestinal Parasitic Infection Positivity Rates Among Clinically Suspected Patients at a Tertiary Centre in Northern India: A Four-Year Retrospective Analysis
4 affiliations
- 1Microbiology, Government Medical College, Haridwar, Haridwar, IND
- 2Microbiology, Govind Ballabh Pant Hospital, New Delhi, IND
- 3Microbiology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
- 4Public Health, International Institute of Health Management Research, Delhi, IND
Abstract
Background
The COVID-19 pandemic changed healthcare-seeking behaviour and clinical priorities, potentially influencing the detection of intestinal parasitic infections (IPIs). Data evaluating these effects remain limited.Objective
The primary objective was to assess changes in the laboratory positivity rate of intestinal parasitic infections (IPIs) among clinically suspected patients during the COVID-19 pandemic, including the period of empirical ivermectin use. The secondary objective was to compare IPI positivity rates across different age and gender groups over the study period.Methodology
This was a retrospective laboratory-based observational study conducted at AIIMS Rishikesh from January 1, 2019, to December 31, 2022. Stool samples underwent macroscopic examination, saline and iodine wet-mount microscopy, and modified Ziehl-Neelsen staining for coccidian parasites. The timeline was divided into three policy-defined periods: pre-COVID (January 1 to December 31, 2019), early COVID-19/ivermectin-included period (January 1, 2020, to August 31, 2021), and late COVID-19/post-ivermectin period (September 1, 2021-December 31, 2022). We applied a chi-square test and Bonferroni correction. Effect sizes are reported as prevalence ratios (PRs) with 95% confidence intervals (CIs).Results
Of 5,389 samples, 97 (1.80%) were confirmed positive for IPIs; 103 parasites were isolated from 97 patients, with five patients harbouring co-infections. Overall positivity rates were highest in the age group of 41-50 years (3.00%; 13/433) and comparable between male (1.88%; 64/3,405) and female (1.66%; 33/1,984) patients. The pre-COVID positivity rate (2.78%; 37/1,330) exceeded that of the early COVID period (1.14%; 17/1,493; PR = 2.44, 95% CI: 1.38-4.32; p = 0.001). Protozoa predominated, with Giardia lamblia being the most frequent (44.66%; 46/103 parasites isolated). Following ivermectin withdrawal, positivity declined transiently (0.14%; 1/692; 95% CI: 0.03%-0.81%) before resurging (2.24%; 42/1,874).Conclusion
Laboratory positivity for IPIs among patients with clinical suspicion fell during the initial COVID-19 period, most likely due to decreased healthcare-seeking and changes in referral patterns rather than a real shift in parasite prevalence at the community level. The observed temporal association with ivermectin use is only hypothesis-generating because individual-level treatment information is not available. Prospective, controlled studies that confirm ivermectin exposure data are required.
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BibTeX
@article{kamboj2026impact,
title = {{Impact of the COVID-19 Pandemic on Intestinal Parasitic Infection Positivity Rates Among Clinically Suspected Patients at a Tertiary Centre in Northern India: A Four-Year Retrospective Analysis}},
author = {Pratiksha Kamboj and Deepika Chakraborty and Yogendra P Mathuria and Sandipta Charkraborty and Binal Mangroliya and Sindura Sudhakar and Tanisha Sharma and NIdhi Soni},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117132},
url = {https://europepmc.org/article/PMC/PMC13717814},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of the COVID-19 Pandemic on Intestinal Parasitic Infection Positivity Rates Among Clinically Suspected Patients at a Tertiary Centre in Northern India: A Four-Year Retrospective Analysis
AU - Pratiksha Kamboj
AU - Deepika Chakraborty
AU - Yogendra P Mathuria
AU - Sandipta Charkraborty
AU - Binal Mangroliya
AU - Sindura Sudhakar
AU - Tanisha Sharma
AU - NIdhi Soni
PY - 2026
DA - 2026/09/29
JO - Cureus
DO - 10.7759/cureus.117132
UR - https://europepmc.org/article/PMC/PMC13717814
AB - Background The COVID-19 pandemic changed healthcare-seeking behaviour and clinical priorities, potentially influencing the detection of intestinal parasitic infections (IPIs). Data evaluating these effects remain limited.Objective The primary objective was to assess changes in the laboratory positivity rate of intestinal parasitic infections (IPIs) among clinically suspected patients during the COVID-19 pandemic, including the period of empirical ivermectin use. The secondary objective was to compare IPI positivity rates across different age and gender groups over the study period.Methodology This was a retrospective laboratory-based observational study conducted at AIIMS Rishikesh from January 1, 2019, to December 31, 2022. Stool samples underwent macroscopic examination, saline and iodine wet-mount microscopy, and modified Ziehl-Neelsen staining for coccidian parasites. The timeline was divided into three policy-defined periods: pre-COVID (January 1 to December 31, 2019), early COVID-19/ivermectin-included period (January 1, 2020, to August 31, 2021), and late COVID-19/post-ivermectin period (September 1, 2021-December 31, 2022). We applied a chi-square test and Bonferroni correction. Effect sizes are reported as prevalence ratios (PRs) with 95% confidence intervals (CIs).Results Of 5,389 samples, 97 (1.80%) were confirmed positive for IPIs; 103 parasites were isolated from 97 patients, with five patients harbouring co-infections. Overall positivity rates were highest in the age group of 41-50 years (3.00%; 13/433) and comparable between male (1.88%; 64/3,405) and female (1.66%; 33/1,984) patients. The pre-COVID positivity rate (2.78%; 37/1,330) exceeded that of the early COVID period (1.14%; 17/1,493; PR = 2.44, 95% CI: 1.38-4.32; p = 0.001). Protozoa predominated, with Giardia lamblia being the most frequent (44.66%; 46/103 parasites isolated). Following ivermectin withdrawal, positivity declined transiently (0.14%; 1/692; 95% CI: 0.03%-0.81%) before resurging (2.24%; 42/1,874).Conclusion Laboratory positivity for IPIs among patients with clinical suspicion fell during the initial COVID-19 period, most likely due to decreased healthcare-seeking and changes in referral patterns rather than a real shift in parasite prevalence at the community level. The observed temporal association with ivermectin use is only hypothesis-generating because individual-level treatment information is not available. Prospective, controlled studies that confirm ivermectin exposure data are required.
SN - 2168-8184
ER -