Prevalence of Parasitic Disease Burden in the Adult Population Presenting With Persistent or Chronic Diarrhea

Introduction Parasitic infection is an overlooked cause of diarrhea in adults. It can cause persistent or chronic diarrhea that contributes to a significant burden on the overall morbidity of the population. Stool sampling would aid in the diagnosis of parasitic infection in adults presenting with diarrhea. Methods A cross-sectional study was conducted from January to June 2024 at Medical Teaching Institution (MTI)-Hayatabad Medical Complex, Peshawar, Pakistan. A total of 500 stool samples were collected using non-probability consecutive sampling. All the patients presenting with complaints of persistent or chronic diarrhea to the medical outpatient department or admitted to the medical units were included in the study. Patients with bloody diarrhea and those less than 13 years of age were excluded from the study. Verbal and written informed consent was obtained from all the patients included in the study. The stool samples of all the patients were collected, reported, and verified by the microbiology department. Results Out of 500 stool samples of the patients with persistent or chronic diarrhea, 174 (34.8%) were found to be infected with cysts or trophozoites of parasites. Gender distribution of parasitic infections showed that 89 out of 245 females (36.3%) and 85 out of 255 males (33.3%) were affected. The comparison between genders yielded a p-value of 0.482. All the patients showed mono parasitism. The most common isolate was <i>Giardia lamblia</i> in 90 (51.72%) cases, followed by H-Nana in 49 (28.17%) isolates, <i>Entamoeba histolytica</i> in 16 (9.20%), <i>Ascaris lumbricoides</i> in 14 (8.04%), <i>Trichuris trichura</i> in two (1.15%), <i>Taenia saginata</i> in two (1.15%), and <i>Cryptosporidium</i> in one (0.6%) infected patient. Conclusion Parasitic intestinal infections, particularly <i>Giardia</i> and H-Nana, are prevalent yet overlooked causes of persistent and chronic diarrhea in adults. These findings underscore the importance of routine stool examination as a cost-effective diagnostic tool, potentially improving patient outcomes and reducing unnecessary medical interventions.​​​​​​​​​.