Prevalence of Intestinal Protozoa and Bacteria Associated with Diarrhea in Infants and Children in Different Locations in Zakho City, Kurdistan Region, Iraq

Background and Objective: Diarrheal diseases remain a significant health concern for infants and young children, particularly in developing regions like Iraq, where environmental and socioeconomic factors contribute to a high burden of enteric infections. This study aimed to investigate the prevalence of intestinal protozoa and bacteria associated with diarrhea in infants and children aged 1 month to 15 years in Zakho City, Iraq. Methodology: A cross-sectional study was conducted between October 2024 and April 2025 across distinct locations in Zakho City. A total of 406 stool samples have been collected and examined using specific diagnostic methods for protozoa and bacteria. Results: Overall, 86.94% of samples were positive for at least one enteric pathogen. Intestinal protozoa were detected in 19.45% of cases, with Entamoeba histolytica (86.07%) and Giardia lamblia (13.92%) being the most prevalent. Bacterial pathogens were identified in 85.96% of samples, predominantly Escherichia coli (87.96%) and Klebsiella spp. (10.60%). The highest protozoan infection rates were in the >1-5 years age group (29.77%), while bacterial infections peaked in the 1-month to 1-year age group (87.17%). Conclusion: Our findings reveal a substantial burden of intestinal protozoan and bacterial infections contributing to diarrhea in the pediatric population. The high prevalence of E. histolytica and E. coli highlights an urgent need for targeted WASH interventions, particularly in high-risk areas and among vulnerable age groups. Continuous epidemiological surveillance is crucial for effective control strategies in the Kurdistan Region of Iraq.