Prevalence of intestinal parasites in pre-school and school-aged Iranian children: a systematic review and meta-analysis

Intestinal parasitic infections (IPIs) are a major public health challenge for children in low- and middle-income countries, linked to malnutrition, stunting, and cognitive deficits. This meta-analysis estimated IPIs prevalence in Iranian preschool and school-aged children and identified associated factors. A systematic literature search was performed across five international bibliographic databases (Scopus, PubMed, Web of Science, Embase, and Google Scholar) to identify articles published between January 2000 and May 2025. The study protocol was in accordance with the reporting guidelines for the Meta-analysis of Observational Studies in Epidemiology (MOOSE). Subsequently, 36 studies met the eligibility criteria and were incorporated into the present meta-analysis. These studies in total accounted for a total sample size of 48,930 individuals, including 3,595 school-aged children in Iran with confirmed infections. Overall IPIs prevalence was 0.081 (95% CI 0.058–0.113). Among protozoa, the highest prevalence was related to Giardia lamblia (0.080, 95% CI: 0.056–0.112) and the most prevalent helminths, was Enterobius vermicularis (0.031, 95% CI: 0.020–0.048). Preschool children showed the highest rate of infection (0.130, 95% CI: 0.070–0.210). To reduce intestinal parasitic infections in Iranian children, regular and periodic screening of pre-school and school-aged children is recommended, particularly in humid regions where prevalence is highest. Health systems within schools must be evaluated and strengthened, including proper sanitation facilities, handwashing infrastructure, and hygiene education. Additionally, school-based deworming programs, environmental measures such as reducing soil contamination in playgrounds, and community health campaigns discouraging geophagy are essential to interrupt transmission cycles and prevent long-term complications.