02537nas a2200217   4500000000100000008004100001260004500042653002900087653001700116653002400133653003900157653003600196100001900232700001800251245011300269856007100382300001400453490000600467520183200473022001402305       2026                            d  c07/2026bGhalib University, Kabul Branch10aMass drug administration10aPolicy brief10aChildren under five10aNeglected tropical diseases (NTDs)10a intestinal parasites infection1 aVafae Eslahi A1 aAdamopoulos I00aPrecision Public Health Approaches to Intestinal Parasitic Infections in Children under Five: A Policy Brief  uhttps://www.ajid.ghalib.edu.af/index.php/ajid/article/view/167/196  a127 - 1360 v43 a<jats:p>The majority of the burden of childhood disease and delayed development worldwide is attributed to one of the most neglected diseases, intestinal parasitic infections (IPIs). Helminth and protozoan infections continue to disproportionately affect under 5-year-old children, especially in low and low-middle income countries. These infections contribute to childhood diarrhea, malnutrition, growth failure, anemia, poor cognitive development, and preventable death. Nearly a third of all under 5 children globally have IPIs; however, this estimate could actually be significantly underestimated given low diagnostic sensitivity. This policy brief provides a comprehensive review of existing evidence on the global burden and causes of IPIs among under-fives, and identifies a range of evidence-based policy actions for governments, international organizations and development partners. Three proposed interconnected policy priorities are targeted geographically specific mass drug administration (MDA) and surveillance in high burden hotspots; climate-smart and context specific Water and sanitation and hygiene (WASH) interventions; and enhanced diagnostic and surveillance capacity for improved burden estimation and targeting resources. Despite the need for it, implementation is severely hampered by insufficient funding, under-developed health systems, inadequate inter-sectoral coordination, continuing environmental transmission environments, and under-diagnosis arising from use of low-sensitivity diagnostics. The challenge posed by IPIs in children under five will necessitate a shift from broad-based control plans to more precision public health approaches. These will include the implementation of hotspot targeting, environmentally tailored WASH interventions and enhanced diagnostic surveillance.</jats:p>  a2959-6491