High prevalence of intestinal protozoan infections among asymptomatic individuals in rural and urban communities in conflict-affected Northwest Cameroon

Background Intestinal protozoan infections remain an important public health problem in sub-Saharan Africa. In Cameroon, there is limited evidence comparing the epidemiology of intestinal protozoan infections in rural and urban settings. This study determined the prevalence of intestinal protozoan infections, identified associated factors, and compared selected diagnostic techniques among asymptomatic individuals in rural and urban communities of Northwest Cameroon. Methods A school and community-based cross-sectional study was conducted between May and August 2025 in rural Bafut and urban Bamenda, Northwest Cameroon. A structured questionnaire was used to collect sociodemographic and hygiene-related data. Stool samples were analyzed using direct wet mount, formol-ether concentration, and modified Ziehl-Neelsen staining techniques. Data were analyzed using SPSS version 28. The Chi-square test or Fisher's exact test, as appropriate, and odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess associations. Statistical significance was set at p < 0.05. Results A total of 270 participants aged 5–63 years were enrolled. Overall, 109 (40.4%) participants were infected with at least one intestinal protozoan species. The prevalence was comparable between the rural (41.5%) and urban (39.3%) settings. Cryptosporidium spp. (19.6%) and Entamoeba histolytica (10.4%) were the most frequently detected protozoans. No statistically significant associations were observed between intestinal protozoan infection and the sociodemographic, environmental, and behavioral factors examined ( p > 0.05). The formol-ether concentration technique yielded the highest number of positive parasite detections and identified all eight parasite species detected in the study, whereas direct wet mount and modified Ziehl–Neelsen techniques identified five and two species, respectively. Conclusion Intestinal protozoan infections remain highly prevalent among asymptomatic individuals in conflict-affected communities of Northwest Cameroon. Improved water, sanitation, and hygiene interventions, along with the use of sensitive diagnostic techniques, may enhance control and surveillance of these infections.