Situation and Outcome of Multiple Parasitic Infections in Iran: A Narrative Review

Multiple parasitic infections are common throughout the world. This phenomenon is particularly prevalent in the developing countries, where a combination of environmental and socioeconomic parameters factors creates an environment conducive to the proliferation of a range of parasitic agents. This phenomenon complicates the diagnosis, treatment, and control of parasitic diseases in endemic communities, causing significant adverse clinical and epidemiological outcomes. This study aimed to explore different aspects of multi-parasitism in humans and tried to present a conceptual outline and a comprehensive outlook on the outcomes of multi-parasitism and missed infections in Iran, where this issue has been understudied. Concomitant parasitic infections present several challenges, including misdiagnosis and underdiagnosis of human parasitic diseases, which represent significant shortcomings in clinical parasitology laboratories in Iran. A reliable diagnosis is essential for the proper and effective treatment of parasitic infections, and this process could be more complicated and challanging in the case of multiple parasitic infections. In immunocompromised individuals, inaccurate diagnosis could have severe consequences. Moreover, the transmission dynamics, distribution patterns, and control programs of parasitic diseases are significantly affected by underdiagnoses of parasitic infections. Polyparasitism is a prevalent phenomenon in the epidemiology of parasitic infections in Iran. The confluence of environmental and sanitary conditions, coupled with socioeconomic parameters that predispose communities to infection, contribute to this phenomenon. The use of complementary diagnostic methods has the potential to detect low-intensity infections that would otherwise remain undiagnosed in a conventional clinical laboratory. In the majority of laboratories located in the endemic countries,the utilization of these methods is neither feasible nor cost- effective.The successful implementation of national reference laboratories for the diagnosis of parasitic infections is essential for the reliable diagnosis, effective treatment, and alleviation of the burden of disease.