In the context of the country and its manifest poverty, the total prevalence of parasitation  in the child population of Department of Managua (71.0%) was very high, with a parasite spectrum consisting of 20 parasite species (11 protozoa and 9 helminths but without trematodes) and a noticeable percentage of multiparasitism to a different degree, of up to 10 different parasite species. Among the most medically relevant parasite species are those reaching the highest prevalences, B. hominis (48.6%) and G. intestinalis (25.1%); and for helminths, the highest prevalences were observed in T. trichiura (4.8%), H. nana (2.5%) and A. lumbricoides (2.3%). In view of these data, the study carried out in Department of Managua yields figures that are above those detected in other departments of equal characteristics of development and population, such as the Departments of León and Carazo (Téllez et al., 1997; Oberhelman et al., 1998; Rosewell et al., 2005) [14,15,18] and actually approaching values closer to those known in other departments of the Pacific Region: Rio San Juan, Corn Island or Laguna de Perlas (both located in the South Atlantic Autonomous Region, RAAS), where socio-economic levels and hygienic-sanitary conditions are extremely low and deficient (Téllez et al., 1992; Muñoz-Antolí et al., 2014, 2017, 2018a, 2018b) [13,21-24]. Compared, in particular, to the results obtained with those in other studies conducted in different locations in Nicaragua, Entamoeba complejo showed the lowest prevalence of parasitation (0.1%) in the Department of Carazo (Oberhelman et al., 1998) [15], while in Department of León it was G. intestinalis  (15.6%) (Téllez et al., 1997) [14]. The highest prevalence of parasitation was determined in Río San Juan and Laguna de Perlas for B. hominis (77.7% and 58.1%, respectively) and G. intestinalis  (32.5% and 17.4%, respectively) (Muñoz-Antolí et al., 2014; 2017) [21,22]. The study of Muñoz-Antolí et al. (2018a) [23] carried out in 7 departments in Nicaragua's Pacific Region, in children until 5-year age group, B. hominis and G. intestinalis also stood out with prevalence values between 32-70% and 21-28%, respectively. The prevalence of T. trichiura was higher than that of A. lumbricoides, a fact that coincides with other works carried out in Nicaragua (Cavouti & Lancaster, 1992; Rosewell et al., 2010; Muñoz-Antolí et al., 2014, 2017, 2018a, 2018b)[12,18,21-24], whilst being in contrast to the results obtained by Oberhelman et al. (1998) [15] in Department of Carazo. When considering geohelminths only, the low prevalences of parasitation obtained for ancylostomatides (0.5%) and S. stercoralis (0.05%), especially with regard to other studies carried out in other departments (between 0.1 % and 18.6%) (Téllez et al., 1992; Rosewell et al., 2010; Muñoz-Antolí et al., 2014, 2017, 2018b) [13,18,21,22,24], is noteworthy. It should be noted that a broad spectrum of parasite species without medical relevance was determined, i.e., E. coli, E. hartmanni, E. nana, I. buestchlii, Ch. mesnili,  R. intestinalis and E. hominis, but which have epidemiological connotations as a result of oral-fecal transmission, or  person-to person, which clearly implies poor hygienic-sanitary conditions in the population studied in both, the urban and rural areas of Department of Managua. This presence of clinically irrelevant parasitic species was also encountered in the studies of Muñoz-Antolí et al. (2014, 2017, 2018a) [21-23] carried out hitherto in urban as well as rural areas of Nicaragua. Similar results were reached in a study conducted in Guatemala where higher parasitation prevalences were observed in densely populated locations

When comparing the results obtained to the Central America and Caribbean island studies (Reyes et al., 1987; Reinthaler et al., 1988; Kaminsky, 1991; Holland et al., 1998; Kaminsky et al., 1998, 2014;  Cruz et al., 1998; Morales-Espinoza et al., 2003; Núñez et al., 2003a; Sánchez-Vega et al., 2006; Lavin et al., 2008; Cook et al., 2009; Jensen et al., 2009; Cañete et al., 2012; Quihui & Morales, 2012; Sandoval et al., 2015; Perea et al., 2020) [28-43] with a global spectrum consisting of 16 parasite species, i.e., 10 protozoa and 8 helminths, greater qualitative wealth was found in this study. These results are even more noticeable when considering the fact that only one coprological sample was analyzed per child, which underestimates the actual prevalence of intestinal parasite species, as protozoan cysts/oocysts and helminth eggs and larvae are expelled intermittently. It should be noted that B. hominis did not turn out to be as common in most studies of these locations, possibly due to the inability or difficulty of recognizing and microscopically identify this species, resulting in prevalences between 1.9 and 38.9% (Reinthaler et al., 1988; Cruz et al., 1998; Kaminsky et al., 1998; Núñez et al., 2003a; Lavin et al., 2008; Cook et al., 2009; Cañete et al., 2012; Sandoval et al., 2015; Perea 2020) [29,32,33,35,37,38,40,42,43]. In contrast, the prevalence of G. intestinalis was lower compared to most Central America and Caribbean island studies showing a  parasitation of between 29.0% and 61.0% (Reyes et al., 1987; Kaminsky, 1991; Sánchez-Vega et al., 2006; Cañete at al., 2012; Quihui & Morales, 2012) [28,30,36,40,41]. For Entamoeba complejo,  mixed results (between 4.5% and 79.7%) (Morales-Espinoza et al., 2003; Sánchez-Vega et al., 2006; Quihui & Morales, 2012; Perea et al., 2020) [34,36,41,43] were found, while T. trichiura and A. lumbricoides were among the most determined geohelminths (Reinthaler et al., 1988; Holland et al., 1998; Jensen et al., 2009; Kaminsky et al., 2014) [29,31,39,44] albeit with lower prevalences than protozoa, due to anthelmintic campaigns carried out in all Latin American countries (Quihui & Morales, 2012) [41].

When considering the sex variable, a higher prevalence of parasitation was detected in the female sex than in the male sex, although only in relation to certain protozoa, likely to be due to occupational and behavioral factors and not a susceptibility inherent to sex, since an Odds Ratio below 1 was obtained both with respect to the male as well as female sex. These results contrast with those provided by some authors in different countries of the Central America and Caribbean island where belonging to a certain sex is not a risk factor for parasitic infection in general, respectively, by protozoas or by helminths, in particular (Cook et al., 2009; Lavin et al., 2008; Quihui & Morales, 2012; Jensen et al., 2009; Kaminsky et al., 2014; Champetier de Ribes et al., 2005; Quihui et al., 2016) [37-39,41,44-46].

The highest overall prevalences of parasitation, in both protozoa and helminths, occur in children above 5 years of age in all geographical areas studied. both urban and rural, although statistically significant differences were not detected between helminth species and the different age groups considered. These results coincide with previous works in the population of Central America and Caribbean islands (Nuñez et al., 2003a, 2003b; Kaminsky et al., 2014) [35,44]. The highest prevalences in the age group below 5 years of age were those of G. intestinalis and Cryptosporidium spp., although without statistically significant differences, being similar to other studies (Cifuente et al., 2000; Corrales et al., 2006; Escobedo et al., 2008; Cook et al., 2009; Cañete et al., 2012) [38,40,47-49]. Although it should be noted that the age variable  was a risk factor with regard to intestinal parasitosis in the infant population over 5 years, which is usually about the age when children begin to socialize with other individuals, away from the continuous care of parents.

The socioeconomic conditions surrounding individuals and the hygienic-sanitary conditions inherent to an individual were studied. Socioeconomic factors play an important role in the transmission of enteroparasitosis as they facilitate the evolution, spreading and maintenance of the different evolutionary forms that are part of the biological cycle of each parasite species (Kaminsky et al., 1998; Asaolu & Ofoezie, 2003; Jarquin et al., 2016; Galván-Ramírez et al., 2019; Zavala et al., 2020) [32,50-53].

In Department of Managua, in general, living a dwelling with dirt floor was a risk factor for contracting intestinal parasitosis. Similar circumstances were documented in various Central America and Caribbean studies (Forrester et al., 1990; Anderson et al., 1993; Holland et al., 1998; Corrales et al., 2006; Galván-Ramírez et al., 2019) [31,48,52,54,55]. This type of floor is an ideal place to keep eggs and cysts viable, which can be transported over long distances on a person’s feet, hands or shoes and deposited inside or around the dwelling.

The relationship between inadequate excreta disposition systems and the acquisition of intestinal parasitosis was a risk factor in Department of Managua. Several studies coincide with these results (Reyes et al., 1987; Forrester et al., 1990; Kaminsky, 1991; Anderson et al., 1993; Cruz et al., 1998; Kaminsky et al., 1998; Cifuentes et al., 2000; Núñez et al., 2003b; Corrales et al., 2006; Quihui et al., 2016; Galván-Ramírez et al., 2019; Sorto et al., 2015) [28,30,32,33,46-48,52,54-57]. If expelled pathogens are not eliminated by adequate sanitation, they can survive in soil, ponds, etc., remaining infective. It should also be noted that the use of human or animal feces as fertilizer is very common, being a potential risk of infection (Silva et al., 2008) [58].

Another determining factor in the transmission of parasite diseases is the consumption of water (Cañete et al., 2012; Damiani et al., 2013) [40,59], which is the cause of the occurrence of epidemic episodes as well as of the maintenance of parasites, along with other factors of  situations of endemicity (Núñez et al., 2003b) [56]. Especially protozoa that play a greater role in water transmission by having resistant forms. Most enteric diseases detected in Central America and the Caribbean islands are related to inadequate water supply and storage (Reyes et al., 1987; Aimpun & Hshieh, 2004; Cifuentes et al., 2004; Zavala et al., 2020) [28,47,53,60]. The results of this study found that consuming "poor quality" water (preserved uncovered) was  a risk factor for the acquisition of enteroparasitoses. The reuse of wastewater for irrigation, a common practice in arid countries, which can cause infecting forms of parasites to be viable in some produce grown at ground level, which may pose a risk of infection for human populations (Cifuentes et al., 2000; Blumenthal et al., 2001) [47,61].

Poor hygienic-sanitary conditions also allow the proliferation of parasitic diseases. Personal hygiene encompasses hand washing before eating, after defecation, and having a daily bath or shower. These simple hygiene practices significantly reduce the risk of enteroparasitoses. Inadequate personal hygiene poses a risk factor in the overall population studied, indicating that  the minimum hygienic conditions that could decrease or eliminate enteroparasitoses are neither followed at home nor at school. In addition, another well-proven fact is that children of these ages, regardless of their sex, become sociable in exchanging food and beverages, further promoting transmission. Some studies  in Central America and the Caribbean coincide with the findings obtained  in this work (Cruz et al., 1998; Cifuentes et al., 2004; Cañete et al., 2012, WHO., 2005) [33,40,62,63].

The consumption of raw unwashed fruits and vegetables, which is related to the frequent practice of using, for irrigation in agriculture, water contaminated with faecal material or even the use of faecal matter as fertiliser of fields, is highlighted (Cañete et al., 2012; Jarquin et al., 2016) [40,51]. Epidemiological data obtained in Department of Managua do not show as a risk factor the incorrect washing of fruits and vegetables before consumption.