Cambodia’s tropical climate, rural landscapes, and variations in sanitation infrastructure create an environment where several parasitic infections remain present.

While many visitors enjoy their travels without issues, understanding how these parasites spread and how to avoid them is essential for staying healthy.

Below is an overview of the most important parasitic infections travelers and residents may encounter in Cambodia, what causes them, and how to reduce the risk.

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Comparative table of parasitic infections in Cambodia

Feature	Amebiasis	Ankylostomiasis (Hookworm)	Anguillulosis (Strongyloidiasis)	Ascariasis	Bilharziosis (Schistosomiasis)	Cutaneous Larva Migrans (CLM)
Causing organism	Entamoeba histolytica (protozoa)	Ancylostoma duodenale, Necator americanus (nematodes)	Strongyloides stercoralis (nematode)	Ascaris lumbricoides (roundworm)	Schistosoma spp. (blood flukes)	Animal hookworm larvae (dogs/cats)
How infection occurs	Ingesting contaminated food or water	Skin contact with contaminated soil	Skin contact with contaminated soil	Ingestion of eggs in contaminated food/water	Contact with contaminated freshwater	Skin contact with contaminated sand/soil
Main symptoms	Diarrhea, abdominal pain, sometimes blood in stool	Anemia, fatigue, abdominal discomfort	Intermittent diarrhea, abdominal pain	Abdominal pain, bloating, growth issues in children	Fever, rash, abdominal pain	Itchy, winding red skin tracks
Body system affected	Intestinal and sometimes liver	Intestinal (blood loss)	Intestinal; can become systemic in severe cases	Intestinal	Blood vessels, liver, bladder/ intestines	Skin
Common risk areas in Cambodia	Raw vegetables, untreated water	Rural farming areas, barefoot walking	Rural areas, soil exposure	Areas with poor sanitation	Rural freshwater bodies	Beaches, playgrounds, areas with stray animals
Time to onset	Days to weeks	Weeks	Weeks to months	Weeks	Days to weeks	Hours to days
Severity	Mild to severe if untreated	Can cause chronic anemia	Potentially severe in immunocompromised individuals	Mild to severe (intestinal blockage possible)	Moderate to severe (chronic organ damage possible)	Mild but extremely itchy and uncomfortable
Treatment	Metronidazole or similar antiparasitics	Albendazole/mebendazole	Ivermectin	Albendazole	Praziquantel	Topical or oral antiparasitics
Key prevention measures	Safe water, food hygiene	Wearing shoes; avoiding contaminated soil	Wearing shoes; minimizing soil contact	Handwashing; safe food/water	Avoid unsafe freshwater	Shoes on sand; avoid contact with contaminated soil/sand

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1. Amebiasis (Amoebic Dysentery)

Cause: Entamoeba histolytica, a protozoan parasite.
How it spreads: Contaminated water, raw vegetables, ice, or food handled with poor hygiene.

Amebiasis is one of the most common protozoal infections in Cambodia, particularly in areas where water sanitation fluctuates. It can cause persistent diarrhea, abdominal pain, and sometimes fever or blood in the stool. While many cases are mild, untreated infections can become more serious and occasionally spread beyond the intestines.

Prevention tips:

• Drink bottled or purified water.
• Avoid raw vegetables that may have been washed in unsafe water.
• Practice frequent handwashing.

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2. Ankylostomiasis (Hookworm Infection)

Cause: Hookworms such as Ancylostoma duodenale or Necator americanus.
How it spreads: Walking barefoot on contaminated soil; contact with soil containing hookworm larvae.

Hookworm infections are especially common in rural Cambodian provinces where barefoot walking and agricultural work are the norm. The larvae penetrate the skin (often the feet) then migrate through the body to the intestines, where they feed on blood. Chronic infections can lead to iron-deficiency anemia and fatigue.

Prevention tips:

• Always wear shoes outdoors, especially in rural areas.
• Avoid sitting or lying directly on bare soil.

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3. Anguillulosis (Strongyloidiasis)

Cause: Strongyloides stercoralis, a soil-transmitted nematode.
How it spreads: Skin contact with contaminated soil; similar to hookworm.

Strongyloidiasis is common in Southeast Asia and is notable for its ability to persist in the human body for years. Many infected individuals experience mild symptoms such as abdominal discomfort or intermittent diarrhea. In people with weakened immune systems, however, it can become life-threatening.

Prevention tips:

• Wear footwear and avoid soil exposure.
• Take extra precautions in farming or construction zones.

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4. Ascariasis (Roundworm Infection)

Cause: Ascaris lumbricoides, a large intestinal roundworm.
How it spreads: Ingestion of eggs from contaminated soil, food, or water.

Ascariasis remains one of the world’s most widespread helminth infections, and Cambodia is no exception. Children in rural areas are particularly affected. While mild infections may go unnoticed, heavier infections can cause abdominal pain, growth delays, or intestinal blockages.

Prevention tips:

• Wash hands before eating.
• Peel fruits and cook vegetables.
• Wash produce thoroughly with safe water.

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5. Bilharziosis (Schistosomiasis)

Cause: Schistosoma species (blood flukes).
How it spreads: Contact with freshwater contaminated by larval parasites released from snails.

While schistosomiasis is less common in Cambodia than in parts of Africa, sporadic cases occur near freshwater bodies where snails carry the parasite. Symptoms can include fever, rash, abdominal pain, and long-term organ complications if untreated.

Prevention tips:

• Avoid swimming in or wading through freshwater sources in rural areas unless known to be safe.
• Favor treated or chlorinated water for recreation.

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6. Cutaneous Larva Migrans (CLM)

Cause: Larvae of hookworms from dogs and cats.
How it spreads: Walking barefoot or sitting on sand or soil contaminated with animal feces.

Cutaneous larva migrans is a skin infection recognized by its intensely itchy, winding red tracks under the skin. It commonly affects beachgoers or people walking barefoot on sand or soil where stray animals roam.

Prevention tips:

• Wear sandals or shoes on beaches or soil.
• Avoid sitting directly on sand without a mat or towel.

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Why these infections are common in Cambodia

Several factors contribute to the persistence of parasitic diseases in the region:

• Warm, humid climate ideal for parasite survival
• Agricultural lifestyles involving soil exposure
• Variable sanitation and water quality in rural and peri-urban areas
• Presence of stray animals, especially dogs and cats
• Limited access to clean water in certain communities

Despite these challenges, public health campaigns and improved water systems continue to reduce infection rates over time.

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How to stay safe during your visit or stay

You can greatly reduce your risk of parasitic infections by following simple precautions:

• Drink only bottled or purified water.
• Avoid raw or unpeeled fruits and vegetables unless washed in safe water.
• Wear shoes, especially in rural or agricultural settings.
• Avoid contact with untreated freshwater sources.
• Wash hands frequently and carry hand sanitizer.
• Use a mat or towel when sitting on sand or soil.

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Parasitic infections in Cambodia are largely preventable with awareness and basic hygiene measures. Millions of travelers and residents stay completely healthy by taking simple precautions.