review · PLoS neglected tropical diseases
Intestinal parasitic infections remain a major public health concern affecting children and adolescents across Ethiopia. A systematic review and meta-analysis analysing 30 studies involving 14,445 primary school children identified an overall pooled prevalence of at least one intestinal parasitic infection of 46.09 percent. The most widespread parasites identified were Entamoeba species at 16.11 percent, Ascaris lumbricoides at 13.98 percent, hookworm at 12.51 percent, and Giardia lamblia at 9.98 percent. Substantial geographic variation was observed, with the highest infection rates found in the Tigray region at 66.6 percent. Key factors significantly linked to infection included the absence of latrines, open defecation, non-pipe drinking water sources, living in rural areas, and mothers lacking formal education. Behavioural factors such as not wearing shoes, infrequent hand washing, poor fingernail hygiene, and eating unwashed produce also drove up infection odds.
Nearly half of primary school pupils assessed in Ethiopia harbour intestinal parasites, presenting a serious barrier to child health and development. Identifying specific environmental and behavioural drivers, such as inadequate sanitation infrastructure, unsafe drinking water, and lack of hand hygiene, highlights the exact public health, domestic, and educational interventions needed to reduce childhood disease burdens effectively.
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INTRODUCTION: Intestinal parasitic infection are a major public health concern affecting both children and adolescents in Ethiopia. The aim of this systematic review and meta-analysis was to determine pooled prevalence and associated factors of intestinal parasitic infection in this target group. METHOD: We systematically retrieved available articles on the prevalence of intestinal parasitic infection following database searches using PubMed, Scopus, Cochrane Library, and Science Direct between March 1 and May 27, 2020. Two authors independently extracted all relevant data using a standardized Microsoft Excel data extraction form. Heterogeneity among included studies was assessed with the Higgins I2 tests. The pooled estimates and associated factors were assessed with a random-effects model using Stata/se Version 14. RESULT: We retrieved 30 eligible articles with a pooled sample size of 14,445 primary school children with response rate of 97.8%. Entamoeba spp (16.11%), Ascaris lumbricoides (13.98%), hookworm (12.51%) and Giardia lamblia (9.98%) are the top causes of intestinal parasitic infection among primary school children in Ethiopia. The pooled prevalence for at least one intestinal parasitic infection was 46.09 (95% CI: 38.50, 53.68). Heterogeneity was assessed by doing subgroup analysis by study province/region. Thus, the highest prevalence of 66.6% (95% CI: 55.5, 77.7) occurred in Tigray region, which was followed by Southern Nations, Nationalities, and Peoples' Region at 50.8% (95% CI: 33.1, 68.5). No latrine availability (OR = 4.39: 2.50,7.73), no fingernail hygiene (OR = 2.37: 1.67, 3.35), open defecation (OR = 1.67:1.64,4.36), no formal maternal education (OR = 2.02: 1.18,3.47), rural residence (OR = 1.88: 1.46, 2.41), no habit of wearing shoes (OR = 2.66: 1.79, 3.96), non-pipe source of drinking water (OR = 1.99: 1.42,2.76), no regular hand washing practices (OR = 3.45:1.85,6.47), and no habit of washing fruits and vegetables (OR = 1.59:1.01,2.49) were associated with parasitic infection. CONCLUSIONS: The prevalence of intestinal parasitic infection was high (46%). Attention should be given to promoting personal hygiene, latrine utilization, wearing shoes, avoiding eating raw food, creating awareness for those mothers who lack formal education. Moreover, future research ideally will expand on the topic by conducting research in regions which have no prior research.
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DOI: 10.1371/journal.pntd.0009379
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