Prevalence of Intestinal Parasite Infection and Their Associated Factors Among University Students and University Food Handlers in Ethiopia: A Systematic Review and Meta-Analysis.

Abstract

Intestinal parasite infections remain a significant public health concern in developing countries. Food handlers are particularly vulnerable to various enteric pathogens, which can then spread to the wider community. There is an urgent need for a comprehensive national review to consolidate findings from existing studies and draw conclusive insights. This systematic review and meta-analysis is aimed at determining the overall prevalence of intestinal parasites and evaluating the pooled odds ratios related to hygiene practices among university students and food handlers in Ethiopia. The review included articles from multiple online peer-reviewed databases such as PubMed, Medline, Google Scholar, and CINAHL, along with unpublished gray literature containing full-text studies in English. A random-effects model with a 95% confidence interval (CI) was utilized, employing STATA Version 17 statistical software for analysis. Forest plots were generated to calculate the prevalence of intestinal parasites, while the I ² heterogeneity test was used to assess variability among the studies. Additionally, subgroup and sensitivity analyses were performed, and funnel plots along with Egger's regression tests were conducted to evaluate potential publication bias. This systematic review encompassed 101 studies to estimate the prevalence of intestinal parasitic infections among food handlers and university students in Ethiopia. Of these, 15 studies met the inclusion criteria for analysis. The findings indicated that approximately 29.65% of food handlers were infected with intestinal parasites (95% CI: 22.79%-36.5%). The most frequently identified parasites included Entamoeba histolytica (11.52%), Ascaris lumbricoides (9.34%), and Giardia lamblia (5.85%). Significant risk factors associated with intestinal parasitic infections included having untrimmed fingernails (AOR = 3.58; 95% CI: 2.49, 5.16) and the inability to wash hands (AOR = 3.86; 95% CI: 1.97, 7.58). Therefore, emphasis on routine parasite screenings and educational initiatives targeting proper nail trimming and hand hygiene practices is essential to prevent foodborne illnesses and protect the health of vulnerable populations as well as highlighting the interplay of geography, study design, detection methods, and personal hygiene in the broader effort to reduce prevalence and enhance public health outcomes.