Parasitic Contamination and Its Associated Factors in Fruits and Vegetables Collected From Ethiopia's Local Markets: A Systematic Review and Meta-Analysis.

Background: Vegetables and fruits are vital components of a healthy diet; however, consuming unclean, uncooked, or improperly prepared products can lead to parasitic infections. Contamination often occurs during both the pre-harvest and post-harvest phases. Thus, the aim of this study is to provide evidence-based scientific information about the level of parasitic contamination and risk factors in Ethiopian fruits and vegetables sold in local markets.

Methods: A random effects model was selected for analysis. Subgroup analyses and sensitivity analyses were performed to explore potential sources of heterogeneity using the I ² test. Publication bias was evaluated using the funnel plot, Begg's, and Egger's tests.

Results: A total of 3697 samples from 11 studies were included. The pooled prevalence of parasitic contamination was 43.99% (1642/3697) with (95% CI: 38.04-49.95). The highest prevalence was recorded from helminths (26.42%), followed by protozoan infections (17.57%). The most predominant parasites were Entamoeba spp. (6.40%), Ascaris spp. (6.28%), Giardia spp. (5.98%), and Strongylida (4.59%). Contamination rate of fruits alone was 7.02%, while that of vegetables was 36.97%. Additionally, cabbage (8.14%), lettuce (6.46%), tomato (6.12%), carrot (5.71%), and green pepper (5.12%) were the most contaminated vegetables. Factors such as the vegetable produce (aOR = 2.26; 95% CI: 0.86-3.65) and not washed prior to display (aOR = 3.36; 95% CI: 2.00-4.73) were factors associated significantly with parasitic contamination of fruits and vegetables.

Conclusion: The current finding revealed a significant level of parasitic contamination in fruits and vegetables. As a result, food and drug regulatory bodies, the agricultural sector, and public health organizations need to educate vendors, farmers, and consumers about safe methods for growing, transporting, handling, and eating these products, while also ensuring the establishment of safe market environments.

Registration: The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number "CRD42024585961."