Hookworm infection and its determinants among schoolchildren in Ethiopia: a systematic review and meta-analysis

Background: Hookworm infection is a common problem among schoolchildren and mothers in tropical and subtropical countries, causing cognitive impairment, growth retardation in children and anaemia, low birth weight, preterm birth, and intrauterine growth delay in susceptible mothers. Since schoolchildren generally have a higher prevalence due to behavioral and hygiene-related factors, our systematic review and meta-analysis aimed to determine the prevalence and risk factors for Hookworm infection among schoolchildren in Ethiopia.

Methods: Relevant studies were retrieved from several search databases. The data were extracted via a standard data extraction format, and STATA version 11 was utilized for the analysis. Funnel plots and Egger's regression tests were used to evaluate publication bias, whereas the I² test was used to determine heterogeneity. A random effects model meta-analysis was conducted to determine the pooled prevalence and associated factors of Hookworm infection among schoolchildren.

Results: In this review, 48 studies with 43,285 participants were included. The pooled prevalence of Hookworm among schoolchildren was 13.01% (95% CI: 10.52, 15.51). Hookworm infection was significantly associated with the inability to use protective footwear (OR = 5.90, 95% CI: 2.86, 12.18) and the inability to use latrines (OR = 3.04, 95% CI: 1.77, 5.23). Subgroup analysis by diagnostic methods revealed that the highest prevalence of Hookworm was found to be 28.50% (95% CI: 24.09, 32.91) using combinations of Kato-Katz, McMaster, and spontaneous tube sedimentation techniques.

Conclusion: Our study revealed that a significant prevalence of schoolchildren were affected by Hookworms, with substantial regional variations. This suggests that there is a need for better control measures such as improving hygiene, sanitation, and protective measures such as footwear. In addition, a combination of one or more diagnostic methods should be employed for better detection of parasites. This systematic review and meta-analysis have been registered in PROSPERO with reference number CRD42024558542.