Prevalence of Intestinal Parasitic Infections and Associated Factors Among Food Handlers in East Africa: A Systematic Review and Meta-analysis

Background: Intestinal parasitic infections are a significant public health concern, especially among food handlers, who can transmit these infections to the public through food preparation and handling. This systematic review and meta-analysis aimed to determine the pooled prevalence and associated factors of intestinal parasitic infections among food handlers in the East African region.

Methods: A systematic review and meta-analysis on intestinal parasitic infections among food handlers involved a comprehensive search across various databases, including Scopus, PubMed, ScienceDirect, Google Scholar, and the institution's library registers. Forty relevant articles were identified and analyzed using STATA Software version 17.0. Sensitivity analysis, publication bias assessment with Egger's test, and the Trim-and-fill meta-analysis for bias adjustment were conducted. Heterogeneity across the studies was assessed using Cochran's Q statistic and I² statistics, and subgroup analysis computed for significant heterogeneity (I² value ≥ 50%). A random effect model was used to determine the pooled prevalence of intestinal parasitic infections.

Results: The pooled prevalence of intestinal parasitic infections among food handlers was 32.27% (95% CI 27.90-36.65). The most prevalent parasites were Entamoeba histolytica/dispar 20.83% (95% CI 13.66-28%), Ascaris lumbricoides 13.84% (95% CI 10-17.68%), Giardia lamblia 8.55% (95% CI 6.03-11.06%), and hookworm 6.43% (95% CI 3.93-8.93%). Using a common knife for cutting raw meat (AOR = 2.27, 95% CI 1.21-4.31), food handler's untrimmed fingernails (AOR = 2.14, 95% CI 1.50-2.78), and no hand washing practices with soap after using the toilet (AOR = 2.25, 95% CI 1.33-3.18) were associated with higher rates of intestinal parasitic infections among food handlers.

Conclusions: Parasitic infections among food handlers were found to be significantly prevalent. Factors contributing to this high prevalence included food handlers' untrimmed fingernails, poor hand hygiene practices, and using a shared knife for chopping various food items, including raw meat. These findings emphasize the need for proper personal hygiene and sanitation practices among food handlers to prevent transmitting parasitic infections to consumers.