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Parasites & Vectors May 2014The relationship between nutrition and soil-transmitted helminthiasis is complex and warrants further investigation. We conducted a systematic review examining the... (Review)
Review
BACKGROUND
The relationship between nutrition and soil-transmitted helminthiasis is complex and warrants further investigation. We conducted a systematic review examining the influence of nutrition on infection and re-infection with soil-transmitted helminths (i.e. Ascaris lumbricoides, hookworm, Trichuris trichiura and Strongyloides stercoralis) in humans. Emphasis was placed on the use of nutritional supplementation, alongside anthelminthic treatment, to prevent re-infection with soil-transmitted helminths.
METHODS
We searched eight electronic databases from inception to 31 July 2013, with no restriction of language or type of publication. For studies that met our inclusion criteria, we extracted information on the soil-transmitted helminth species, nutritional supplementation and anthelminthic treatment. Outcomes were presented in forest plots and a summary of findings (SoF) table. An evidence profile (EP) was generated by rating the evidence quality of the identified studies according to the GRADE system.
RESULTS
Fifteen studies met our inclusion criteria; eight randomised controlled trials and seven prospective cohort studies. Data on A. lumbricoides were available from all studies, whereas seven and six studies additionally contained data on T. trichiura and hookworm, respectively. None of the studies contained data on S. stercoralis. Positive effects of nutritional supplementation or the host's natural nutritional status on (re-)infection with soil-transmitted helminths were reported in 14 studies, while negative effects were documented in six studies. In terms of quality, a high, low and very low quality rating was assigned to the evidence from four, six and five studies, respectively.
CONCLUSIONS
Our findings suggest that the current evidence-base is weak, precluding guidelines on nutrition management as a potential supplementary tool to preventive chemotherapy targeting soil-transmitted helminthiasis. Moreover, several epidemiological, immunological and methodological issues have been identified, and these should be considered when designing future studies.
Topics: Anthelmintics; Child; Child, Preschool; Helminthiasis; Humans; Infant; Nutritional Status
PubMed: 24885622
DOI: 10.1186/1756-3305-7-229 -
BMC Pregnancy and Childbirth Jul 2021Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia.
METHODS
Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software.
RESULTS
Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia.
CONCLUSIONS
Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.
Topics: Ethiopia; Female; Humans; Intestinal Diseases, Parasitic; Pregnancy; Pregnant Women; Prevalence; Risk Factors
PubMed: 34210260
DOI: 10.1186/s12884-021-03908-0 -
Infection Dec 2021Comprehensive nationwide data on prevalence and distribution of intestinal parasites (IPIs) among pregnant women are lacking. Therefore, the aim of this study was to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Comprehensive nationwide data on prevalence and distribution of intestinal parasites (IPIs) among pregnant women are lacking. Therefore, the aim of this study was to provide pooled prevalence estimate, prevalence in different regions and species-specific IPIs among pregnant women in Ethiopia.
METHODS
The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science and Google Scholar on published and unpublished data between 2008 and Sep 2020 for studies describing rate of IPIs among pregnant women in Ethiopian. A random-effects model and forest plots to estimate pooled effect size and effect of each study with their confidence interval (CI) were used to provide a visual summary of the data. We conducted meta-regression to understand the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14.
RESULTS
A total of 3149 of the 9803 pregnant women were infected with one or more species of IPIs resulted in an overall prevalence of 29% (95% CI 22-37%). The prevalence estimate varied among studies with considerable heterogeneity (χ = 2069.19, p < 0.001 I = 98.84). The prevalence of IPIs was 36% (95% CI 22-50%) in Oromia region, 29% (95% CI 10-47%) in Amhara region, 24% (95% CI 17-32%) in southern nation, nationality and people region, 24% (95% CI 22-27%) in Tigray region and 24% (95% CI 20-29%) in Addis Ababa city. Hookworms with pooled prevalence estimate of 10% (95% CI 8-13%) followed by Ascaris lumbricoides 10% (95% CI 7-13%), and Entamoeba histolytica/dispar 6% (95% CI 4-8%) were the three common species of IPIs identified in this group of population.
CONCLUSION
The prevalence of IPIs among pregnant women is relatively high in comparison to other general population. Hookworms and Ascaris lumbricoides were the most dominant species of intestinal helminths, whereas Entamoeba histolytica/dispar was the dominant intestinal protozoa among pregnant women in Ethiopia.
Topics: Animals; Ethiopia; Female; Helminths; Humans; Intestinal Diseases, Parasitic; Pregnancy; Pregnant Women; Prevalence
PubMed: 34110569
DOI: 10.1007/s15010-021-01635-4 -
PLoS Neglected Tropical Diseases Dec 2021To estimate the impact of preventive chemotherapy on the prevalence and intensity of soil-transmitted helminth (STH) infections, schistosomiasis, and lymphatic... (Meta-Analysis)
Meta-Analysis
Prevalence of soil-transmitted helminth infections, schistosomiasis, and lymphatic filariasis before and after preventive chemotherapy initiation in the Philippines: A systematic review and meta-analysis.
OBJECTIVE
To estimate the impact of preventive chemotherapy on the prevalence and intensity of soil-transmitted helminth (STH) infections, schistosomiasis, and lymphatic filariasis in the Philippines, using systematic review and meta-analysis.
METHODS
We included reports reporting prevalence of STH infections, schistosomiasis, or lymphatic filariasis in the Philippines published until 31 March 2021. Peer-reviewed studies were identified in electronic databases. Grey literature reports by the University of the Philippines and the Department of Health were also included. Pooled infection prevalence, before and after the initiation of preventive chemotherapy, stratified by age group, was calculated using the inverse variance heterogeneity model.
FINDINGS
A total of 109 reports were included in the review and meta-analysis. Overall prevalence of moderate-heavy intensity Ascaris lumbricoides (6.6%) and Trichuris trichiura (2.7%) infection after initiation of preventive chemotherapy were significantly lower than the prevalence prior to initiation (23.6% for A. lumbricoides and 12.2% for T. trichiura). Prevalence reductions were also found in school and preschool-age children for A. lumbricoides and T. trichiura. Studies conducted after preventive chemotherapy initiation had significantly lower overall prevalence of moderate-heavy intensity schistosomiasis (3.1% vs 0.2%) and of schistosomiasis in school-age children (30.5% vs 1%). Pooled prevalence of lymphatic filariasis prior to preventive chemotherapy initiation was 3.2% across 12 provinces, while currently only two provinces still have prevalence of more than 1%. There were no published studies reporting prevalence of lymphatic filariasis after initiation of preventive chemotherapy. Heterogeneity was high with I2 mostly above 90%.
CONCLUSION
The burden of STH infections and schistosomiasis in children were significantly lower in studies conducted following the initiation of preventive chemotherapy. Eliminating morbidity and interrupting transmission, however, may require expanded control initiatives including community-wide treatment, and improved water, sanitation, and hygiene. Lymphatic filariasis burden has decreased since the implementation of preventive chemotherapy, with all but two provinces having reached the elimination of lymphatic filariasis as a public health problem.
Topics: Adolescent; Adult; Animals; Anthelmintics; Child; Child, Preschool; Elephantiasis, Filarial; Feces; Female; Helminthiasis; Helminths; Humans; Infant; Male; Middle Aged; Philippines; Prevalence; Schistosomiasis; Soil; Young Adult
PubMed: 34928944
DOI: 10.1371/journal.pntd.0010026 -
International Journal of Environmental... Jan 2021Coinfection of malaria and intestinal helminths affects one third of the global population, largely among communities with severe poverty. The spread of these parasitic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Coinfection of malaria and intestinal helminths affects one third of the global population, largely among communities with severe poverty. The spread of these parasitic infections overlays in several epidemiological locations and the host shows different outcomes. This systematic review and meta-analysis determine the pooled prevalence of malaria and intestinal helminthiases coinfections among malaria suspected patients in Ethiopia.
METHODS
Primary studies published in English language were retrieved using appropriate search terms on Google Scholar, PubMed/MEDLINE, CINHAL, Scopus, and Embase. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. A pooled statistical meta-analysis was conducted using STATA Version 14.0 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test, respectively. Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis. The Random effects model was used to estimate the summary prevalence of comorbidity of malaria and soil transmitted helminthiases and the corresponding 95% confidence intervals (CI). The review protocol has registered in PROSPERO number CRD42019144803.
RESULTS
We identified ten studies ( = 6633 participants) in this study. The overall pooled result showed 13% of the ambulatory patients infected by malaria and intestinal helminths concurrently in Ethiopia. The pooled prevalence of and , and mixed infections were 12, 30, and 6%, respectively. The most common intestinal helminth parasites detected were , , and .
CONCLUSIONS
The comorbidity of malaria and intestinal helminths causes lower hemoglobin level leading to maternal anemia, preterm delivery, and still birth in pregnant women and lactating mother. School-aged children and neonates coinfected by plasmodium species and soil transmitted helminths develop cognitive impairment, protein energy malnutrition, low birth weight, small for gestational age, and gross motor delay. The Ministry of Health of Ethiopia and its international partners working on malaria elimination programs should give more emphasis to the effect of the interface of malaria and soil transmitted helminths, which calls for an integrated disease control and prevention.
Topics: Animals; Child; Comorbidity; Ethiopia; Female; Health Facilities; Helminths; Humans; Infant, Newborn; Lactation; Malaria; Outpatients; Pregnancy; Prevalence
PubMed: 33498343
DOI: 10.3390/ijerph18030862 -
Journal of Laboratory Physicians Mar 2023Soil-transmitted helminths (STH) is a major healthcare challenge in the pediatric age group affecting poor and deprived parts of our community. The main species that... (Review)
Review
Soil-transmitted helminths (STH) is a major healthcare challenge in the pediatric age group affecting poor and deprived parts of our community. The main species that infect people are roundworm (AL, ), whipworm (TT, ), and hookworms (HW, and ). We aimed to estimate the pooled prevalence of STH infections in India in the pediatric age group (< 18 years) and assess the risk factors associated with STH in this age group. Three databases were searched (PubMed, Scopus, and Embase) up to February 16, 2021 with deliberate and inclusive search terms for original research articles estimating the prevalence of either of the three STH in India. Data extracted included individual prevalence of the three STH, prevalence of double or triple infections, and associated risk factors. We identified systematically 1,408 publications, of which 44 were included for the final analysis, including studies from 20 states covering 34,590 children. In our study, the prevalence of AL ranged from 0.8 to 91% with a pooled prevalence of 25%, prevalence of TT ranged from 0.3 to 72% with a pooled prevalence of 13%, and for HW prevalence ranged from 0.2 to 80% with pooled prevalence of 10%. Two most important risk factors with higher odds ratio were open defecation practices or open latrine (odds ratio: 5.2) and washing hands without soap using water only (odds ratio: 2.49). Knowledge of areas with high prevalence of STH and associated risk factors would help in designing effective control strategies in the high-risk groups to prevent infection and aid in a drastic reduction of morbidity in children.
PubMed: 37064993
DOI: 10.1055/s-0042-1751319 -
JAMA Apr 2008More than a quarter of the human population is likely infected with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) in highly... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
More than a quarter of the human population is likely infected with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) in highly endemic areas. Preventive chemotherapy is the mainstay of control, but only 4 drugs are available: albendazole, mebendazole, levamisole, and pyrantel pamoate.
OBJECTIVE
To assess the efficacy of single-dose oral albendazole, mebendazole, levamisole, and pyrantel pamoate against A lumbricoides, hookworm, and T trichiura infections.
DATA SOURCES
A systematic search of PubMed, ISI Web of Science, ScienceDirect, the World Health Organization library database, and the Cochrane Central Register of Controlled Trials (1960 to August 2007).
STUDY SELECTION
From 168 studies, 20 randomized controlled trials were included.
DATA EXTRACTION AND DATA SYNTHESIS
Information on study year and country, sample size, age of study population, mean infection intensity before treatment, diagnostic method used, time between evaluations before and after treatment, cure rate (the percentage of individuals who became helminth egg negative following treatment with an anthelminthic drug), egg reduction rate, adverse events, and trial quality was extracted. Relative risk, including a 95% confidence interval (CI), was used to measure the effect of the drugs on the risk of infection prevalence with a random-effects model.
RESULTS
Single-dose oral albendazole, mebendazole, and pyrantel pamoate for infection with A lumbricoides resulted in cure rates of 88% (95% CI, 79%-93%; 557 patients), 95% (95% CI, 91%-97%; 309 patients), and 88% (95% CI, 79%-93%; 131 patients), respectively. Cure rates for infection with T trichiura following treatment with single-dose oral albendazole and mebendazole were 28% (95% CI, 13%-39%; 735 patients) and 36% (95% CI, 16%-51%; 685 patients), respectively. The efficacy of single-dose oral albendazole, mebendazole, and pyrantel pamoate against hookworm infections was 72% (95% CI, 59%-81%; 742 patients), 15% (95% CI, 1%-27%; 853 patients), and 31% (95% CI, 19%-42%; 152 patients), respectively. No pooled relative risks could be calculated for pyrantel pamoate against T trichiura and levamisole for any of the parasites investigated.
CONCLUSIONS
Single-dose oral albendazole, mebendazole, and pyrantel pamoate show high cure rates against A lumbricoides. For hookworm infection, albendazole was more efficacious than mebendazole and pyrantel pamoate. Treatment of T trichiura with single oral doses of current anthelminthics is unsatisfactory. New anthelminthics are urgently needed.
Topics: Albendazole; Ancylostomatoidea; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Hookworm Infections; Humans; Levamisole; Mebendazole; Pyrantel Pamoate; Soil; Trichuriasis; Trichuris
PubMed: 18430913
DOI: 10.1001/jama.299.16.1937 -
TheScientificWorldJournal 2022Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce the pooled prevalence and associated risk factors of human intestinal helminth parasitic infections (HIHPIs) in Ethiopia.
METHODS
Articles written in English were searched from online databases. Sixty-seven studies were included. Meta-analysis was computed using STATA version 14.
RESULT
The pooled prevalence of HIHPIs was (33.35%, 95% CI: 28.85%, 37.86%). (10.84%, 95% CI: 9.34, 12.34), hookworm spp. (8.89%, 95% CI: 7.75, 10.04), (4.22%, 95% CI: 3.64, 4.81), (2.51%, 95% CI: 2.17, 2.86), (2.29%, 95% CI: 1.96, 2.63), species (1.01%, 95% CI: 0.80, 1.22), (1.17%, 95% CI: 0.92, 1.41), and (0.71%, 95% CI: 0.52, 0.90) were recorded. Handwashing before food (OR: 5.22,95% CI: 3.49, 6.94), handwashing after toilet (OR: 3.03, 95%; CI: 1.01, 5.05), age (OR: 1.66, 95% CL. 1.09, 2.23), open defecation (OR: 2.42, 95% CI: 1.60, 3.24), eating raw and unwashed vegetables/fruits (OR: 1.98, 95%; CI: 1.30, 2.66), maternal education (OR: 1.81, 95% CI: 0.91, 2.72), family income (OR: 2.00, 95% CI: 0.87, 3.31), source of drinking water (OR: 3.12, 95% CI: 1.96, 4.27), swimming/contact with river water (OR: 1.90, 95% CI: 1.11, 2.69), barefoot (OR: 3.28, 95% CI: 1.67, 4.88), playing with soil (OR: 2.64, 95% CI: 1.40, 3.88), and family size (OR: 3.75, 95% CI: 2.03, 5.46) were factors associated with HIHPIs in Ethiopia. High heterogeneity of the prevalence of HIHPIs was observed among the studies within and among regions (I > 99.6% and ≤ 0.001).
CONCLUSION
HIHPIs in Ethiopia were significantly high. Therefore, special attention should be given by all stakeholders to minimize HIHPIs in Ethiopia.
Topics: Animals; Cross-Sectional Studies; Ethiopia; Helminthiasis; Helminths; Humans; Intestinal Diseases, Parasitic; Prevalence; Risk Factors
PubMed: 36093316
DOI: 10.1155/2022/3905963 -
The Cochrane Database of Systematic... Jun 2022It is estimated that 1.5 billion people are infected with soil-transmitted helminths (STHs) worldwide. Re-infection occurs rapidly following deworming, and interruption... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is estimated that 1.5 billion people are infected with soil-transmitted helminths (STHs) worldwide. Re-infection occurs rapidly following deworming, and interruption of transmission is unlikely without complementary control efforts such as improvements in water, sanitation, and hygiene (WASH) access and behaviours.
OBJECTIVES
To assess the effectiveness of WASH interventions to prevent STH infection.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was 19 October 2021.
SELECTION CRITERIA
We included interventions to improve WASH access or practices in communities where STHs are endemic. We included randomized controlled trials (RCTs), as well as trials with an external control group where participants (or clusters) were allocated to different interventions using a non-random method (non-RCTs). We did not include observational study designs. Our primary outcome was prevalence of any STH infection. Prevalence of individual worms was a secondary outcome, including for Ascaris lumbricoides, Trichuris trichiura, hookworm (Ancylostoma duodenale or Necator americanus), or Strongyloides stercoralis. Intensity of infection, measured as a count of eggs per gram of faeces for each species, was another secondary outcome.
DATA COLLECTION AND ANALYSIS
Two review authors independently reviewed titles and abstracts and full-text records for eligibility, performed data extraction, and assessed risk of bias using the Cochrane risk of bias assessment tool for RCTs and the EPOC tool for non-RCTs. We used a random-effects meta-analysis to pool study estimates. We used Moran's I² statistic to assess heterogeneity and conducted subgroup analyses to explore sources of heterogeneity. We assessed the certainty of the evidence using the GRADE approach.
MAIN RESULTS
We included 32 studies (16 RCTs and 16 non-RCTs) involving a total of 52,944 participants in the review. Twenty-two studies (14 RCTs (16 estimates) and eight non-RCTs (11 estimates)) reported on our primary outcome, prevalence of infection with at least one STH species. Twenty-one studies reported on the prevalence of A lumbricoides (12 RCTs and 9 non-RCTs); 17 on the prevalence of T trichiura (9 RCTs and 8 non-RCTs); 18 on the prevalence of hookworm (10 RCTs and 8 non-RCTs); and one on the prevalence of S stercoralis (1 non-RCT). Sixteen studies measured the intensity of infection for an individual STH type. Ten RCTs and five non-RCTs reported on the intensity of infection of A lumbricoides; eight RCTs and five non-RCTs measured the intensity of infection of T trichiura; and eight RCTs and five non-RCTs measured the intensity of hookworm infection. No studies reported on the intensity of infection of S stercoralis. The overall pooled effect estimates showed that the WASH interventions under study may result in a slight reduction of any STH infection, with an odds ratio (OR) of 0.86 amongst RCTs (95% confidence interval (CI) 0.74 to 1.01; moderate-certainty evidence) and an OR of 0.71 amongst non-RCTs (95% CI 0.54 to 0.94; low-certainty evidence). All six of the meta-analyses assessing individual worm infection amongst both RCTs and non-RCTs had pooled estimates in the preventive direction, although all CIs encapsulated the null, leaving the possibility of the null or even harmful effects; the certainty of the evidence ranged from very low to moderate. Individual studies assessing intensity of infection showed mixed evidence supporting WASH. Subgroup analyses focusing on narrow specific subsets of water, sanitation, and hygiene interventions did very little to elucidate which interventions might be better than others. Data on intensity of infection (e.g. faecal egg count) were reported in a variety of ways across studies, precluding the pooling of results for this outcome. We did not find any studies reporting adverse events resulting from the WASH interventions under study or from mass drug administration (MDA).
AUTHORS' CONCLUSIONS
Whilst the available evidence suggests that the WASH interventions under study may slightly protect against STH infection, WASH also serves as a broad preventive measure for many other diseases that have a faecal oral transmission route of transmission. As many of the studies were done in addition to MDA/deworming (i.e. MDA was ongoing in both the intervention and control arm), our data support WHO recommendations for implementation of improvements to basic sanitation and adequate access to safe water alongside MDA. The biological plausibility for improved access to WASH to interrupt transmission of STHs is clear, but WASH interventions as currently delivered have shown impacts that were lower than expected. There is a need for more rigorous and targeted implementation research and process evaluations in order that future WASH interventions can better provide benefit to users. Inconsistent reporting of the intensity of infection underscores the need to define the minimal, standard data that should be collected globally on STHs to enable pooled analyses and comparisons.
Topics: Animals; Ascaris lumbricoides; Humans; Hygiene; Observational Studies as Topic; Sanitation; Soil; Water
PubMed: 35726112
DOI: 10.1002/14651858.CD012199.pub2 -
Transactions of the Royal Society of... May 2021Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited information is available about the global status of IPIs in pregnant women. Here we undertook a meta-analysis to estimate the global prevalence of IPIs and associated risk factors in pregnant women.
METHODS
We searched the PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases for relevant studies that were published between 1 January 1987 and 30 December 2019. A random effects meta-analysis model was used to estimate the pooled prevalence, odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
A total of 114 studies comprising 98 342 pregnant women across 35 countries were included in the systematic review and meta-analysis. Among IPIs identified from pregnant women, three helminth infections (hookworm 19% [95% CI 15 to 23], Ascaris lumbricoides 17% [95% CI 13 to 21] and Trichuris trichiura 11% [95% CI 7 to 16]) and three protozoan infections (Blastocystis sp. 21% [95% CI 4 to 46], Entamoeba histolytica/dispar 9% [95% CI 3 to 19] and Giardia sp. 8% [95% CI 4 to 13]) were identified as the most prevalent intestinal parasites. Moreover, we found that there was a significant association between IPIs with increased risk of anaemia in pregnant women (OR 2.65 [95% CI 2.08 to 3.37]). The prevalence of IPIs was slightly higher in geophagic pregnant women compared with controls, but this was not significant (OR 1.22 [95% CI 0.87 to 1.71]). According to species, the pooled OR of A. lumbricoides infection had a significantly higher risk in geophagic pregnant women compared with controls (OR 2.66 [95% CI 1.37 to 5.16]). There was a positive relationship between the high prevalence of IPIs in pregnant women living in rural areas compared with urban residents (OR 3.36 [95% CI 1.57 to 7.19]).
CONCLUSIONS
The current review revealed a relatively high prevalence of IPIs in pregnant women, especially in some low- and middle-income countries. These results suggest a need for improved prevention and control efforts to reduce the health risks to pregnant women.
Topics: Animals; Cross-Sectional Studies; Feces; Female; Humans; Infant, Newborn; Intestinal Diseases, Parasitic; Pregnancy; Pregnant Women; Prevalence; Risk Factors
PubMed: 33007067
DOI: 10.1093/trstmh/traa101