Prevalence of intestinal parasitic infection in food handlers of Iran: A systematic review and meta‐analysis

Food handlers regardless of whether preparing or serving food, play key roles in the transmission of food‐borne infections. This study aimed to evaluate the prevalence of intestinal parasitic infections in food handlers in Iran. In the present study, a comprehensive literature search was carried out in electronic databases, including PubMed, Scopus, Google Scholar, Science Direct, Magiran, Scientific Information Database (SID), Iran Medex and Iran Doc, to identify all the published studies from 2000 to 31st April 2019. A total of 25 articles from different regions of Iran were identified and fulfilled our eligibility criteria. Totally, 140,447 cases were examined and 1163 cases were infected with intestinal parasites. Of all cases, 19,516 were male and 5901 were female with 1163 and 652 infected cases, respectively. The overall prevalence of intestinal parasitic infections was evaluated 14.0% [95% CI: 11.0‐17.0%]. It is revealed that protozoan, such as Giardia lamblia, with prevalence of 41.0% [95% CI: 25.0‐59.0%], Blastosystis hominis with 28.0% [95% CI: 15.0‐44.0%] and Entamoeba coli with 22.0% [95% CI: 16.0‐29.0%] had the highest prevalence while, Dientamoeba fragilis 5.0% [95% CI: 4.0‐7.0%], Iodamoeba bütschlii 5.0% [95% CI: 2.0‐8.0%], Chilomastix mesnili 5.0% [95% CI: 2.0‐9.0%] and Endolimax nana with 3.0% [95% CI: 1.0‐7.0%], were less prevalent. Infection with Ascaris lumbricoides7.0% [95% CI: 0.0‐29.0%] was more prevalent helminth followed with Enterobius vermicularis 3.0% [95% CI: 1.0‐5.0%], Hymenolepis nana 2.0% [95% CI: 1.0‐3.0%], Taenia spp. 2.0% [95% CI: 0.0‐7.0%] and Trichuris trichiura 1.0% [95% CI: 0.0‐1.0%]. The high prevalence of commensal parasites, such as Entamoeba coli, which does not need cure is indicating the importance of personal hygiene in food handlers. Our results revealed the high prevalence of intestinal parasitic infection in food handlers in Iran. Monitoring programs to prevent and controlling of transmission to individuals are needed.