Intestinal parasitic infections and associated factors among street dwellers and prison inmates: A systematic review and meta-analysis

Abstract

Background: Intestinal parasitic infections are closely associated with low household income, poor personal and environmental sanitation, and overcrowding, limited access to clean water, tropical climate and low altitude. Street dwellers and prisoners are forced to live in deprived situations characterized by inadequate facilities. Therefore, this study aimed to estimate the pooled prevalence and associated factors of intestinal parasitic infections among street dwellers and prison inmates.

Method: Study searches were carried out in Electronic data bases such as PubMed/Medline, HINARI, EMBASE, Science Direct, Scopus, Google Scholar and Cochrane Library. Studies published only in English and have high quality Newcastle Ottawa Scale (NOS) scores were included for analysis using Stata version 14 software. Random-effects meta-analysis model was used for analysis. Heterogeneity was assessed using the Cochrane's Q test and I2 test statistics with its corresponding p-values. Moreover, subgroup, sensitivity analyses and publication bias were computed.

Result: Seventeen eligible studies consist of 4,544 study participants were included. Majority of the study participants were males (83.5%) and the mean age of the study participants was 25.7 years old. The pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was 43.68% (95% CI 30.56, 56.79). Sub-group analysis showed that the overall pooled prevalence of intestinal parasitic infections among prison inmates and street dwellers was 30.12% (95%CI: 19.61, 40.62) and 68.39% (95%CI: 57.30, 79.49), respectively. There was statistically significant association between untrimmed fingernail and intestinal parasitic infections (AOR: 1.09 (95%CI: 0.53, 2.23).

Conclusion: In this study, the pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was relatively high. Fingernail status had statistically significant association with intestinal parasitic infection. The prevention and control strategy of intestinal parasitic infection should also target socially deprived segment of the population such as street dwellers and prison inmates.

Fig 1. Flow chart of study selection for systematic review and meta-analysis on the prevalence and associated factors of intestinal parasitic infections among street living people and prison inmates.

Fig 2. Forest plot showing the pooled prevalence estimate of intestinal parasitic infection among street dwellers and prison inmates.

Fig 3. Forest plot showing the pooled prevalence of intestinal parasitic infection among prison inmates.

Fig 4. Forest plot showing the pooled prevalence estimate of intestinal parasitic infection among street dwellers.

Fig 5. Funnel plots showing publication bias test of the included studies in this meta-analysis.

Fig 6. The pooled odds ratio of the association between hand washing habit and intestinal parasitic infection among street dwellers and prison inmates.

Fig 7. The pooled odds ratio of the association between residence and intestinal parasitic infection among street dwellers and prison inmates.

Fig 8. The pooled odds ratio of the association between finger nail status and intestinal parasitic infection among street dwellers and prison inmates.