Prevalence of intestinal protozoan parasites among Asian schoolchildren: a systematic review and meta-analysis

Abstract

Purpose: Intestinal protozoan parasites among Asian schoolchildren are a subject of concern due to their prevalence and potential health impact. Understanding and addressing this issue is crucial for public health in the region.

Methods: We conducted a comprehensive search for articles published up to December 2023 across four databases, including Scopus, PubMed, ProQuest, and Web of Science. To estimate the combined prevalence, a random-effects model with a 95% confidence interval (CI) was applied, and the statistical analysis was performed using meta-analysis packages in R version (3.6.1). This study is registered with PROSPERO (CRD42023481146).

Results: Among 131 eligible articles, the prevalence of intestinal protozoan parasites was 0.208 (95% CI = 0.180-0.238). Lebanon and Tajikistan had the highest country-level prevalence at 0.851 and 0.836, respectively, with Giardia duodenalis being the most prevalent species at 0.082.

Conclusion: In summary, our study highlights the urgent public health issue of protozoan parasites among Asian schoolchildren due to poor sanitation and water quality. Immediate interventions are essential, considering climate and socioeconomic factors, to combat these infections and improve overall health.

Keywords: Asia; Intestinal protozoan parasites; Meta-analysis; Prevalence; Schoolchildren.

Fig. 1

Flow diagram of the study design process

Fig. 2

Forest plots for random-effects meta-analysis of intestinal protozoan parasites among Asian schoolchildren (the box indicate the effect size of the studies (prevalance) and the whiskers indicate its confidence interval for corresponding effect size. There is no specific difference between white and black bars, only studies with a very narrow confidence interval are shown in white. In the case of diamonds, their size indicates the size of the effect, and their length indicate confidence intervals)

Fig. 3

(a) Geographical region where the study was published, (b) distribution of intestinal protozoan parasites among Asian schoolchildren per GDB Geography

Fig. 4

A meta-regression graph for the prevalnce of intestinal protozoan parasites among Asian schoolchildren based on humidity (A), and year of publication (B). The pink line is the regression line, which was plotted based on the intercept and the slope of the regession model. The different colour bubbles represent the countries under study and their sizes indicates the effect size of each study

Fig. 5

Egger's funnel plot to access publication bias in studies evaluating of intestinal protozoan parasites among Asian schoolchildren (A). Doi plot: A Luis Furuya-Kanamori (LFK) index 1.27 indicates minor asymmetry (B)