Abstract
Intestinal protozoa infections are responsible for considerable morbidity and mortality, especially where the exposed population suffers from a lack of drinking water and sanitation facilities. In this study, the association between the lack of safe drinking water and sanitation (toilet) facilities with intestinal Entamoeba spp infection in the children (5–11 years), adult (18–55 years), and all age (5–55 years) were assessed. For this purpose, some of the international databases such as Scopus, PubMed, Web of Science, and Embase were screened to up to 7 June 2019 in order to retrieve the related citations. Also, the pooled odds ratios (ORs) following 95% confidence intervals (CIs) were calculated using a random-effects model. Twenty-nine articles with 36 studies were included while the OR extracted or calculated by using 2 × 2 contingency tables. However, the ingestion of contaminated water insignificantly can increase the odds ratio (OR) of Entamoeba spp infection (OR 1.01, (95% confidence interval [CI] 0.58 to 1.43), no access to sanitation (toilet) facilities significantly can increase odds of Entamoeba spp infection (OR 1.18, 95% CI 1.05 to 1.32). The meta-regression analysis showed that over time, odds of intestinal Entamoeba spp infection increased in both lack of safe drinking water (Coefficient: 3.24, P-value < 0.01) and sanitation (toilet) facilities (Coefficient: 2.36, P-value < 0.05) subgroups. Considering the findings, lack of safe drinking water resulted in a further increase in intestinal Entamoeba spp infection among adult (OR: 2.76), children (OR = 0.57) and all age groups (OR: 1.50), and also lack of sanitation (toilet) facilities resulted in further increase intestinal Entamoeba spp infection in children (OR: 1.06), adult (OR: 1.26) and all age (OR: 1.16). In this context, the lack of safe drinking water and sanitation facilities (toilet) was associated with a high risk of intestinal Entamoeba spp infection. Further attempts to providing public health facilities can control the prevalence of intestinal Entamoeba spp.
Highlights
While the intestinal protozoa infections with some types of Entamoeba spp such as Entamoeba histolytica, Giardia intestinalis, Strongyloides stercoralis, and Crypto sporidium spp, they can be considered as one of the serious human health threats due to the notable malnutrition, mortality and morbidity rates in the worldwide [1,2,3,4,5,6]. In this context, according to the World Health Organization (WHO), the endemic of schistosomiasis occurred in 78 countries, which resulted in further treatments for about 261 million people [7]
The prevalence of Giardia intestinalis among the developing and developed countries was estimated as 20–30% and 2–3%, respectively, which can be accounted for serious health risks [4, 8]
While the high prevalence of Giardia intestinalis among developing was highlighted, the higher prevalence of Cryptosporidium spp in the people infected with HIV highlighted the dangerous consequences of Intestinal protozoa infections [9, 10]
Summary
While the intestinal protozoa infections with some types of Entamoeba spp such as Entamoeba histolytica, Giardia intestinalis, Strongyloides stercoralis, and Crypto sporidium spp, they can be considered as one of the serious human health threats due to the notable malnutrition, mortality and morbidity rates in the worldwide [1,2,3,4,5,6]. In this context, according to the World Health Organization (WHO), the endemic of schistosomiasis occurred in 78 countries, which resulted in further treatments for about 261 million people [7]. DALYs related to both intestinal protozoa and schistosomiasis infections were estimated at about 26.1 million persons in 2015 [13]
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