Worldwide prevalence of protozoans and helminths among disabled people: a systematic review and meta-analysis
Background
Parasitic diseases represent a substantial public health concern on a global scale, particularly affecting communities characterized by low socioeconomic status and insufficient sanitation practices. Within these communities, individuals with disabilities are disproportionately impacted. According to the existing literature, it is posited that the prevalence of parasitic infections among disabled individuals is notably high, a factor often neglected when examining the intestinal parasites present in these individuals, alongside the diverse geographical and socioeconomic variations worldwide. This study posits that the prevalence of parasitic infections in individuals with disabilities is indeed elevated, and that there are significant socioeconomic and geographic disparities in species-specific prevalence. This study aimed to ascertain the global pooled prevalence of helminth and protozoan infections in individuals with disabilities, identify the prevalent parasite species, and compare the prevalence across various geographic regions worldwide.
Methods
A systematic review and meta-analysis were conducted using the Reporting System for Systematic Reviews and Meta-Analyses. PubMed, Web of Science, Scopus, and the TR index were searched in August 2024 using the predetermined keywords. No time restrictions were imposed. The methodological quality of the studies was evaluated using the Joanna Briggs Institute’s Critical Appraisal Checklist for randomized controlled, experimental, and cross-sectional studies. A meta-analysis method was used to pooled the data.
Results
A total of 12608 samples from 50 articles were included in the analysis. The pooled helminth and protozoan parasite prevalence was 40%, with high heterogeneity (I2 = 98.48%, P < 0.001). Subgroup analysis revealed that the most common country for helminths and protozoans in disabled people was Canada, at a rate of 73% (I2 = 95.23%, P < 0.001). Subgroup analysis of parasite species revealed that Toxoplasma sp. (40%; prevalence with 95% CI: 40%, I2 = 98.83) was the most frequently detected parasite among disabled people, followed by Entamoeba histolytica/dispar and Toxocara spp. Entamoeba coli, Entamoeba hartmanni, Ascaris lumbricoides and Blastocystis spp. In the subgroup analysis performed with the data obtained in the classification according to the differences in diagnostic methods, 42% (I2 = 98.03, P < 0.001) in molecular techniques, 36% (I2 = 98.52, P < 0.001) in serological methods, 41% (I2 = 98.4, P < 0.001) in gaita microscopic examinations.
Conclusion
The global prevalence of protozoa and helminths among individuals with disabilities is significantly high, with notable occurrences in Canada, Philippines, and Ethiopia. The primary determinants of this situation include socioeconomic conditions, educational level, and geographical factors. It is imperative to educate disabled individuals and their families about transmission pathways and preventive measures for protozoa and helminths. Furthermore, local governments and public authorities should endeavor to improve the living conditions of individuals with disabilities, particularly those facing self-care challenges.