Intestinal parasites among intellectually disabled individuals in Iran: a systematic review and meta-analysis

Abstract

Background Poor self-care skills and personal hygiene resulted from limitations in learning and understanding, put intellectually disabled individuals at greater risk for intestinal parasitic infections (IPIs). Despite several regional reports in Iran, the overall burden on IPIs among intellectually disabled individuals is poorly understood. Hence, the present study aimed to estimate the pooled prevalence of IPIs among intellectually disabled individuals in Iran. Methods Using the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from seven electronic databases (PubMed, Web of Science, Scopus, Embase, and ProQuest for English articles, as well as SID and Magiran for Persian) from their inception up to December 2020. Pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI) and depicted as a forest plot, while heterogeneity was evaluated using Cochran’s Q-test. Results Exactly 1263 of the 3004 intellectually disabled individuals examined by 14 studies across 10 provinces of Iran were positive for IPIs. Overall pooled prevalence estimate was 41% (95% CI 29–53%) with a range of 21% (95% CI 10–32%) to 68% (95% CI 55–80%) across sub-groups. Entamoeba coli (16.2%; 95% CI 10.3–22%), Blastocystis spp. (12.2%; 95% CI 7.2–17.2%), and Giardia duodenalis (11.9%; 95% CI 7.4–16.3%) were the most prevalent protozoan species. In terms of helminthic agents, the most prevalent species were Enterobius vermicularis (11.3%; 95% CI 6.3–16.3%) followed by Strongyloides stercoralis (10.9%; 95% CI 5.0–16.9%) and Hymenolepis nana (2.8%; 95% CI 0.4–5.2%) Conclusion IPIs are highly prevalent among intellectually disabled individuals in Iran. Improving the health status and implementing infectious disease prevention strategies in rehabilitation centers, health promotion interventions to improve personal hygiene of intellectually disabled individuals, as well as utilize sensitive diagnostic methods besides routine stool examination techniques, and treatment of infected individuals will help in the control of these infections among intellectually disabled individuals.

Intestinal parasitic infections among patients referred to hospitals affiliated to Shiraz University of Medical Sciences, southern Iran: a retrospective study in pre- and post-COVID-19 pandemic

“…The current study revealed a low prevalence of helminthic parasites compared to protozoan parasites (0.04% and 4.4%, respectively). These results were consistent with the previous studies that indicated a decreasing trend in intestinal helminth infections, while intestinal protozoa still have a high prevalence in various areas of Iran (Rokni 2008 ; Teimouri et al 2020 ; Abbaszadeh Afshar et al 2021 ). The high prevalence of protozoan parasites is possibly due to their high proliferation rate and the simple route of infection via contaminated foods and water (Abera et al 2010 ).…”

“…H. nana , E. vermicularis , and S. stercoralis were reported as the parasitic helminths in the present study. In line with our findings, A. lumbricoides , E. vermicularis , S. stercoralis , and H. nana were the most predominant helminths reported among food handlers and intellectually disabled individuals in Iran (Teimouri et al 2020 ; Abbaszadeh Afshar et al 2021 ). Although the prevalence of human helminthic diseases has decreased in recent decades throughout Iran, some of them, particularly those with direct fecal–oral transmissions, such as Enterobius and Hymenolepis , are still common (Rokni 2008 ; Goudarzi et al 2021 ).…”

“…Blastocystis spp., E. coli , and G. intestinalis were the most prevalent intestinal parasites in the present study. These parasites have been reported almost in most studies on IPIs among different populations in Iran (Nasiri et al 2009 ; Barkhori Mahni et al 2016 ; Afshar et al 2020 ; Teimouri et al 2020 ; Abbaszadeh Afshar et al 2021 ; Mohebali et al 2021 ). The prevalence rate of Blastocystis spp.…”

“…Most people infected with these parasites are asymptomatic and excrete many infectious cysts that survive in the environment for a long time. It seems that the healthy carrier, which enhances the chance of transmission of these parasites to the new host, could explain the high prevalence of these parasites compared with other protozoan parasites (Abbaszadeh Afshar et al 2021 ).…”

Intestinal Parasitic Infections among Intellectually Disabled Individuals in Bandar Abbas County, Southern Iran

“…Blastocystis hominis was the most common detected parasite followed by Entamoeba coli , Giardia lamblia , Cryptosporidium , Iodamoeba butchlii , and Endolimax nana . Blastocystis is considered a common protozoan infection in humans in Iran [ 11 – 16 ]. Results of a recent systematic review and meta-analysis revealed that Entamoeba coli , Blastocystis spp., and Giardia lamblia are the most prevalent protozoan parasite among intellectually disabled individuals in Iran [ 11 ].…”