Abstract
Food handlers regardless whether preparing or serving food, key roles in transmission of food-borne infections. This study aimed to evaluate the prevalence of intestinal parasitic infections in food handlers. In present study, a comprehensive literature search was carried out in electronic databases including: PubMed, Scopus, Google Scholar, Science Direct, Magiran, Scientific Information Database (SID), Iran Medex and Iran Doc to identify all the published studies from 2000 to 31st April, 2019. A total of 25 articles from different regions of Iran identified and fulfilled our eligibility criteria. Totally 140447 cases were examined and 1163 cases were infected with intestinal parasites. Of all cases, 19516 were male and 5901 were female with 1163 and 652 infected case respectively. The overall prevalence of intestinal parasitic infections was evaluated 14% [95%CI: 11-17%]. Results indicated that protozoan such asGiardia lamblia , with prevalence of 41.0% [95%CI: 25.0%-59.0%], Blastosystice hominis with 28% [95%CI: 15.0%-44.0%] and Entamoaba coli with 22.0% [95%CI: 16.0%-29.0%] had the highest prevalence while, Dientamoeba fragilis 5.0% [95%CI: 4.0%-7.0%], Iodamoeba. bütschlii5.0% [95%CI: 2.0%-8.0%], Chilomastix mesnili 5.0% [95%CI: 2.0%-9.0%] and Endolimax. nana with 3.0% [95%CI: 1.0%-7.0%], were less prevalent. Infection withAscaris lumbricoides 7.0% [95%CI: 0.0%-29.0%] was more prevalent helminthes followed with Enterobius vermicularis 3.0% [95%CI: 1.0%-5.0%], Hymenolepis nana 2.0% [95%CI: 1.0%-3.0%], Taenia spp 2.0% [95%CI: 0.0%-7.0%] andTrichuris. trichiura 1.0% [95%CI: 0.0%-1.0%].
Our results revealed the high prevalence of intestinal parasitic infection in food handlers in Iran. Monitoring programs to prevent and controlling of transmission to individuals are needed.
Keywords: Intestinal, Parasitic Infection, Food handler, Iran
INTRODUCTION
Intestinal parasitic infections are widespread in the world and transmitting directly or indirectly among populations. In some cases, carriers without any symptoms of disease are the main source of infection especially if they work as food handlers. given the high prevalence of 2 billion chronically infected individuals in the world, this factis not from the reality. The importance of this issueemerges when those people work as food handlers and do not care personal hygiene (Saki et al., 2012).
Although people are in constant contact with environmental pathogens including parasites, they are not affected seriously sincethe immunity is important in disease etiology. Despite the well toleration of parasitic infection in most of the healthy individuals, some people are vulnerable against parasites. The importance of parasitic infection ishighlighted when the infected individualplays a major role in food handling or food industries.
Iran is a suitable region for most of parasitesgrowth and distribution due to the geographic, socioeconomic and behavioral conditions. Serious efforts tocontrol parasitic infection have resulted in burden decrease of parasitic infections, but contamination with intestinal parasites is still a concern for health care services (Kusolsuk et al.,2011). Using animal and human feces asfertilizersfor agricultures and vegetable gardens, climatic conditions, traditions and customs are consideredthe main reasons for the incidence of parasitic infections in some parts of the country. Direct transmission from person to person is another factor which complicates the parasite control programs. This kind of parasite transmission is markedly important in food handlers and particularly in oral-fecal parasites such as Giardia lamblia, Hymenolepis nanaand Enterobius vermicularis (Kusolsuk et al.,2011; Kheirandish et al.,2014). If food handlers do not care about personal hygiene, they can contaminate dishes, salad and other food materials which finally results in the contamination of the customers (Koohsaret al.,2012). Studies on transmitted parasites by food handlers indicate that Entamoeba coli is the most common nonpathogenic protozoa indicating contamination with fecal materials and poor hygiene (Kassani et al., 2015). There is a doubt about pathogenesis of some protozoan such as Blastocystis hominis, but the presence of it in large number may be associated with diarrhea (Motazedian et al., 2016).
Several studies have been conducted in different parts of the world regarding the prevalence of intestinal parasites in food handlers (Esparar et al., 2004). In this study, we performed a systematic review and meta-analysis to find out the pooled estimate of prevalence of intestinal parasites such as G. lamblia, E. coli , B. hominis and H. nana in food handlers, so the healthcare officials discovered the routs to prevent and control the disease transmitted by parasites and also the best and most practical method used in conducting experiments to achieve the best results.