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.