A meta-analysis ofEntamoeba histolytica/disparin Iraq
Authors: Chalabi Khder Niazi 
Published: October 2018

Background

Amebiasis is a major health problem caused by the protozoan parasiteEntamoeba histolyticawith a worldwide distribution, especially in developing countries. The aim of this systematic review and meta-analysis was to estimate the proportion prevalence ofE. histolytica/disparin human in Iraq.

Methodology/Principal Findings

Published studies on human infection withE. histolytica/disparin Iraq were searched in electronic databases using Google scholar, Iraqi Academic Scientific Journals (IASJ), PubMed, ScienceDirect and WHO Global Health Library (GHL). Eligible studies were cross-sectional and used fecal and/or serological methods to diagnoseE. histolytica/disparinfection in human in Iraq, and published between 1970 and July 2017. The pooled prevalence was calculated using random effect model meta-analyses with 95% confidence interval (CI). Ninety nine studies were eligible for the meta-analysis that included 117694 individuals. The pooled proportion for E. histolytica/dispar infection in Iraq was estimated at 20.61% with a 95% confidence interval (CI) of 17.83, 23.53. A high level of heterogeneity was found among the studies. The prevalence among Iraqi population ranged between 1.66 and 90.5% per study (mean: 22.36%). The pooled prevalence of infection was 58.43% (95% CI: 54.71%?62.1%) and 43.10% (95% CI: 39.66%–46.6%) for males and females respectively. Parasite screening using microscopy did not differentiate between the pathogenic and nonpathogenic species ofEntamoebaresulted in higher proportion prevalence than PCR proportion prevalence, (20.32%, 95% CI: 17.80%–22.96%) (17.57%, 95% CI: 8.07%–29.75%) respectively. Hospital based studies recorded the highest prevalence ofE. histolytica/disparinfection at 22.69% (95% CI: 19.55%–25.99%). The prevalence decreased into 18.46 (95% CI: 14.28%–23.04%) between 2010 and 2017.

Conclusions/Significance

Although there was a reduction in prevalence of amebiasis since 2010, the prevalence of amebiasis is still considerable in population of Iraq. Therefore, prevention strategies of fecal contamination are required to reduce the infection.

Author summary

Amebiasis is the infection withEntamoeba histolyticaan invasive parasite dwelling the intestine or other organs such as liver, lungs, or skin of human. Infection with this parasite could be acquired by consumption of contaminated water, vegetables, and fruits with feces of infected human. The infection may be asymptomatic or symptomatic causing dysentery. We performed this meta-analysis to estimate the prevalence of amebiasis in the population of Iraq between 1970 and 2017. Ninety nine published studies were identified and the data were extracted from them to use in our meta-analysis and the total included individuals were 117694. The prevalence of population infection in Iraq was evaluated at 20.61%. The infection prevalence was higher in males than in females. The infection prevalence decreased during the period 2010 to 2017 in Iraqi population. This level of infection needs further efforts to eradicate amebiasis, these efforts begin with the prevention of the disease transmission through water and food and treatment of infected people. So awareness of simple hygienic principles can control the disease by boiling water and washing vegetables and fruits thoroughly.