Efficacy of sanitization protocols in the removal of parasites in vegetables: a systematic review with meta-analysis.
Creators: name: Maia, Cláudio Márcio de Medeiros
name: da Silva Chaves Damasceno, Karla
name: Freitas, Juliana
name: Chaves, Gabriela
name: Seabra, Larissa
name: de Assis, Cristiane
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Parasitology
subject: Immunology and Infectious Disease
subject: Nutrition
subject: Life Sciences
subject: Food Science
subject: Food safety
subject: Vegetables

description: Summary: The contamination of vegetables by parasites is reported in several countries around the world as an important transmission pathway of cysts and oocytes of protozoa, eggs and helminthes larvae. The need to prevent and reduce this risk requires strict monitoring hygiene of these foods, which are predominantly consumed raw. The evaluation of sanitization protocols, which minimize this contamination, is relevant to ensure that such foods are offered with quality and safety. This systematic review will evaluate the efficacy of different sanitization protocols in removing parasitic forms from vegetables. Review question: What is the best sanitization protocol to minimize or exclude the presence of parasitic forms in vegetables? Search strategy: The following databases will be searched: MEDLINE, The Cochrane Library, Embase, Web of Science, FSTA - Food Science and Technology Abstracts, LILACS - Latin American and Caribbean Health Sciences, Scopus, AGRIS (International Information System for the Agricultural Sciences and Technology). Additional search will be done in related articles, references of included articles and thesis and dissertations directories. No language or date restrictions will be applied on the search. The search strategy will include terms such as: "parasite", "vegetables contamination" and "sanitization protocols" in titles, abstracts, key words and texts. The search strategy will be adapted to search in different databases. Population (inclusion and exclusion criteria): Studies that report parasitic analyses in vegetables before and after a process of sanitization and compare its effect. Exclusion: Studies about prevalence of parasites in vegetables . Intervention (inclusion and exclusion criteria): Action of different sanitization protocols (chemical, physical or associated) in removal or reduction of parasitic forms adhered to the vegetables. Exclusion: Studies that report only the hygienization effect on microbiological contamination in vegetables Comparative control: Unsanitized vegetables Main outcomes: Assessment of the reduction or absence of parasitic forms in vegetables for each intervention or combined intervention. Measures of effect: Parasitic concentration in samples (egg count and oocytes/cysts count and larvae count). In order to have a correct comparison between the studies, the parasite count will be adjusted according to the percentage of reduction and the amount of sample analyzed. Additional outcome(s): - Identication the main parasites that contaminate vegetables; - Evaluation of the time needed for processing the sanitization protocol ( in minutes); - Cost-effectiveness analysis (costs / reduction of number of cysts and eggs of parasites). The costs will be calculated in local currency (Brazilian Real (BRL R$)) Screening and data extraction: After running the search strategy, all publications found will be uploaded to the software Mendeley. Two review authors will independently read the titles and abstracts identified from the initial search to select studies that met our inclusion criteria. We will retrieve full-text articles and review the results to determine eligibility. A third review author will resolve differences when necessary. Two reviewers will independently extract the following information from the included studies: author, year of publication, title, type of research, methodology and outcomes. Similarly, will be extracted data related to analysis with vegetables samples, parasitological analysis, microbiological analysis, chemical intervention, physical intervention, associated intervention, processing time and controlled study. Risk of bias: We will apply the criteria established by Cochrane Handbook with some adaptations for evaluating risk of bias in food analysis studies and the web app Risk of Bias Visualization (RoBVis) will be used to create the bias assessment figures. A pilot sample with study reports will be tested to ensure that multiple reviewers can consistently apply the criteria. Disagreements will be resolved by discussion; if there is no consensus, a third reviewer will arbitrate. Data synthesis: The extracted data to be included in the analyses will be the percentage rate of efficacy in reducing the parasitic forms in vegetables of each sanitization protocol. We will evaluate heterogeneity through I² statistic and χ² test. If the results are considered acceptable and sufficiently homogeneous, we will use Review Manager software (RevMan version 5.4) to pool the data in meta-analysis. Analysis of subgroups: We plan to analyze subgroups based on: - Food categories (vegetables and leafy vegetables) - Intervention types (chemichal or physical or combined) - Analysis of the most effective methods for protozoa - Analysis of the most effective methods for helminths Funding sources This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001