Trend of Soil Transmitted Helminths in Ethiopian children: A Systematic Review and Meta-analysis (2000-2018)

Abstract Background: Ethiopia is one of the tropical countries with heavy burden of soil transmitted helminths. As a result, the nation has been implementing mass drug administration, water, sanitation and hygiene and health extension programs in order to control those parasites. Hence, updated data about the prevalence and trend of parasites over time has pivotal role to assess the success of existing control programs. Methods: Studies conducted between 2000 and 2018 were searched from PubMed, Google Scholar and local journals for systematic review and meta-analysis following PRISMA guideline and checklist. Eligible studies were selected based on pre-set inclusion and exclusion criteria. The quality of included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. Comprehensive meta-analysis (CMA 2.0) was used to calculate the pooled prevalence and meta-regression was run to assess trend of parasite prevalence over time.Results: Thirty-eight studies recruiting 16,266 participants were included in the review. The pooled prevalence of intestinal prevalence was 52.0% (95%CI: 44.4-59.5). Amhara region was with the highest prevalence (60.3%; 95%CI: 50.1-69.6). Among soil transmitted helminths, Ascaris lumbricoides (11.2%; 95%CI: 8.4-14.8) was with the highest pooled prevalence followed by hookworms (10.4%; 95%CI:7.9-13.7) and Trichiuris trichiura (3.6%; 95%CI: 2.4-5.4). Meta-regression analysis revealed that all soil transmitted helminths didn’t show significantly decreasing trend over time (p>0.05). Conclusion: Despite various control efforts have been made, soil transmitted helminths are with high distribution and their prevalence is not significantly decreasing in Ethiopia. Hence, other control approaches like community led sanitation should be integrated with mass drug administration in order to achieve the national goal of soil transmitted helminths elimination by 2025.