Title: National burden of intestinal parasitosis and its determinants among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis

Background: Intestinal parasites are a group of opportunistic gastrointestinal diseases commonly encountered among people living with human immunodeficiency virus (HIV). In the absence of early preventions and interventions, intestinal parasites increased the risk of morbidity and mortality among these vulnerable population. Therefore, to design appropriate intervention and prevention strategies, current and up-to-date information concerning the prevalence of intestinal parasite among people living with HIV is crucial. However, studies assessing the prevalence and associated factors of intestinal parasite among people living with HIV in Ethiopia are inconsistent and widely varied. Therefore, this systematic review and meta-analysis is designed to assess the pooled prevalence and determine risk factors

Methods: PubMed, Web of Science,Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were searched for studies that looked at intestinal parasites among people living with HIV. A funnel plot and Egger’s regression test were used to determine publication bias. The I2 statistic was used to checkheterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size.subgroup and meta-regression analyses were conducted. Sensitivity analysiswas done to see the effect of a single study on the overall estimation. STATA version 14 statistical software was used for themeta-analysis.

Results: A total of 27 studies with 8,946 individuals were used to estimate the pooled prevalence of intestinal parasitosis among people living with HIV.The estimated pooled prevalence of intestinal parasitosis was 40.24% (95% CI: 33.8–46.6). Subgroup analysis of this study revealed that the highest prevalence of intestinal parasite was observed in Tigray region 45.7% (95% CI: 7.9­-83.5), followed by Oromia region 42.2% (95% CI: 28.8–55.6). Availability of latrine (OR: 26.6, 95%CI: 2.8-15.8), presence of animal (OR: 2.7, 95% CI: 1.2-5.8) and source of drinking water (OR: 3.2, 95% CI: 1.3-7.5) were significantly associated with intestinal parasitosis.

Conclusions/Recommendations: In this study, the prevalence of intestinal parasite was high in Ethiopia.

There should be a need to work for improving the hygienic standard on quality of drinking water and

regular utilization of latrine among people living with HIV/AIDS.

Keywords: Parasitosis, HIV/AIDS, Determinants, Meta-analysis, Ethiopia