Prevalence and subtype distribution of Blastocystis infections among community participants in Thailand: A systematic review and meta-analysis

Abstract

A comprehensive understanding of the prevalence and subtype distribution of Blastocystis infections among community participants in Thailand is essential to inform targeted public health interventions. This systematic review and meta-analysis aimed to estimate the overall prevalence of Blastocystis infections and to determine the distribution of subtypes among community participants in Thailand. Relevant studies on Blastocystis infections in community participants in Thailand were searched in PubMed, Embase, Scopus, Ovid, ProQuest, and the Thai-Journal Citation Index. The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Prevalence estimates and subtype distributions were calculated using random-effects models. A total of 947 articles were identified, with 60 studies included in the systematic review and meta-analysis. The meta-analysis led to an estimated overall prevalence of Blastocystis infections in community participants in Thailand at 8.34% (95% CI: 5.48% 12.51%; I²: 98.2%; number of studies: 60; number of participants: 33,101). Meta-regression analysis showed no significant temporal trends in infection prevalence. The highest prevalence rates were observed in Eastern Thailand (13.54%) and Western Thailand (10.09%). Subtype analysis identified ST3 and ST1 as the most common subtypes, accounting for 50.05% and 23.50% of positive samples, respectively. The highest prevalence was reported in military personnel (29.87%), followed by orphans (29.01%). Improved use of molecular and culture-based diagnostic methods is recommended to enhance detection accuracy. Public health interventions should prioritize high-risk groups, such as military personnel and orphans, and address regional disparities to reduce the burden of Blastocystis infections.