Prevalence Estimates and Distribution of Entamoeba histolytica and Entamoeba dispar Infections in Several Regions of Thailand: A Systematic Review and Meta-Analysis

Abstract

Entamoeba histolytica (E. histolytica) causes amebiasis, which is a major health concern in tropical regions, including Thailand. This systematic review and meta-analysis aimed to assess the prevalence, distribution, and epidemiological trends of E. histolytica and morphologically identical species infections in Thailand to inform public health strategies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this study was registered in PROSPERO (CRD42025636219). A comprehensive search in the PubMed, EMBASE, Journal@Ovid, Nursing & Allied Health Premium, Scopus, and the Thai Journal Citation Index databases was conducted. Two authors independently screened the studies, extracted data, and assessed quality using the Joanna Briggs Institute critical appraisal tool. The meta-analysis was conducted by using logit transformation and random effects models, with heterogeneity assessed via Q tests, I2 statistics, and meta-regression. Publication bias was examined by using funnel plots and Egger's test. Of 899 records, 44 studies with 36,720 participants met the inclusion criteria. The overall prevalence of E. histolytica and infections with morphologically identical species in Thailand was 1.30% (95% CI: 0.89-1.89%) with high heterogeneity (I2 = 92.0%). The highest prevalence was in western (2.86%) and northeastern Thailand (1.93%). High-risk groups, including dam personnel (10.28%), individuals with intellectual disabilities (7.05%), and orphaned children (3.95%), exhibited elevated prevalence levels. Molecular methods resulted in the detection of higher rates (5.12%) than traditional techniques. Despite low overall prevalence, regional variations and high-risk populations highlight the need for sensitive diagnostics, targeted interventions, and continuous surveillance to reduce the burden of amebiasis in Thailand.