Estimating the Prevalence of Parasitic Infections in Migrant Workers in The Middle East: A Systematic Review and Meta-Analysis
-
Seyedeh Maryam Taheri
,
Hanieh Makipour
,
Saeed Bahadory
,
Ehsan Javanmard
,
Samaneh Dehbanipour
,
Ali Taghipur
,
Gholamreza Hassanpour
,
Elham Kazemirad
Abstract
Background: Parasitic diseases, including food-borne and vector-borne infections, remain a significant burden, especially with the increased migration from underdeveloped to developed regions. We aimed to estimate the prevalence of parasitic infections among migrant workers in the Middle East.
Methods: This systematic review and meta-analysis followed the PRISMA protocol. A search was conducted across major databases (Scopus, PubMed, Web of Science, Google Scholar) for studies on parasitic infections among migrant workers in the Middle East from April 1, 1993, to November 15, 2024. Data were analyzed using Comprehensive Meta-Analysis software (CMA), and 25 studies were included.
Results: The overall prevalence of parasitic infections in this study was estimated at 16.5%. (95% CI 2.7 to 58.5%). The prevalence based on microscopic diagnostic methods was 19.4% (95% CI 13.5% to 27.5%), and molecular diagnosis was 15.2% (95% CI 6.4% to 32.4%). The P-value in Egger's test was 0.5343, indicating no statistically significant evidence of publication bias. The pooled prevalence varied across countries: 34.7% in Iraq (n = 1 study), 19.6% in Saudi Arabia (n = 12 studies), 16.8% in the UAE (n = 4 studies), 13.2% in Qatar (n = 7 studies), and 4.2% in Kuwait (n = 1 study).
Conclusion: The prevalence of parasitic infections among migrant workers in the Middle East was estimated at 16.5%. Given this rate, routine mandatory screening is recommended along with targeted health education to reduce exposure risk and improve health. These findings highlight the public health concern that infected migrant workers may contribute to the spread of parasitic diseases in destination countries.
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6. Dailey MD (2001). Parasitic diseases. CRC handbook of marine mammal medi-cine: CRC Press. p. 407-30.
7. Wakid MH, Al-Refai MF (2024). Contribu-tion of socio-demographic factors in prevalence of soil-transmitted helminth infections among newly arrived laborers in Jeddah, Saudi Arabia. PeerJ, 12: e18216.
8. Fletcher SM, Stark D, Harkness J, et al (2012). Enteric protozoa in the devel-oped world: a public health perspective. Clin Microbiol Rev, 25(3):420-49.
9. Payment P (2001). Transmission of gastro-intestinal diseases: Hygiene as the final barrier. Am J Infect Control, 29(4):218-21.
10. Chen J, Gong Y, Chen Q, et al (2024). Global burden of soil-transmitted hel-minth infections, 1990-2021. Infect Dis Poverty, 13(1): 77.
11. Bharti B, Bharti S, Khurana S (2018). Worm infestation: diagnosis, treatment and prevention. Indian J Pediatr, 85(11):1017-24.
12. Ngui R, Ishak S, Chuen CS, et al (2011). Prevalence and risk factors of intestinal parasitism in rural and remote West Ma-laysia. PLoS Negl Trop Dis, 5(3): e974.
13. Hotez PJ (2009). One world health: neglected trop-ical diseases in a flat world. Public Library of Science San Francisco, USA. p. e405.
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31. Abahussain NA, Abahussain N (2005). Prevalence of intestinal parasites among expatriate workers in Al-Khobar, Saudi Arabia. MEJFM, 3(3):17-21.
32. Abu-Madi MA, Behnke JM, Ismail A (2008). Patterns of infection with intestinal par-asites in Qatar among food handlers and housemaids from different geo-graphical regions of origin. Acta Trop, 106(3):213-20.
33. Abu-Madi MA, Behnke JM, Doiphode SH (2010). Changing trends in intestinal parasitic infections among long-term-residents and settled immigrants in Qa-tar. Parasit Vectors, 3:98.
34. Abu-Madi MA, Behnke JM, Ismail A, et al (2011). Comparison of intestinal parasit-ic infection in newly arrived and resi-dent workers in Qatar. Parasit Vectors, 4:211.
35. Mohammad KA, Koshak EA (2011). A pro-spective study on parasites among ex-patriate workers in Al-Baha from 2009-2011, Saudi Arabia. J Egypt Soc Parasitol, 41(2): 423-32.
36. Taha HA, Soliman MI, Banjar SA (2013). In-testinal parasitic infections among ex-patriate workers in Al-Madina Al-Munawarah, Kingdom of Saudi Arabia. Trop Biomed, 30(1): 78‑88.
37. Abu-Madi MA, Behnke JM, Doiphode SH (2013). Intestinal parasitic infections among long-term-residents and settled immigrants in Qatar in the period 2005 to 2011. Am J Trop Med Hyg, 88(6):1185-96.
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39. Humphrey JM, Ranbhise S, Ibrahim E, et al (2016). Multiplex polymerase chain reac-tion for detection of gastrointestinal pathogens in migrant workers in Qatar. Am J Trop Med Hyg, 95(6):1330-1337.
40. Abu-Madi MA, Behnke JM, Ismail A, et al (2016). Assessing the burden of intestinal parasites affecting newly arrived immi-grants in Qatar. Parasit Vectors, 9(1):619.
41. Dafalla AIA, Almuhairi SASO, AlHosani MHJ, et al (2017). Intestinal parasitic in-fections among expatriate workers in various occupations in Sharjah, United Arab Emirates. Rev Inst Med Trop Sao Pau-lo, 59: e82.
42. El Bakri A, Mogane L, Ezzedine S, et al (2018). Prevalence of Cryptosporidium spp. among asymptomatic healthy expatriate workers in Sharjah, United Arab Emir-ates. Afr J Infect Dis,12(2):7-13.
43. Boughattas S, Behnke JM, Al-Sadeq D, et al (2019). Cryptosporidium spp., prevalence, molecular characterisation and socio-demographic risk factors among immi-grants in Qatar. PLoS Negl Trop Dis, 13(10): e0007750.
44. Al-Awadhi M, Iqbal J, Ahmad S (2020). Cys-ticercosis, a potential public health con-cern in Kuwait: a new diagnostic meth-od to screen Taenia solium taeniasis carri-ers in the expatriate population. Med Princ Pract, 29(4):347-53.
45. Al-Rifai RH, Loney T, Sheek-Hussein M, et al (2020). Prevalence of, and factors as-sociated with intestinal parasites in mul-tinational expatriate workers in Al Ain City, United Arab Emirates: an occupa-tional cross-sectional study. J Immigr Mi-nor Health, 22(2):359-74.
46. Wakid MH (2020). Prevalence of entero-parasites among non-Saudis in Bahrah, Saudi Arabia. Cureus, 12(7): e9253.
47. Haouas N, Alharazi T, Al Rasheedi AO, et al (2021). Intestinal parasitic infection among foreign housemaids in north-western Saudi Arabia: A cross-sectional study. Parasitol Int, 80:102208.
48. Saif A, Alshahrani MA, Alshehri AA, et al (2021). Filariasis: A Major Potential Im-ported Parasitic Disease in Najran Dis-trict of Saudi Arabia. King Khalid Universi-ty Journal of Health Sciences, 6(2):85-92.
49. Alshahrani MA, Saif A, Bahnass MM (2023). Prevalence of intestinal parasitic infec-tions among Saudis and expatriate workers in Najran, Saudi Arabia. Zagazig Vet J, 51(2):101-11.
50. Egger M, Smith GD, Schneider M, et al (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109):629-34.
51. Taghipour A, Javanmard E, Rahimi HM, et al (2024). Prevalence of intestinal para-sitic infections in patients with diabetes: a systematic review and meta-analysis. Int Health, 16(1):23-34.
52. European Centre for Disease Prevention and Control (2018). Public health guid-ance on screening and vaccination for infectious diseases in newly arrived mi-grants within the EU/EEA Stockholm.
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55. Mohd Hanapi IR, Behnke JM, Sahimin N, et al (2024). Intestinal parasitic infec-tions and risk analysis among urban ref-ugees in the Klang Valley, Malaysia. Trans R Soc Trop Med Hyg, 118(1):18-32.
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59. Yaqot M, Menezes BC, Swart K, et al (2024). Leveraging Major Sport Events' Success Towards Positioning Qatar as a Snort Tourism Destination. Proc Int Conf Tour Res, 7(1): 203-2012.
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61. Wang L-C (2004). Changing patterns in in-testinal parasitic infections among Southeast Asian laborers in Taiwan. Par-asitol Res, 92(1):18-21.
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2. Malit Jr FT, Naufal G (2016). Asymmetric information under the Kafala sponsor-ship system: Impacts on foreign domes-tic workers' income and employment status in the GCC countries. International Migration, 54(5):76-90.
3. Organization WHO (2022). World report on the health of refugees and migrants: summary: World Health Organization.
4. Al-Refai MF, Wakid MH (2024). Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly ar-rived expatriate labors in Jeddah, Saudi Arabia. PeerJ, 12: e16820.
5. Hotez PJ, Brindley PJ, Bethony JM, et al (2008). Helminth infections: the great neglected tropical diseases. J Clin Invest, 118(4):1311-21.
6. Dailey MD (2001). Parasitic diseases. CRC handbook of marine mammal medi-cine: CRC Press. p. 407-30.
7. Wakid MH, Al-Refai MF (2024). Contribu-tion of socio-demographic factors in prevalence of soil-transmitted helminth infections among newly arrived laborers in Jeddah, Saudi Arabia. PeerJ, 12: e18216.
8. Fletcher SM, Stark D, Harkness J, et al (2012). Enteric protozoa in the devel-oped world: a public health perspective. Clin Microbiol Rev, 25(3):420-49.
9. Payment P (2001). Transmission of gastro-intestinal diseases: Hygiene as the final barrier. Am J Infect Control, 29(4):218-21.
10. Chen J, Gong Y, Chen Q, et al (2024). Global burden of soil-transmitted hel-minth infections, 1990-2021. Infect Dis Poverty, 13(1): 77.
11. Bharti B, Bharti S, Khurana S (2018). Worm infestation: diagnosis, treatment and prevention. Indian J Pediatr, 85(11):1017-24.
12. Ngui R, Ishak S, Chuen CS, et al (2011). Prevalence and risk factors of intestinal parasitism in rural and remote West Ma-laysia. PLoS Negl Trop Dis, 5(3): e974.
13. Hotez PJ (2009). One world health: neglected trop-ical diseases in a flat world. Public Library of Science San Francisco, USA. p. e405.
14. Norhayati M, Fatmah M, Yusof S, et al (2003). Intestinal parasitic infections in man: a review. Med J Malaysia, 58(2):296-305.
15. Harp JA (2003). Parasitic infections of the gastrointestinal tract. Curr Opin Gastroen-terol, 19(1):31-6.
16. Knight CA, Harris DR, Alshammari SO, et al (2023). Leishmaniasis: Recent epide-miological studies in the Middle East. Front Microbial, 13:1052478.
17. González-Sanz M, Berzosa P, Norman FF (2023). Updates on malaria epidemiolo-gy and prevention strategies. Curr Infect Dis Rep, 1-9.
18. Wang F, Tian C, Qin W (2020). The impact of epidemic infectious diseases on the wellbeing of migrant workers: a system-atic review. International Journal of Wellbe-ing, 10(3):7-25.
19. Bianchi FP, Fiacchini D, Frisicale EM, et al (2024). Infectious risk profile and strate-gies for prevention and control of out-breaks in refugee, asylum seekers and migrant populations in EU/EEA coun-tries: a systematic narrative review of ev-idences. Ann Ig, 36(5):549-568.
20. Pryiatelchuk O, Amirabbas S (2021). Re-newable energy for sustainable devel-opment in Middle East. APIR, 1(148):70-80.
21. World Population Review (2025). The Mid-dle East Population by Country. Availa-ble from: https://worldpopulationreview.com/continents/the-middle-east
22. Oso L, Kaczmarczyk P, Salamońska J (2022). Labour migration. In: Scholten P, editor. Introduction to Migration Studies. Imis-coe Research Series. Cham: Springer In-ternational Publishing. p. 117 135.
23. Moher D, Shamseer L, Clarke M, et al (2015). Preferred reporting items for sys-tematic review and meta-analysis proto-cols (PRISMA-P) 2015 statement. Syst Rev, 4:1.
24. Wells GA, Shea B, O'Connell D, et al (2000). The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
25. Taghipour A, Olfatifar M, Javanmard E, et al (2020). The neglected role of Enterobi-us vermicularis in appendicitis: A systemat-ic review and meta-analysis. PLoS One, 15(4): e0232143.
26. Taghipour A, Bahadory S, Badri M, et al (2022). A systematic review and meta-analysis on the co-infection of Helicobac-ter pylori with intestinal parasites: public health issue or neglected correlation. Int J Environ Health Res, 32(4):808-18.
27. Ibrahim OM, Bener A, Shalabi A (1993). Prevalence of intestinal parasites among expatriate workers in Al-Ain, United Ar-ab Emirates. Ann Saudi Med, 13(2):126-9.
28. Bi K, Li X, Zhang R, et al (2024). Clinical and laboratory characterization of cuta-neous leishmaniasis in Chinese migrant workers returned from Iraq. PLoS Negl Trop Dis, 18(3): e0012006.
29. Al-Madani AA, Mahfouz A (1995). Preva-lence of intestinal parasitic infections among Asian female house keepers in Abha District, Saudi Arabia. Southeast Asian J Trop Med Public Health, 26(1):135-7.
30. Omar MS (1996). A survey of bancroftian filariasis among Southeast Asian expat-riate workers in Saudi Arabia. Trop Med Int Health, 1(2):155-60.
31. Abahussain NA, Abahussain N (2005). Prevalence of intestinal parasites among expatriate workers in Al-Khobar, Saudi Arabia. MEJFM, 3(3):17-21.
32. Abu-Madi MA, Behnke JM, Ismail A (2008). Patterns of infection with intestinal par-asites in Qatar among food handlers and housemaids from different geo-graphical regions of origin. Acta Trop, 106(3):213-20.
33. Abu-Madi MA, Behnke JM, Doiphode SH (2010). Changing trends in intestinal parasitic infections among long-term-residents and settled immigrants in Qa-tar. Parasit Vectors, 3:98.
34. Abu-Madi MA, Behnke JM, Ismail A, et al (2011). Comparison of intestinal parasit-ic infection in newly arrived and resi-dent workers in Qatar. Parasit Vectors, 4:211.
35. Mohammad KA, Koshak EA (2011). A pro-spective study on parasites among ex-patriate workers in Al-Baha from 2009-2011, Saudi Arabia. J Egypt Soc Parasitol, 41(2): 423-32.
36. Taha HA, Soliman MI, Banjar SA (2013). In-testinal parasitic infections among ex-patriate workers in Al-Madina Al-Munawarah, Kingdom of Saudi Arabia. Trop Biomed, 30(1): 78‑88.
37. Abu-Madi MA, Behnke JM, Doiphode SH (2013). Intestinal parasitic infections among long-term-residents and settled immigrants in Qatar in the period 2005 to 2011. Am J Trop Med Hyg, 88(6):1185-96.
38. Imam NF, Abdulbaqi ZB, Fahad RA (2015). The prevalence of intestinal parasitic infections among foreign workers in Madinah, Kingdom of Saudi Arabia. Saudi J Med Med Sci, 3(2):112-7.
39. Humphrey JM, Ranbhise S, Ibrahim E, et al (2016). Multiplex polymerase chain reac-tion for detection of gastrointestinal pathogens in migrant workers in Qatar. Am J Trop Med Hyg, 95(6):1330-1337.
40. Abu-Madi MA, Behnke JM, Ismail A, et al (2016). Assessing the burden of intestinal parasites affecting newly arrived immi-grants in Qatar. Parasit Vectors, 9(1):619.
41. Dafalla AIA, Almuhairi SASO, AlHosani MHJ, et al (2017). Intestinal parasitic in-fections among expatriate workers in various occupations in Sharjah, United Arab Emirates. Rev Inst Med Trop Sao Pau-lo, 59: e82.
42. El Bakri A, Mogane L, Ezzedine S, et al (2018). Prevalence of Cryptosporidium spp. among asymptomatic healthy expatriate workers in Sharjah, United Arab Emir-ates. Afr J Infect Dis,12(2):7-13.
43. Boughattas S, Behnke JM, Al-Sadeq D, et al (2019). Cryptosporidium spp., prevalence, molecular characterisation and socio-demographic risk factors among immi-grants in Qatar. PLoS Negl Trop Dis, 13(10): e0007750.
44. Al-Awadhi M, Iqbal J, Ahmad S (2020). Cys-ticercosis, a potential public health con-cern in Kuwait: a new diagnostic meth-od to screen Taenia solium taeniasis carri-ers in the expatriate population. Med Princ Pract, 29(4):347-53.
45. Al-Rifai RH, Loney T, Sheek-Hussein M, et al (2020). Prevalence of, and factors as-sociated with intestinal parasites in mul-tinational expatriate workers in Al Ain City, United Arab Emirates: an occupa-tional cross-sectional study. J Immigr Mi-nor Health, 22(2):359-74.
46. Wakid MH (2020). Prevalence of entero-parasites among non-Saudis in Bahrah, Saudi Arabia. Cureus, 12(7): e9253.
47. Haouas N, Alharazi T, Al Rasheedi AO, et al (2021). Intestinal parasitic infection among foreign housemaids in north-western Saudi Arabia: A cross-sectional study. Parasitol Int, 80:102208.
48. Saif A, Alshahrani MA, Alshehri AA, et al (2021). Filariasis: A Major Potential Im-ported Parasitic Disease in Najran Dis-trict of Saudi Arabia. King Khalid Universi-ty Journal of Health Sciences, 6(2):85-92.
49. Alshahrani MA, Saif A, Bahnass MM (2023). Prevalence of intestinal parasitic infec-tions among Saudis and expatriate workers in Najran, Saudi Arabia. Zagazig Vet J, 51(2):101-11.
50. Egger M, Smith GD, Schneider M, et al (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109):629-34.
51. Taghipour A, Javanmard E, Rahimi HM, et al (2024). Prevalence of intestinal para-sitic infections in patients with diabetes: a systematic review and meta-analysis. Int Health, 16(1):23-34.
52. European Centre for Disease Prevention and Control (2018). Public health guid-ance on screening and vaccination for infectious diseases in newly arrived mi-grants within the EU/EEA Stockholm.
53. Greenaway C, Castelli F (2019). Infectious diseases at different stages of migration: an expert review. J Travel Med, 26(2):taz007.
54. Alruwaili M, Carrillo P, Soetanto R, et al (2024). Occupational Accidents, Injuries, and Associated Factors among Migrant and Domestic Construction Workers in Saudi Arabia. Buildings, 14(9):2714.
55. Mohd Hanapi IR, Behnke JM, Sahimin N, et al (2024). Intestinal parasitic infec-tions and risk analysis among urban ref-ugees in the Klang Valley, Malaysia. Trans R Soc Trop Med Hyg, 118(1):18-32.
56. Al-Zubairi A, AL-Akheli A, Elfarra B (2025). The impact of financial development, renewable energy and political stability on carbon emissions: sustainable devel-opment prospective for arab econo-mies. Environ Dev Sustain, 27(7):15251-73.
57. Dash N A-ZM, Anwar K, Panigrahi D (2010). Prevalence of intestinal parasitic infections in Sharjah, United Arab Emirates. Hum Parasit Dis, 2:21-4.
58. Kuzehkanani AB, Rezaei S, Babaei Z, et al (2011). Enteric protozoan parasites in rural areas of Bandar-Abbas, southern Iran: comparison of past and present situation. Iran J Public Health, 40(1):80-85.
59. Yaqot M, Menezes BC, Swart K, et al (2024). Leveraging Major Sport Events' Success Towards Positioning Qatar as a Snort Tourism Destination. Proc Int Conf Tour Res, 7(1): 203-2012.
60. Abu-Madi MA, Behnke JM, Boughattas S, et al (2016). Helminth infections among long-term-residents and settled immi-grants in Qatar in the decade from 2005 to 2014: temporal trends and varying prevalence among subjects from differ-ent regional origins. Parasit Vectors, 9:153.
61. Wang L-C (2004). Changing patterns in in-testinal parasitic infections among Southeast Asian laborers in Taiwan. Par-asitol Res, 92(1):18-21.
62. Rice J, Skull SA, Pearce C, et al (2003). Screening for intestinal parasites in re-cently arrived children from East Afri-ca. J Paediatr Child Health, 39(6):456-9.
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| Files | ||
| Issue | Vol 54 No 12 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Parasitic infections Migrant workers Middle East | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Taheri SM, Makipour H, Bahadory S, Javanmard E, Dehbanipour S, Taghipur A, Hassanpour G, Kazemirad E. Estimating the Prevalence of Parasitic Infections in Migrant Workers in The Middle East: A Systematic Review and Meta-Analysis. Iran J Public Health. 2025;54(12):2608-2622.
