Prevalence and Epidemiological Patterns of Enterobius vermicularis Infection in Thailand: A Systematic Review and...

Enterobiasis, caused by Enterobius vermicularis, is recognized as a common intestinal helminthiasis worldwide. Despite multiple surveys in Thailand, no pooled synthesis at the country level has been carried out to evaluate prevalence patterns, temporal trends, or vulnerable groups. Therefore, this systematic review and meta-analysis were undertaken to provide an updated and comprehensive estimate of the prevalence of E. vermicularis in Thailand and to identify high-risk populations for targeted interventions.

The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251053217). Studies reporting E. vermicularis infection in Thailand were systematically searched in international and Thai databases. Pooled prevalence and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses and meta-regression were performed according to year, region, age, population type, and diagnostic method.

A total of 56 studies, including 52,765 participants, were analyzed. The overall pooled prevalence was estimated at 3.6% (95% confidence interval [CI]: 2.1-5.9%), with a decline observed in the subgroup analysis by publication year, from 4.75% in 2000-2009 to 1.15% in 2020-2023. The highest prevalence was reported in Central Thailand (7.93%). High infection rates were found among immigrant children (25.2%), hilltribe children (19.9%), Karen students (15.5%), and children in orphanages (11.4%). A markedly higher prevalence was detected by the Scotch tape method compared with direct smear/concentration (12.9% vs. 0.33%). No significant difference in infection risk was observed between males and females (OR = 1.03, p = 0.65).

The pooled prevalence of E. vermicularis in Thailand was estimated at 3.6%, but this figure should be interpreted with caution due to high heterogeneity across studies. More meaningful insights were identified in subgroup analyses, which revealed a temporal decline in prevalence, geographic clustering in Central Thailand, and disproportionately high infection rates among socioeconomically disadvantaged child populations. No statistically significant association was found between gender and risk of infection. These patterns underscore the need for targeted screening, deworming, and hygiene interventions, along with the standardized use of the Scotch tape technique for accurate surveillance and comparability of future studies.