A systematic review of frequency and geographic distribution of water-borne parasites in the Middle East and North Africa

Background: Water-borne parasitic infections are caused by pathogenic parasites found in water. These parasites are often not well-monitored or reported, therefore, there is an underestimation of their prevalence.Aims: We systemically reviewed the prevalence and epidemiology of water-borne diseases in the Middle East and North Africa (MENA) Region, which has a population of about 490 million people distributed over 20 independent countries.Methods: Online scientific databases, mainly PubMed, ScienceDirect, Scopus, Google Scholar, and MEDLINE were searched for the main water-borne parasitic infections in MENA countries during 1990-2021.Results: The main parasitic infections were cryptosporidiosis, amoebiasis, giardiasis, schistosomiasis, and toxocariasis. Cryptosporidiosis was the most frequently reported. Most of the published data were from Egypt, the country with the highest population in MENA.Conclusions: Water-borne parasites are still endemic in many MENA countries, however, their incidence has reduced dramatically due to the control and eradication programmes in countries that could afford such programmes, some with external support and funding.