The carriage of intestinal parasites among food handlers: Current status in Tunisia and contribution of surveillance.

Food handlers are a significant source of intestinal parasite transmission. The aim of this study was to establish the prevalence of intestinal parasite carriage among food handlers and to track its evolution. A retrospective study was conducted between 2019 and 2024 among food handlers in the framework of screening for intestinal parasitosis. A stool sample was collected from each individual and analyzed by direct microscopy and concentration using the Ritchie method. A total of 3866 individuals were included in the study, among whom 425 (11%) revealed carriers of intestinal parasites. This prevalence was significantly lower than that reported in a similar survey between the 1998-2008 period (13.5%, p<10-3). The rate of intestinal parasites was higher among private sector employees (12.6% vs. 10.6% in the public sector), without significant difference. Protozoa were predominant (98.3%) compared to helminths (1.7%). Directly transmitted pathogenic or potentially pathogenic species accounted for 76.3% of diagnosed parasites. Blastocystis sp. was the most prevalent parasite (40.5%). Dientamoeba fragilis, Giardia intestinalis and Entamoeba histolytica/dispar accounted for 27.5%, 3.8% and 3.5% of identified parasites, respectively. Nearly one-third (30.6%) of infected individuals were polyparasitized. Despite its decrease, the prevalence of intestinal parasitosis remains high among food handlers. The surveillance of this population should be strengthened through frequent screening, more stool samples and the implementation of sensitive techniques.