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. 2025 Dec 9;25:1704. doi: 10.1186/s12879-025-12045-4

The bacterial and parasitic contamination of raw vegetables and fruits collected from local farms and markets in Ethiopia: a systematic review and meta-analysis of patterns and associated factors

Abayeneh Girma 1,✉, Asmamaw Menelih 1, Natnael Getachew 1, Alqeer Aliyo 2
PMCID: PMC12690821  PMID: 41366318

Abstract

Background

Vegetables and fruits are essential parts of a healthy diet; however, the consumption of unclean, uncooked, and improperly prepared vegetables and fruits is a major cause of parasitic and bacterial infections. These vegetables and fruits are contaminated during pre- and post-harvest stages. Therefore, this systematic review and meta-analysis provides evidence-based scientific information about the level of both parasitic and bacterial contamination of vegetables and fruits and its associated factors in Ethiopia.

Methods

A systematic search was conducted in the PubMed, Scopus, Web of Science, ScienceDirect, and African Journals Online (AJOL) databases for studies published between March 2010 and January 2025. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-2020 guidelines. Microsoft Excel 2016 sheet template was employed to extract the data. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the included studies. A random effects model was selected for analysis. Heterogeneity was quantified using the I² statistic, and sources of heterogeneity were explored via subgroup analyses and Galbraith plot. Publication bias was evaluated using funnel plots and Egger’s test. Risk factors were summarized as adjusted odds ratios (aOR) with 95% confidence intervals (CI). All analysis was performed via STATA version 14 with metan command.

Results

Twenty-nine studies with 6659 vegetables and fruits were included. The overall prevalence of contaminated fresh produce was 48.76% (95% CI: 40.78–56.74). The meta-analysis yielded a pooled prevalence of 52.85% (95% CI: 32.10–73.60) for bacterial contamination and 46.40% (95% CI: 40.04–52.75) for parasitic contamination. Gram-positive bacteria were more common (28.97%) than gram-negative bacteria (23.88%). Similarly, helminths were more prevalent (29.07%) than protozoans (17.30%). Among bacteria, the predominant family/genera were Enterobacteriaceae (14.78%), Bacillus spp. (10.27%), Staphylococcus spp. (8.86%), and Micrococcus spp. (5.20%). The most prevalent parasites identified were Ascaris spp. (8.34%), Entamoeba spp. (6.92%), Strongylida (6.51%), and Giardia spp. (5.67%). Lettuce (61.0%), salad (57.4%), spinach (54.2%), and cabbage (52.9%), were the vegetables most contaminated by parasites, while salad (73.8%), green pepper (35.3%), lettuce (26.0%), and cabbage (20.0%), were the most contaminated by bacteria. The contamination rates of fruits by bacteria and parasites were 0.55% and 5.4%, respectively, while those of vegetables were 52.30% and 41.00%, respectively. The mode of produce display (adjusted odds ratio [aOR]: 2.15, 95% CI: 1.17–3.13), type of produce (aOR: 2.10, 95% CI: 1.13–3.08), vendors’ fingernail hygiene (aOR: 2.02, 95% CI: 1.10–2.93), source of produce (aOR: 2.46, 95% CI: 1.45–3.47), education status of vendors (aOR: 11.43, 95% CI: 6.18–29.05), handwashing habits of vendors (aOR: 3.10, 95% CI: 1.53–4.67) and washing before display (aOR: 2.41, 95% CI: 1.52–3.30) were the significantly associated factors.

Conclusion

This meta-analysis found a high prevalence of bacterial and parasitic contamination in vegetables and fruits. Therefore, food and drug authorities and public health institutions should increase awareness among vendors and consumers about safe practices for the handling and consumption of vegetables and fruits, and region/city administrators should prepare safe farms and marketplaces. Furthermore, the agricultural industry should increase awareness among farmers about the cultivation and transportation of vegetables and fruits.

Protocol registration

This systematic review and meta-analysis study is registered in International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42025640154.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-025-12045-4.

Keywords: Bacteria, Ethiopia, Contamination, Farms, Foodborne pathogens, Fruits, Markets, Parasite, Public health, Vegetables, Meta-analysis

Introduction

Vegetables and fruits are essential parts of a healthy diet because they contain various bioactive compounds, such as minerals, phytochemicals, vitamins, and fibers [1, 2]. On the other hand, consuming unclean and undercooked vegetables and fruits is a primary way to spread various medically important pathogens [3, 4]. Many medically important parasites, such as Giardia spp., Entamoeba spp., Ascaris spp., hookworms, Enterobius vermicularis, Trichuris trichiura, Cryptosporidium spp., Toxocara spp., Hymenolepis spp., Taenia spp., Fasciola spp., and members of the family Trichostrongylidae, are the commonly detected parasites that infect humans when they are eating contaminated vegetables and fruits [5–7]. Furthermore, surveillance studies have indicated that vegetables and fruits can be contaminated with various bacterial pathogens, including Enterobacteriaceae, Bacillus spp., Staphylococcus spp., Micrococcus spp., Pseudomonas spp., Aeromonas spp., Acinetobacter spp., Campylobacter spp., Corynebacterium spp., Streptococcus spp., and Neisseria spp [8–17].

Vegetables and fruits are contaminated in farm fields by organic fertilizer or contaminated water used in irrigation; they also become contaminated during harvesting, processing, distribution, sale, and consumption of vegetables and fruits [18–20]. Approximately 70% of diarrheal illnesses in developing countries are thought to be food-borne, meaning that they can spread through direct contact with food, water, soil, vertebrate and arthropod vectors. These findings indicate that several documented outbreaks are the result of foodborne bacterial and parasitic diseases [18–21].

Globally, 1 billion people are affected by intestinal parasite infections (IPIs) [22], and in 2010, an estimated 438.9 million people were infected with hookworm, 819.0 million with Ascaris spp., and 464.6 million with T. trichiura [23]. Intestinal parasites cause significant morbidity and mortality throughout the world, especially in developing countries [24, 25]. However, pooled evidence of bacterial and parasitic contamination and its associated factors was lacking for vegetables and fruits, and this combined information is important for responsible bodies in Ethiopia to reconsider the control and prevention mechanisms of enteric diseases.

Identifying the sources of contamination and understanding the pathogen’s environment is a key step in reducing pathogenic microbes. However, in countries such as Ethiopia, where there are not enough systems in place for regular testing, tracking, and sharing information about food-borne pathogens, outbreaks often occur because the presence of these pathogenic microbes in vegetables and fruits is not properly recognized or addressed [26, 27].

Although several individual studies exist, no pooled evidence on both bacterial and parasitic contamination has been published in Ethiopia. The study was designed to answer key questions regarding the synergistic public health threat and the efficiency of a combined analysis for guiding policymakers and responsible bodies in developing targeted intervention mechanisms for enteric diseases. Specifically, it aimed to determine the prevalence and types of contaminating bacteria and parasites, identify the key risk factors associated with this contamination, and assess whether the contamination levels differ significantly between samples collected from farms and those from local markets. As the first such study in Ethiopia, this systematic review and meta-analysis provides a novel synthesis of data on both bacterial and parasitic contamination of vegetables and fruits, and quantitatively analyzes the associated factors to deliver consolidated, evidence-based findings.

Methods

Study area

Ethiopia is the country in Africa that is the second most populous and has a wide range of cultures, languages, and geography, with approximately 130 million people [28]. The regions and cities included in this study are clearly shown in Fig. 1.

Fig. 1.

Fig. 1

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Study region map

Study design and protocol registration

This study used a systematic review and meta-analysis approach to collect data on how many raw vegetables and fruits in Ethiopia are contaminated with bacteria and parasites. International databases, websites, and PROSPERO were searched to confirm that no previously published meta-analysis on this topic exists. This review was conducted in accordance with the PRISMA-2020 guidelines to ensure rigor and transparency [29] (see Supplemental File 1). The protocol for this systematic review and meta-analysis is registered in PROSPERO under registration number CRD42025640154.

Eligibility criteria

Studies were included in the review if they met the following criteria:

  • Parasite and host: Studies that report on the prevalence and/or predictors (risk factors or determinants) of bacteria and parasites in vegetables and fruits.

  • Country: Study conducted in Ethiopia.

  • Language: Studies reported in the English language.

  • Study type: Cross-sectional studies.

  • Publication types: Published and unpublished free full texts.

  • Sampling settings: Local farms or markets.

  • Year of publication: Published from March 2010 to January 2025.

Studies were excluded if they met the following criteria:

  • Studies not involving vegetables or fruits or studies conducted outside Ethiopia.

  • Studies that do not report on either the prevalence or predictors of contaminants.

  • Studies lacking adequate data for extraction or analysis, even after attempts to contact the authors.

  • Duplicate publications of the same study (the most complete or latest version will be retained).

  • Reviews, case reports, correspondence, proceedings, conference abstracts, and letters to the editor.

Literature search strategy

The search strategy for this systematic review and meta-analysis employed a structured approach to ensure comprehensive coverage of the relevant literature. A systematic search was conducted across multiple electronic databases, including PubMed, Scopus, Web of Science, ScienceDirect, and AJOL (see Supplemental File 2), for studies published from March 2010 to January 2025. To identify relevant studies, the following search terms were used individually or in combination with Boolean operators: “bacterial contamination,” OR “parasitic contamination,” AND “vegetables,” OR “fruits,” AND “farms,” OR “markets,” AND “Ethiopia.” Moreover, additional searches included screening the reference lists of retrieved articles for relevant studies. The last literature search was conducted on January 20, 2025.

Study selection

All the retrieved articles were imported into reference management software (version X8 of EndNote software) for deduplication. Three reviewers (AM, NG, AA) independently screened the titles and abstracts. The inter-reviewer agreement was high (Cohen’s κ = 0.85). The full-text articles were assessed for final inclusion on the basis of predefined criteria, as illustrated in the PRISMA flowchart (Fig. 2 Discrepancies were resolved through discussion with a fourth reviewer (AG).

Fig. 2.

Fig. 2

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PRISMA-2020 flow diagram illustrating the selection process of studies

Data extraction

A Microsoft Excel 2016 (Microsoft®, Redmond, Washington, USA) was used as a template for data extraction to collect the following information:

  • Study characteristics (author, year, region).

  • Sampling setting: local farms or markets.

  • Type of produce sampled.

  • Pathogens identified (bacteria or parasites).

  • Prevalence rates and associated factors.

  • Detection methods.

Three reviewers (AM, NG, AA) independently extracted the data to minimize bias. Any discrepancies identified between the reviewers during data extraction were resolved through discussion with the fourth reviewer (AG).

Quality assessment

The quality of the included studies was evaluated via the Joanna Briggs Institute (JBI) checklist for prevalence studies with nine criteria [30]. This 9-item tool evaluated (1) appropriateness of the sampling frame, (2) proper participant recruitment, (3) adequacy of the sample size, (4) standardized condition measurement, (5) appropriateness of the statistical analysis, (6) response rate adequacy, (7) confounding management, (8) outcome assessment validity and (9) appropriateness of the result reporting. The final analysis included only studies with low or moderate risk of bias, categorized by scores of 6–8 (low), 3–5 (moderate), and 0–2 (high) [31].

Statistical analysis

The pooled odds ratios (ORs) were calculated using a random-effects model based on the DerSimonian–Laird method to account for heterogeneity among studies. Statistical heterogeneity was assessed using Galbraith plots and the I² statistic, which was interpreted as follows: low (0–25%), moderate (26–50%), substantial (51–75%), and considerable (76–100%) heterogeneity. Subgroup analyses based on sample size, study region, sampling setting, detection method, contaminant type, and publication year were conducted in order to explore possible sources of heterogeneity. To assess publication bias, we utilized funnel plots, and regression-based Egger’s test (p < 0.05 indicating significance presence of publication bias). Sensitivity analyses were performed to evaluate the influence of individual studies on the overall effect size. Statistical analyses were performed using STATA version 14 with metan command (StataCorp, College Station, TX, USA).

Results

Selection of studies

We identified 825 studies through searches of the specified databases. After 217 duplicate records were removed, 608 articles remained for title and abstract screening. Of these, 518 were excluded because they did not meet the criteria. The full texts of 90 articles were subsequently assessed in detail, resulting in the inclusion of 29 studies in the final systematic review and meta-analysis. The complete selection process, along with the reasons for exclusion, is presented in Fig. 2.

Parasitic contamination report in vegetables and fruits

Among the nineteen parasitic studies, 11 types of vegetables tested, such as green pepper, cabbage, lettuce, salad, carrot, tomato, spinach, potato, onion, swiss chard, and kale, and four types of fruits were tested, such as banana, mango, avocado, and orange. These data were collected from 19 studies on different farms and markets in five regions of Ethiopia, including Oromia, Southern Nations, Nationalities, and Peoples (SNNP), Amhara, Tigray, and Harari, as well as the cities of Addis Ababa and Dire Dawa. In the 19 included studies such as, Tomass & Kidane 2012 (60/190) [32], Tefera et al. 2014 (208/360) [33], Alemayehu et al. 2015 (29/55) [34], Bekele et al. 2017 (196/360) [35], Alamnie et al. 2018 (60/72) [10], Hailemeskel et al. 2018 (95/150) [36], Endale et al. 2018 (178/376) [37], Gesese 2019 (26/123) [38], Bekele & Shumbej 2019 (115/270) [39], Alemu et al. 2019 (87/347) [40], Fekadu 2020 (58/120) [41], Alemu et al. 2020 (150/384) [3], Bekele et al. 2020 (98/270) [42], Gebremariam & Girmay 2020 (220/384) [43], Asfaw et al. 2023 (75/180) [44], Gemechu et al. 2023 (142/391) [45], Zeynudin et al. 2024 (173/375) [4], Gurmassa et al. 2024 (170/252) [46], and Yenew et al. 2025 (117/360) [47], the parasite contaminated/total sample collected were presented in Table 1; Fig. 3. The frequency of parasitic contamination in local farms and markets in Ethiopia is presented in Fig. 3.

Table 1.

Detailed characteristics of the included studies

Author Publication year Region Sample size +ve samples Percent (%) Quality
Guchi & Ashenafi 2010 [8] Addis Ababa 80 72 90 7
Tomass & Kidane 2012 [32] Tigray 190 60 31.6 7
Dugassa et al. 2014 [9] Oromia 180 162 90 7
Tefera et al. 2014 [33] Oromia 360 208 57.8 9
Alemayehu et al. 2015 [34] Tigray 55 29 52.7 6
Bekele et al. 2017 [35] SNNPR 360 196 54.4 9
Alemu et al. 2018 [11] SNNPR 347 169 48.7 9
Hailemeskel et al. 2018 [36] Amhara 150 95 63.4 7
Endale et al. 2018 [37] Dire Dawa 376 178 47.3 9
Alamnie et al. 2018 [10] Harari 72 60 83.4 7
Alamnie et al. 2018 [10] Harari 72 18 25 7
Gesese 2019 [38] Amhara 123 26 21.1 7
Bekele & Shumbej 2019 [39] SNNPR 270 115 42.6 9
Alemu et al. 2019 [40] SNNPR 347 87 25.1 9
Fekadu 2020 [41] Harari 120 58 48.3 7
Belay et al. 2020 [12] SNNPR 12 3 25 6
Alemu et al. 2020 [3] Amhara 384 150 39.1 9
Bekele et al. 2020 [42] SNNPR 270 98 36.3 9
Gebremariam & Girmay 2020 [43] Tigray 384 220 57.3 8
Berhanu et al. 2022 [13] Amhara 192 128 66.7 7
Asfaw et al. 2023 [44] Amhara 180 75 41.7 8
Asfaw et al. 2023 [14] Amhara 180 119 66.1 8
Gemechu et al. 2023 [45] Oromia 391 142 36.3 9
Zeynudin et al. 2024 [4] Oromia 375 173 46.1 9
Demisie & Melese 2024 [15] Addis Ababa 119 100 83.3 8
Gurmassa et al. 2024 [46] Addis Ababa 252 170 67.5 9
Ahmed et al. 2025 [17] SNNPR 216 39 18.1 8
Zeynudin et al. 2025 [16] Oromia 242 31 12.8 9
Yenew et al. 2025 [47] Amhara 360 117 32.5 9
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SNNPR: Southern Nations, Nationalities and Peoples Region

Fig. 3.

Fig. 3

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Frequency distribution of parasitological contamination of vegetables and fruits collected from Ethiopian local farms and markets

The following items were contaminated by parasites: lettuce 61.0% (435/713), salad 57.4% (39/68), spinach 54.2% (207/382), cabbage 52.9% (416/787), potato 46.9% (30/64), Swiss chard 44.9% (96/214), carrot 43.9% (249/567), onion 40.4% (19/47), banana 39.4% (87/221), avocado 37.6% (83/221), kale 36.4% (48/132), tomato 35.6% (260/730), mango 35.1% (80/228), green pepper 32.4% (196/605), and orange 25.5% (12/47) (See Fig. 4). The contamination rate for fruits (banana, mango, avocado, and orange) was 5.4%, and for vegetables (green pepper, cabbage, lettuce, salad, carrot, tomato, spinach, and potato), it was 41.00%.

Fig. 4.

Fig. 4

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Prevalence rate of parasitic contamination in vegetables and fruits collected from Ethiopian local farms and markets. The prevalence rate was calculated as the number of contaminated samples by parasites divided by the total samples tested for each produce type, expressed as a percentage. The graph is sorted in descending order of prevalence

The results from the 19 studies revealed an overall contamination rate of 46.40% (95% CI, 40.04–52.75. Helminths were more prevalent (29.07%) than protozoans (17.30%). Ascaris spp. (8.34%) ranked highest, followed by Entamoeba spp. (6.92%), Strongylida (6.51%), Giardia spp. (5.67%), Toxocara spp. (2.65%), Cryptosporidium spp. (2.62%), Hymenolepis nana (2.61%), Taenia spp. (2.59%), and Hookworm (2.31%) (Table 2).

Table 2.

Prevalence of parasite among vegetables and fruits collected in local farms and markets of Ethiopia

Detected parasites Pooled frequency (%)
Protozoa 1220 (17.30)
Entamoeba spp. 488 (6.92)
Giardia spp. 400 (5.67)
Cryptosporidium spp. 185 (2.62)
Cyclospora spp. 78 (1.11)
Cystoisospora spp. 34 (0.49)
Entamoeba coli 20 (0.28)
Balantidium coli 15 (0.21)
Helminths 2049 (29.07)
Ascaris spp. 588 (8.34)
Strongylida 459 (6.51)
Toxocara spp. 187 (2.65)
Hymenolepis nana 184 (2.61)
Taenia spp. 182 (2.59)
Hookworm 163 (2.31)
Hymenolepis diminuta 85 (1.21)
Enterobius vermicularis 83 (1.18)
Fasciola spp. 75 (1.06)
Trichuris trichiura 43 (0.61)
Mixed infections 2 (0.03)
(Giardia + Ascaris) 1 (0.015)
(Entamoeba + Strongylida + Ascaris) 1 (0.015)
Total 3271 (46.40)
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Bacterial contamination of vegetables and fruits

Among the ten bacterial contamination studies, 11 types of vegetables were tested, such as green pepper, lettuce, carrot, cabbage, tomato, spinach, salad, kale, potato, onion, garlic and four types of fruits, such as mango, avocado, banana, and papaya. These samples came from studies performed on different farms and markets across four regions and one city in Ethiopia—Oromia, SNNP, Amhara, Harari, and Addis Ababa. The results of the ten included studies, such as those of Guchi & Ashenafi 2010 (72/80) [8], Dugassa et al. 2014 (162/180) [9], Alamnie et al. 2018 (18/72) [10], Alemu et al. 2018 (169/347) [11], Belay et al. 2020 (3/12) [12], Berhanu et al. 2022 (128/192) [13], Asfaw et al. 2023 (119/180) [14], Demisie & Melese 2024 (100/119) [15], Zeynudin et al. 2025 (31/242) [16], and Ahmed et al. 2025 (39/216) [17], are presented in Table 1; Fig. 5. The frequency distributions of bacterial contamination of items on local farms and markets in Ethiopia are shown in Fig. 5.

Fig. 5.

Fig. 5

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Frequency distribution of bacterial contamination of vegetables and fruits collected from Ethiopian local farms and markets

The following items were contaminated by bacteria: salad (73.8%), green pepper (35.3%), lettuce (26.0%), cabbage (20.0%), banana (20.0%), carrot (19.6%), spinach (19.1%), garlic (18.8%), kale (18.0%), mango (16.2%), tomato (15.6%), potato (15.0%), onion (14.4%), avocado (13.2%), and papaya (10.0%) (See Fig. 6). The contamination rate for fruits (banana, mango, avocado and papaya) was 0.55%, and for vegetables (green pepper, lettuce, carrot, cabbage, tomato, spinach, salad, kale, potato, onion, and garlic), it was 52.30%.

Fig. 6.

Fig. 6

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Prevalence rate of bacterial contamination in vegetables and fruits collected from Ethiopian local farms and markets. The prevalence rate was calculated as the number of contaminated samples by bacteria divided by the total samples tested for each produce type, expressed as a percentage. The graph is sorted in descending order of prevalence

The results from the ten bacterial studies revealed an overall contamination rate of 52.85% (95% CI, 32.10–73.60). Gram-positive bacteria were more prevalent (28.97%) than Gram-negative bacteria (23.88%). Enterobacteriaceae (14.78%) ranked highest, followed by Bacillus spp. (10.27%), Staphylococcus spp. (8.86%), Micrococcus spp. (5.20%), Pseudomonas spp. (4.86%), other G + rods (4.44%), and Aeromonas spp. (3.55%) (Table 3).

Table 3.

Prevalence of bacteria among vegetables and fruits collected in local farms and markets of Ethiopia

Detected bacteria Pooled frequency (%)
Gram-negative (G-) 1204 (23.88)
Enterobacteriaceae 745 (14.78)
Pseudomonas spp. 245 (4.86)
Aeromonas spp. 179 (3.55)
Acinetobacter spp. 32 (0.63)
Campylobacter spp. 2 (0.04)
Neisseria spp. 1 (0.02)
Gram-positive (G+) 1461 (28.97)
Bacillus spp. 518 (10.27)
Staphylococcus spp. 447 (8.86)
Micrococcus spp. 262 (5.20)
Other G + rods 224 (4.44)
Corynebacterium spp. 4 (0.08)
Lactobacillus spp. 4 (0.08)
Streptococcus spp. 2 (0.04)
Total 2665 (52.85)
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Characteristics of the included studies

The 29 included studies were conducted between 2010 and 2025 and involved a total of 6659 samples across Ethiopia [3, 4, 8–17, 32–47]. Among these, fifteen studies were conducted before 2020, and the remaining 14 were conducted after 2020. Nineteen studies investigated parasitic contaminants of vegetables and fruits in local markets and farms, whereas the remaining ten studies investigated bacterial contaminants. Twenty-one studies were conducted in local market settings, and nine were conducted on local farms. Ten studies used microbiological analysis to detect bacteria, ten-used both light microscopy and modified Ziehl–Neelsen, and nine employed only light microscopy for the detection of parasites. The sample sizes ranged from 12 to 391 participants. The reported prevalence in individual studies varied widely: from 12.8% (bacterial, Oromia) to 90.0% (bacterial, Oromia and Addis Ababa city) and from 21.1% (parasitic, Amhara) to 63.4% (parasitic, Amhara). Seven studies each were from SNNPR (Southern Nations, Nationalities and Peoples) and Amhara; five were from Oromia; three each were from Tigray, Harari and Addis Ababa; and one was from Dire Dawa. A unique methodological consideration involved the study by Alamnie et al. (2018) [10], which presented distinct prevalence data for both bacterial and parasitic infections despite the use of a unified sampling framework. Consequently, this study was analytically treated as two separate datasets in our meta-analysis to preserve contaminant-specific accuracy (Table 1). Moreover, Gesese 2019 [38] sampled vegetables and fruits from both local markets and farms; therefore, this study was counted as two separate entries during the subgroup analysis based on sampling settings.

Pooled bacterial and parasitic contamination

The pooled bacterial and parasitic contamination of vegetables and fruits in Ethiopia was 48.76% (95% CI: 40.78–56.74) based on a random effects model. Significant heterogeneity was observed among the included studies (I² = 98.1%, p < 0.001) (see Fig. 7).

Fig. 7.

Fig. 7

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Forest plot summary of pooled prevalence of bacterial and parasitic contamination of vegetables and fruits in Ethiopia

Subgroup analysis

We conducted a subgroup analysis to identify factors contributing to the variation among the studies. We examined variables such as the number of participants, region, study setting, detection method, contaminant type, and year of publication (Table 4). Studies with fewer than 300 participants reported a higher prevalence rate of 50.99% (95% CI: 38.19 − 63.79) than the 44.03% (95% CI: 37.47 − 51.40) reported in studies with more than 300 participants. The highest vegetable and fruit contamination was observed in Addis Ababa at 80.18% (95% CI: 66.59 − 93.76), whereas the lowest was in SNNPR at 36.33% (95% CI: 25.50 − 47.16).

Table 4.

Subgroup analysis

Variables Characteristics Included studies Sample size Prevalence (%) (95% CI) Heterogeneity
I2, p–value		 Between subgroup difference (P-value)
Sample size > 300 10 3684 44.03 (37.47 − 51.40) 95.0, p < 0.001 p = 0.378
< 300 19 2975 50.99 (38.19 − 63.79) 98.6, p < 0.001
Region Addis Ababa 3 451 80.18 (66.59 − 93.76) 92.7, p < 0.001 p < 0.001
Tigray 3 629 47.06 (28.66 − 65.47) 94.8, p < 0.001
Oromia 5 1548 48.60 (22.11 − 75.09) 99.4, p < 0.001
SNPPR 7 1822 36.33 (25.50 − 47.16) 95.8, p < 0.001
Amhara 7 1569 47.16 (34.43 − 59.90) 96.6, p < 0.001
Dire Dawa 1 376 47.30 (42.28 − 52.32) —,—
Harari 3 264 52.30 (18.68 − 85.92) 97.6, p < 0.001
Sampling settings Local markets 21 5664 47.28 (37.88 − 56.68) 98.4, p < 0.001 p = 0.809
Local farms 9 1118 49.38 (35.16 − 63.61) 96.1, p < 0.001
Detection method Microbiological analysis 10 1640 52.85 (32.10 − 73.60) 99.1, p < 0.001 p = 0.781
Light microscope 9 1652 47.66 (34.92 − 60.41) 96.8, p < 0.001
Light microscope and Modified Ziehl − Neelsen 10 3367 45.37 (38.52 − 52.23) 94.2, p < 0.001
Contaminant type Bacterial 10 1640 52.85 (32.10 − 73.60) 99.1, p < 0.001 p = 0.560
Parasitic 19 5019 46.40 (40.04 − 52.75) 95.6, p < 0.001
Publication year Before 2020 15 2994 50.86 (38.88 − 62.83) 98.2, p < 0.001 p = 0.591
After 2020 14 3665 46.50 (36.06 − 56.94) 98.0, p < 0.001
Overall 29 6659 48.76 (40.78 − 56.74) 98.1, p < 0.001
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SNNPR: Southern Nations, Nationalities and Peoples Region

With respect to the sampling settings (Table 4), the pooled prevalence of contamination in local farm studies was 49.38% (35.16 − 63.61), whereas local market studies reported a prevalence of 47.28% (95% CI: 37.88 − 56.68). Microbiological examination for the detection of bacteria reported a prevalence of 52.85% (95% CI: 32.10–73.60); light microscopy for the detection of parasites reported a prevalence of 47.66% (95% CI: 34.92–60.41); and studies employing both light microscopy and modified Ziehl–Neelsen for parasite detection reported a prevalence of 45.37% (95% CI: 38.52–52.23). In terms of contaminant type, bacterial studies had a prevalence of 52.85% (95% CI: 32.10 − 73.60), whereas parasitic studies had a prevalence of 46.40% (95% CI: 40.04 − 52.75). The rate of contamination in studies conducted before 2020 was 50.86% (95% CI: 38.88 − 62.83), whereas studies conducted after 2020 reported a prevalence of 46.50% (95% CI: 36.06 − 56.94).

Quality assessment and publication bias

All included articles were of high quality, as demonstrated in Table 1. Egger’s regression intercept test for small-study effects yielded a p value of 0.506 (Table 5), suggesting no evidence of publication bias. Similarly, the funnel plot also suggested no positive publication bias (Fig. 8A). As shown in Fig. 8B, in the sensitivity analysis, the studies not included affected the pooled effect size, resulting in a value of 47.61% (95% CI: 46.34–48.88). The Galbraith plot showed some heterogeneity among the included studies, with the dispersion of studies away from the “no-effect” line indicating considerable differences in effect estimates (Fig. 9).

Table 5.

Egger’s test for small-study effects in meta-analysis of bacterial and parasitic contamination of raw vegetables and fruits collected from local farms and markets in Ethiopia

Std_Eff Coef. Std. Err. t P>|t| [95% Conf. Interval]
Slope 37.43328 15.6112 2.40 0.024 [5.401739 69.46482]
Bias 3.534082 5.243506 0.67 0.506 [-7.224704 14.29287]
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Fig. 8.

Fig. 8

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(A) Funnel plot representing evidence of publication bias; (B) Sensitivity analysis result of the involved studies that assessed the effect of individual studies on the overall contamination rate of vegetables and fruits in Ethiopia

Fig. 9.

Fig. 9

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Galbraith plot, for assessing heterogeneity of the included studies on bacterial and parasitic contamination of vegetables and fruits in Ethiopia

Factors associated with bacterial and parasitic contamination

In this systematic review and meta-analysis, Table 6 shows the factors linked to bacterial and parasitic contamination of vegetables and fruits in Ethiopia. Five studies reported that floor displays of vegetables and fruits were 2.15 times more likely to be contaminated than were properly constructed shelves (aOR: 2.15, 95% CI: 1.17–3.13). Eleven articles reported that vegetables were 2.10 times more likely to be contaminated by parasites and bacteria than were fruits (aOR: 2.10, 95% CI: 1.13–3.08). Five studies also revealed that vendors with untrimmed fingernails were 2.02 times more likely to contaminate vegetables and fruits than those with trimmed fingernails (aOR: 2.02, 95% CI: 1.10–2.93). Three studies reported that produce sourced from farmers was 2.46 times more likely to be contaminated than its counterparts (aOR: 2.46, 95% CI: 1.45–3.47). Two studies revealed that those with no formal education were associated with an 11.43 times higher odds of contamination compared to their counterparts (aOR: 11.43, 95% CI: 6.18–29.05). Furthermore, two articles revealed that vendors with poor handwashing habits were 3.10 times more likely to contaminate vegetables and fruits than their counterparts (aOR: 3.10, 95% CI: 1.53–4.67). Finally, nine articles indicated that venders not washing vegetables and fruits before display were 2.41 times more likely to be contaminated by parasites and bacteria than those displaying the produce after washing (aOR: 2.41, 95% CI: 1.52–3.30).

Table 6.

Factors associated with the bacterial and parasitic contamination of raw vegetables and fruits collected from local farms and markets in Ethiopia

Variables Number of articles Pooled odds ratio (95% CI) I-squared (%) I2 p-value
The type of market 4 0.49 (0.22–0.76) 12.2 0.332
The medium of the display 5 2.15 (1.17–3.13) 14.9 0.320
The kind of produce 11 2.10 (1.13–3.08) 71.0 < 0.001
Fingernail status of vendors 5 2.02 (1.10–2.93) 26.5 0.245
The source of the produce 3 2.46 (1.45–3.47) 7.2 0.340
Education status of vendors 2 11.43 (6.18–29.05) 85.7 0.008
Venders’ handwashing habit 2 3.10 (1.53–4.67) 0.0 0.743
Washing condition of the product before it is displayed 9 2.41 (1.52–3.30) 89.9 < 0.001
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On the other hand, the type of market was reported in four articles; however, this factor was not significantly associated with the bacterial and parasitic contamination of vegetables and fruits in Ethiopia (Table 6).

Discussion

The consumption of vegetables and fruits is crucial for the prevention of chronic disease [48, 49]. However, the consumption of unclean vegetables and fruits is the highest source of bacterial and parasitic infections throughout the world population, including Ethiopia [50]. The pooled prevalence of contamination of fresh produce in the present systematic review and meta-analysis was 48.76% (95% CI: 40.78–56.74), with high heterogeneity between studies of I2 = 98.1%, with a p value of < 0.001. This result indicates that prevention of bacterial and parasitic infection from the source is the mandatory responsibility of health systems and policymakers. The results of the present study was in line with those of individual studies performed elsewhere in Ethiopia (41.7% [44], 42.6% [39], 46.1% [4], 47.3% [37], 52.7% [34]). However, this magnitude was greater than that reported in previous meta-analysis studies performed in Nigeria (32.4% [51]), Thailand (35.1% [52]), worldwide (vegetables 31% and 20% for fruits [50]), Iran (14.6% [53]), and Norway (6%) [54]. Conversely, the results of the present study was much lower than those of previous surveillance studies conducted in Iran (52.7%) [55], Yemen (76.9%) [56], Egypt (86%) [57] and Ethiopia (90%) [8]. The possible reasons for this discrepancy might be differences in the nature of the study population of the included articles according to which the current review synthesized the prevalence of bacterial and parasitic contamination of the studies conducted in low socio-economic population, which is one of the major preconditions of highly prevalent bacterial and parasitic infection. Additionally, the differences in the prevalence of bacterial and parasitic contamination may have been caused by the difference in geographical location, climatic conditions, and degree of water contamination, sample size and detection mechanisms used in the studies. Again, Ethiopia might also be more prone to animal feces and livestock contamination in farm or harvesting, because of differences in livestock management practices. This likely contributes to the higher contamination rates observed bacterial and parasitic contaminations in vegetables and fruits. Increased rates of contamination could also be caused by differences in the awareness and practices of Ethiopian farmers and food handlers concerning food safety compared to other countries. Moreover, in Ethiopia there are no intervention systems or policies for the prevention of contamination of vegetables and fruits with foodborne pathogens, which clearly means that vendors sold their produce by displaying them on the floor; there are no well-constructed markets for displaying these vegetables and fruits, and majority of the consumers have a habit of consuming raw produce [3, 58].

The pooled prevalence of bacterial contamination was 52.85% (95% CI: 32.10 − 73.60), with high heterogeneity (I2 = 99.1%) between studies and a p value of < 0.001. This result was in line with individual studies of 48.7% [11] and higher than those of 12.8% [16] and 26.3% [59] from Ethiopia and Thailand and much lower than reports of 90% [8] and 97.3% [60] from Ethiopia and India. With regard to the bacterial isolates, Gram-positive bacteria were more prevalent (28.97%) than Gram-negative bacteria (23.88%). Gram-positive bacteria (like Bacillus and Staphylococcus) are often more resilient in dry, dusty environments and are common indicators of handling and soil contamination, which aligns with the identified risk factors. This finding contrasts with that of Asfaw et al. (2023) [14], where Gram-negative bacteria (70.5%) were more predominant than Gram-positive bacteria (29.5%). This variation could be due to differences in markets or farms, such as dust-emitting vehicles around these locations, long-distance transportation of vegetables and fruits, unhygienic production, and open storage in locations exposed to multiple contaminants, which can be sources of various microbial contaminants.

The pooled prevalence of parasitic contamination in the present systematic review and meta-analysis was 46.40% (95% CI: 40.04 − 52.75), with substantial heterogeneity between studies of I2 = 95.6% and a p value of < 0.001, which is in agreement with the findings of previous surveillance study conducted in Mexico (45%) [61] and systematic reviews and meta-analyses performed in Ethiopia (43.38%) [62] and 43.99% [63]. Inconsistently, the results of the present study was much greater than those of previous studies conducted in Nigeria (8.44%) [64], Tunisia (12.5%) [65], Sudan (13.5%) [66], and Pakistan (19.7%) [67]. However, the present findings was lower than those of previous surveillance reports from Yemen (76.9%) [56] and Egypt (86%) [57]. Among the detected parasites, helminths were more prevalent (29.07%) than protozoans (17.30%). The observed discrepancy might be explained by differences in the nature of the study population, geographical location, climatic conditions, livestock management practices, extent of water contamination used for farm and washing purposes, farmer and food handler awareness, study sample size, and parasitic detection mechanisms.

In terms of produce type, vegetables were more infected with bacteria (52.30%) and parasites (41.0%) than fruits (bacteria, 0.55% and parasites, 5.4%). This finding is consistent with that of a study conducted in Nigeria [51]. The variation in contamination between the products might be due to the larger and uneven surfaces of vegetables such as cabbage, lettuce, and carrot, which can easily facilitate contaminant attachment, resulting in varying contamination levels. The differences in contamination might be because vegetables have rougher surfaces that can hold contaminants better, whereas other items, such as potatoes and oranges, have smoother surfaces, which may reduce contamination [25, 35, 68]. Moreover, in low-resource settings like Ethiopia, the culture of raw spinach, tomato, lettuce, green pepper, and carrot consumption is relatively high; thus, there is a greater chance of acquiring intestinal parasitic and bacterial infections while these infections are ingested without proper washing.

In the subgroup analysis, the contamination rate of bacteria and parasites on vegetables and fruits in the studies whose sample sizes below and above 300 were [52.27%; 95% CI (40.10–64.44)] and [47.39%; 95% CI (37.24–53.54)], respectively. This finding is inconsistent with those of previous systematic reviews and meta-analyses conducted in Nigeria, which reported that the prevalence estimates were 25.1% and 38.4% for sample size groups >800 and between 400 and 800, respectively [51].

The present study’s subgroup analysis revealed that the Addis Ababa city administration (80.18%) had the greatest pooled prevalence of contamination, followed by the Harari (52.30%) and Oromia regions (48.60%). One possible reason for the greater contamination in these areas than in other regions in Ethiopia could be differences in farming practices and environmental factors. Several factors, such as weather, cultural background, the season when samples were collected, the types of vegetables and fruits studied, and other conditions, affect the levels and types of bacteria and parasites found in the studies.

With respect to the sampling settings, the pooled prevalence of contamination in local farm studies was 49.38% (35.16 − 63.61), followed by local market studies, which reported a prevalence of 47.28% (95% CI: 37.88 − 56.68). This might be because farmers in Ethiopia often use human and animal waste as fertilizers and contaminated irrigation water [4, 40]. The use of contaminated water or soil might be more common in certain regions, or there could be differences in how animal waste is managed. Additionally, differences in the knowledge and practices of food safety among farmers and sellers in different regions could be a reason for the differences in contamination levels. Another important reason for the variation in the prevalence of bacterial and parasitic contamination in different regions may be the different levels of human infections with bacteria and parasites in those areas [69–72]. More research is needed to better understand the reasons behind these differences in contamination of vegetables and fruits in farms and markets of Ethiopia.

In this meta-analysis, studies that conducted microbiological analysis for bacterial detection reported a prevalence of 52.85% (95% CI: 32.10 − 73.60); those using only light microscopy for parasite detection had a prevalence of 47.66% (95% CI: 34.92 − 60.41); and studies employing both light microscopy and modified Ziehl − Neelsen parasite detection methods reported a prevalence of 45.37% (95% CI: 38.52 − 52.23). This result contradicts previous systematic reviews and meta-analyses conducted on vegetables and fruits in markets by Girma et al. [63], who reported that pooled parasitic contamination was greater in studies that used both light microscopy and modified Ziehl–Neelsen staining for detection (45.10%; 95% CI: 38.02–52.19) than in studies that utilized only one parasite detection method (38.99%; 95% CI: 33.70–44.28). However, another study [62] reported that the pooled prevalence of parasitic contamination was lower when both techniques were used than when one was used. This is because combining both methods should allow for a more accurate diagnosis. This could be because research using both approaches came from areas where bacterial and parasitic contamination in vegetables and fruits is low [62].

Furthermore, the rate of contamination in studies conducted before 2020 was 50.86% (95% CI: 38.88 − 62.83), whereas studies conducted after 2020 reported a prevalence of 46.50% (95% CI: 36.06 − 56.94). This finding is in agreement with a systematic review and meta-analysis performed in Ethiopia [63], which reported that pooled parasitic contamination decreased from 45.43% during the period between 2014 and 2019 to 42.80% in the next five years (2020–2024). However, this finding contradicts the systematic review and meta-analysis conducted in Nigeria, in which the prevalence of parasites increased in studies conducted between 2007 and 2011 and in studies conducted between 2012 and 2016, which were 26.4% and 39.6%, respectively [51]. These differences might be due to variations in publication year, geographical differences [73], the level of environmental contamination with bacteria and parasites, and the ways in which vegetables and fruits are grown, harvested, and transported from farms to markets [74].

According to this systematic review and meta-analysis, fresh vegetables and fruits widely purchased from Ethiopian farms and marketplaces are a source of potentially harmful bacteria, posing a public health risk. In this systematic review and meta-analysis, Enterobacteriaceae (Escherichia spp., Salmonella spp., Shigella spp., Klebsiella spp., Enterobacter spp., Serratia spp., Proteus spp., Citrobacter spp., Providencia spp.) (14.78%) were the most common isolates from vegetables and fruits. This result was significantly lower than the enterobacterial count (82.9%) detected above the detection limit in fresh produce from Spain [75]. More consistent results were reported from Ethiopia [11, 17], Sweden [76], Italy [77], Turkey [78], India [79], and Bangladesh [80], where Enterobacteriaceae was reported as the dominant species. However, in some places, such as Ethiopia [72], Nigeria [81], Sudan [82] and India [83], Staphylococcus was more frequently found. This might be due to differences in the number of bacteria in the environment, the culture technique utilized, and the period of data collection. In general, the prevalence of enteric bacteria might be attributed to coliform bacteria, which are generally discharged with feces and are obviously prevalent in environments where open defecation is widespread. Moreover, farmers sometimes utilize human and animal manure as a natural fertilizer, which contributes to the contamination of vegetables and fruits cultivated on these farms [84, 85].

In this study, Bacillus spp. (10.27%) was the second most prevalent species from vegetables and fruits. However, in Nigeria, the most frequently identified bacteria was Bacillus species [85]. The isolation of environmental isolates such as Bacillus species may be indicative of soil contamination [85]. Moreover, the presence of endospores that are more resistant than vegetative cells to harsh weather conditions and even antimicrobial treatments may result in a high percentage of Bacillus species [12].

In this systematic review and meta-analysis, Staphylococcus spp. (8.86%) were the third most common species isolated from vegetables and fruits. However, in other places, such as Ethiopia [72], Nigeria [81], Sudan [82] and India [83], Staphylococcus was more frequently found. The isolation of skin commensals such as Staphylococcus spp. may serve as indicators of contamination by handlers, either during transportation or during postharvest processing, as staphylococci can survive on the hand and surface for a long time after initial contact [85].

Regarding parasites, Ascaris spp. was the leading parasite found in vegetables and fruits, with a prevalence of 8.34%. Similarly, A. lumbricoides was the most abundantly found helminth in vegetables in a systematic review and meta-analysis conducted in Iran [86] and worldwide [50] and in other surveillance studies from Nigeria [64], Pakistan [67], the Philippines [87] and Kenya [25]. In comparison, the Ova of Ascaris was the third contaminant according to a previous similar systematic review and meta-analysis performed in Nigeria [51]. This might be because Ascaris eggs are widespread, are produced in large numbers by female worms, and are highly resilient to harsh conditions. These eggs can remain viable even without oxygen, can survive for up to two years in cold conditions (5 °C to 10 °C), and can remain undamaged even after drying for up to three weeks [63].

In the present study, Entamoeba spp. cysts (6.92%) were the second most frequently detected parasite from all vegetables and fruits examined in different studies. This was similar to findings in Nigeria (4.82%) [51]. However, in some areas, such as Yemen (20.9%) [56], Sudan (42.9%) [66], and Egypt (40.6%) [57], the presence of Entamoeba was much greater. On the other hand, this finding was greater than those reported in other countries, such as Turkey [88], Mexico [61], and Cameroon [89]. Entamoeba spp. is prevalent mainly because of the extensive irrigation with contaminated water and the use of untreated raw manure as a fertilizer in most of the agricultural areas. This problem is exacerbated by inadequate sanitation infrastructure and poor hygiene practices, which allow human and animal waste containing hardy cysts to enter the environment. Consequently, these unsanitary conditions during cultivation and handling directly facilitate the parasite’s transmission onto fresh produce consumed by the public.

In this study, Strongylida (6.51%) was the third most frequently detected parasite from all vegetables and fruits examined in different studies. This value was lower than that reported elsewhere [90–92]. This result was also inconsistent with previous meta-analysis studies conducted from Nigeria [51] and Iran [93], as well as in individual study in Ghana [94], where Strongylida was more commonly found than other parasites were. The reason for this variation might be that Strongylida can live both as parasites and freely in the environment, especially in unhygienic areas with animal and human waste [94, 95].

Giardia spp. was the fourth most common parasite, at 5.67%. This finding was consistent with an individual study from Iran (5.8%) [55]. However, the current finding was greater than that of individual studies conducted in Palestine (1.5%) [96] and lower than those reported in Egypt (11.6%) [57], Sudan (22.9%) [66], and Zambia (24.2%) [97]. The use of contaminated and untreated water sources for irrigation, animal manure as fertilizer, and poor hygiene practices during handling could contribute to the increased occurrence of G. lamblia in Ethiopia.

The current meta-analysis identified seven factors that were significantly associated with the occurrence of bacterial and parasitic contamination in raw vegetables and fruits in Ethiopia. These include the medium of produce display; the kind of produce, fingernail and educational status of vendors; the source of the produce; the vendor’s handwashing habit; and not washing the produce before display. According to the scope of the reviewer in this study, systematic reviews that were performed in different countries (Nigeria and the world) [50, 51] did not identify the factors associated with parasite contamination of vegetables and fruits. The associated factors in this study was in agreement with those reported in individual studies conducted in Ethiopia [3, 4, 45, 98] and studies conducted in Nigeria [99].

In this systematic review and meta-analysis, vegetables and fruits displayed for sale on the floor had 2.15 times greater odds of being contaminated by bacteria and parasites than those displayed on the shelf. This finding is consistent with results from Ethiopian surveillance studies [14, 44] and a meta-analysis [62]. These findings highlight the importance of proper display of vegetables and fruits in minimizing the risk of contamination by bacteria and parasites. Displaying produce on the floor may increase the likelihood of contact with contaminants, such as dirt and dust, which can easily harbor bacteria and parasites. Therefore, it is important for policymakers to create rules or guidelines for proper display in markets and stores.

The type of produce was also another significantly associated factor for contamination. In the present systematic review and meta-analysis, vegetables were 2.10 times more likely to be contaminated than fruits. The use of human and animal excreta as organic fertilizers might contribute to this contamination, as confirmed by studies in Ecuador [100], Nigeria [101], and Ethiopia [32], as edible parts of vegetables grow closer to the soil than fruits do.

Hygiene-related factors, such as poor handwashing habits, were associated with a 3.10-fold higher likelihood of contaminating vegetables and fruits (OR: 3.10, 95% CI: 1.53–4.67). Similarly, a study by Akoachere et al. [102] in Cameroon reported poor hygiene and vegetable preservation practices among vendors, which could aggravate contamination. Untrimmed fingernails were also associated to a twofold higher risk of contamination compared with trimmed nails (OR: 2.02). Similar finding was also noted in other study [17]. The condition of vendors’ fingernails serves as a key indicator of hygiene. Untrimmed nails can harbor bacteria and parasites that may be transferred to fresh produce during handling. Therefore, maintaining clean hands and short nails is essential to prevent cross-contamination and the spread of enteric pathogens, including antimicrobial-resistant strains. This highlights the importance of promoting regular handwashing and proper nail care among vendors to safeguard public health [17].

Vegetables and fruits purchased from farmers were 2.46 times more contaminated than those obtained from markets (OR: 2.46, 95% CI: 1.45–3.47). This might be due to the contamination of irrigation water through washing bodies and clothes, animal watering, and discharging wastewater into rivers, a common phenomenon in Ethiopia; thus, freshly grown vegetables might contain pathogenic microbes, posing a risk of food-borne disease to consumers, including ailments such as gastroenteritis, diarrhea, and typhoid and paratyphoid fevers [13]. Similar results were reported by Goja et al. [82], who confirmed that the microorganisms present in vegetables was a direct reflection of the sanitary quality of the irrigation water. Muinde and Kuria [103] also reported that wastewater from the bathroom, kitchen, and laundry used in the cultivation of these vegetables is the most common source of contamination. In addition, Akinde et al. [104], indicated that microbial contamination of vegetables occurs throughout their life cycle, from cultivation to consumption, and includes irrigation water sources. Moreover, produce at markets may undergo longer storage times, potentially allowing for pathogen die-off, while more frequent and varied handling during harvest and packaging at the farm level could increase initial contamination. This complex interplay of factors warrants further longitudinal investigation to determine the critical control points for intervention.

Unwashed produce was 2.41 times more likely to be contaminated with bacteria and parasites than produce washed before display. This might be due to the risk of contamination of the produce during transportation and other postharvest-related activities [98, 105]. The surface dirt, debris, and possible pathogens of produce can be removed by washing, which lowers the chance of contracting a foodborne illness [62]. Moreover, pathogens that were internalized were known to be relatively resistant to chemical and physical washing [76].

Another important factor linked to contamination was the education level of vendors. Compared with those with formal education, those with no formal education had 11.43 times greater odds of being contaminated by bacteria and parasites. In line studies were conducted elsewhere [62]. This finding suggests that vendors who have no formal education may have less knowledge and awareness about food safety practices, including proper handling and storage of produce. The strong association between a lack of vendor education and higher contamination highlights a key area for public health intervention. In addition, policymakers may need to consider measures to promote education and training among vendors.

Strengths and limitations

This review looks at how often vegetables and fruits from local farms and markets in Ethiopia were contaminated with both bacteria and parasites. Additionally, it identifies the aggregated risk factors linked to bacterial and parasitic contamination. However, certain limitations exist in this review. First, the high statistical heterogeneity (I² = 98.1%) indicates substantial variation in study designs, settings, and methodologies among the included articles, which affects the generalizability of the pooled prevalence estimates. A key methodological source of this heterogeneity was the variation in laboratory detection techniques; for instance, the sensitivity of light microscopy for parasites is lower than that of Ziehl–Neelsen staining methods, and the choice of culture media varied for bacteria, likely leading to an underestimation of the true contamination burden. Second, the restriction to cross-sectional study designs inherently limits our ability to establish causality or temporal relationships between risk factors and contamination. Third, the meta-analysis of associated factors is constrained by an uneven and sometimes small number of studies for each predictor. This limitation affects the robustness and precision of the reported pooled adjusted odds ratios (aORs). Fourth, the geographic coverage was limited to only five regions and two city administrations, which may not fully represent the national situation. An additional significant limitation is the inability to assess co-contamination (i.e., the same sample contaminated with both bacteria and parasites), as the primary studies did not report such data. This is a relevant public health gap, as co-contamination could signify a higher risk of multiple infections. Finally, no temporal trend or seasonality analysis was conducted due to insufficient data across studies, which prevented assessment of how contamination rates have changed over time. Therefore, while this review provides a crucial consolidated evidence base, caution is warranted in its interpretation and application.

Conclusions

In conclusion, this systematic review and meta-analysis reveals a high prevalence of bacterial and parasitic contamination in fresh produce across Ethiopia. The most commonly identified contaminants were Ascaris spp. and Enterobacteriaceae. Several factors were significantly associated with an increased risk of contamination, including the washing status of the produce, poor vendor handwashing habits, unclean fingernails, low educational status, the source and type of produce, and the means of product display. These findings underscore the urgent need for enhanced food safety interventions, focusing on vendor education and strict adherence to hygiene practices throughout the supply chain. To effectively mitigate this public health threat, we recommend that Ethiopian public health authorities strengthen integrated food safety surveillance systems to monitor contamination and guide targeted interventions. Finally, future research should move beyond point prevalence surveys by employing longitudinal designs to establish causality for the identified risk factors, and should integrate molecular identification and antimicrobial resistance profiling of isolates to better understand the specific pathogens and their public health implications.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Material 1 (25.3KB, docx)
Supplementary Material 2 (13.8KB, docx)

Acknowledgements

Not applicable.

Abbreviations

aOR

Adjusted odds ratio

CI

Confidence interval

OR

Odds ratio

SNNPR

Southern Nations, Nationalities and Peoples Region

Author contributions

AG, AM conceptualization and methodology; AM, NG, AA collected and curated the data; AG, AA analyzed and interpreted the data; AM, NG wrote the original draft; AG, AA revised and edited the manuscript.

Funding

None.

Data availability

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

Declarations

Ethics approval and consent to participate

Ethical approval was not required as this study used only secondary data from previously published articles.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Footnotes

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

  • 1.Bvenura C, Sivakumar D. The role of wild fruits and vegetables in delivering a balanced and healthy diet. Food Res Int. 2017;99:15–30. [DOI] [PubMed] [Google Scholar]
  • 2.Liu RH. Health-promoting components of fruits and vegetables in the diet. Adv Nutr. 2013;4(3):S384–92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Alemu G, Nega M, Alemu M. Parasitic contamination of fruits and vegetables collected from local markets of Bahir Dar City, Northwest Ethiopia. Res Rep Trop Med 2020:17–25. [DOI] [PMC free article] [PubMed]
  • 4.Zeynudin A, Degefa T, Belay T, Mumicha JB, Husen A, Yasin J, Abamecha A, Wieser A. Parasitic contamination of fresh vegetables and fruits sold in open-air markets in peri-urban areas of Jimma City, Oromia, ethiopia: A community-based cross-sectional study. PLoS ONE. 2024;19(3):e0290655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Kozan E, Gonenc B, Sarimehmetoglu O, Aycicek H. Prevalence of helminth eggs on Raw vegetables used for salads. Food Control. 2005;16(3):239–42. [Google Scholar]
  • 6.Erez MS, Kozan E, Göksu A. Detection of helminth egg contamination on Raw vegetables in Afyonkarahisar, Turkey. Kocatepe Veterinary J. 2022;15(4):374–80. [Google Scholar]
  • 7.Al-Abboodi A. Parasitological contamination of Raw vegetables collected from selected local markets in Maysan Province, South of Iraq. Nigerian J Parasitol 2023;44(2).
  • 8.Guchi B, Ashenafi M. Microbial load, prevalence and antibiograms of salmonella and shigella in lettuce and green peppers. Ethiop J Health Sci 2010;20(1). [DOI] [PMC free article] [PubMed]
  • 9.Dugassa A, Bacha K, Ketama T. Microbiological quality and safety of some selected vegetables sold in Jimma town, Southwestern Ethiopia. Afr J Environ Sci Technol. 2014;8(11):633–53. [Google Scholar]
  • 10.Menkir GAAKS. Microbiological quality of leafy vegetables irrigated with wastewater in harar town vegetable farm, eastern Ethiopia. 2018.
  • 11.Alemu G, Mama M, Siraj M. Bacterial contamination of vegetables sold in Arba minch town, Southern Ethiopia. BMC Res Notes. 2018;11(1):775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Belay Z, Gelgelu E, Chala B. Assessment of Microbiological quality and drug resistance patterns of Raw vegetables irrigated with Hasassa River, West Arsi Zone, oromia Region, Ethiopia. Afr J Microbiol Res. 2020;14(9):507–15. [Google Scholar]
  • 13.Berhanu L, Abebe M, Gizeyatu A, Berihun G, Teshome D, Walle Z. Evaluation of the effect of wastewater irrigation on the Microbiological quality of vegetables in Northeast ethiopia: implication for Food-Borne infection and intoxications. Environ Health Insights. 2022;16:11786302221127856. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Asfaw T, Genetu D, Shenkute D, Shenkutie TT, Yitayew B. Commonly consumed vegetables as a potential source of multidrug-resistant and β-lactamase-producing bacteria in Debre Berhan Town, Ethiopia. Infect Drug Resist 2023:3693–705. [DOI] [PMC free article] [PubMed]
  • 15.Demisie KN, Melese DM. Assessment of bacterial and parasitic contamination of fruits gathered from specific local markets in addis Ababa, Ethiopia. Front Sustainable Food Syst. 2024;8:1402898. [Google Scholar]
  • 16.Zeynudin A, Degefa T, Belay T, Mumicha JB, Husen A, Yasin J, Abamecha A, Wieser A, Abayneh M. Detections of antimicrobial resistance phenotypes and extended-spectrum beta-lactamase (ESBL)-producing Salmonella Spps and Escherichia coli O157: H7 in Raw vegetables and fruits from open markets in Jimma town, Ethiopia and evaluation of hygiene and handling practices of vendors. One Health Outlook. 2025;7(1):2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Ahmed DS, Gebre AB, Erancho HT, Shinato HT, Ormago MD. Prevalence and drug-resistance patterns of methicillin-resistant staphylococcus aureus and extended-spectrum β-lactamase producing enterobacteriaceae among raw vegetables. medRxiv 2025:2025.2001. 2028.25321130.
  • 18.Kusumaningrum HD, Riboldi G, Hazeleger W, Beumer R. Survival of foodborne pathogens on stainless steel surfaces and cross-contamination to foods. Int J Food Microbiol. 2003;85(3):227–36. [DOI] [PubMed] [Google Scholar]
  • 19.Todd E. Food-borne disease prevention and risk assessment. In. Vol. 17. MDPI; 2020. p. 5129. [DOI] [PMC free article] [PubMed]
  • 20.Gourama H. Foodborne pathogens. Food safety engineering. edn.: Springer; 2020. pp. 25–49.
  • 21.Newell DG, Koopmans M, Verhoef L, Duizer E, Aidara-Kane A, Sprong H, Opsteegh M, Langelaar M, Threfall J, Scheutz F. Food-borne diseases—the challenges of 20 years ago still persist while new ones continue to emerge. Int J Food Microbiol. 2010;139:S3–15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Debbarma S, Talukdar J, Maurya P, Barkalita LM, Brahma A. Neglected parasitic infections: history to current status. Parasitic Infections: Immune Responses Ther. 2023;156:175. [Google Scholar]
  • 23.Pullan RL, Smith JL, Jasrasaria R, Brooker SJ. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasites Vectors. 2014;7(1):37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Wakid MH. Improvement of Ritchie technique by identifying the food that can be consumed pre-analysis. J Appl Sci Res. 2009;5(3):293–6. [Google Scholar]
  • 25.Nyarango RM, Aloo PA, Kabiru EW, Nyanchongi BO. The risk of pathogenic intestinal parasite infections in Kisii Municipality, Kenya. BMC Public Health. 2008;8(1):237. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Malann Y, Tim U. The prevalence of intestinal parasites on fruits sold in markets around Gwagwalada area council, FCT, Abuja. AASCIT Commun. 2016;3(2):107–11. [Google Scholar]
  • 27.Dorny P, Praet N, Deckers N, Gabriël S. Emerging food-borne parasites. Vet Parasitol. 2009;163(3):196–206. [DOI] [PubMed] [Google Scholar]
  • 28.Worldometer. Current World Population. https://www.worldometers.info/world-population/ethiopia-population/. 2025.
  • 29.Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372. [DOI] [PMC free article] [PubMed]
  • 30.Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Systematic reviews of prevalence and incidence. Joanna Briggs Inst Reviewer’s Man. 2017;5:1. [Google Scholar]
  • 31.Peters MD, Godfrey CM, McInerney P, Soares CB, Khalil H, Parker D. The Joanna Briggs Institute reviewers’ manual 2015: methodology for JBI scoping reviews. 2015.
  • 32.Tomass Z, Kidane D. Parasitological contamination of wastewater irrigated and Raw manure fertilized vegetables in Mekelle City and its suburb, Tigray, Ethiopia. Momona Ethiop J Sci. 2012;4(1):77–89. [Google Scholar]
  • 33.Tefera T, Biruksew A, Mekonnen Z, Eshetu T. Parasitic contamination of fruits and vegetables collected from selected local markets of Jimma Town, Southwest Ethiopia. Int Sch Res Notices. 2014;2014(1):382715. [DOI] [PMC free article] [PubMed]
  • 34.Alemayehu S, Asmelash T, Alemayehu T. Microbial and parasitological quality of pre-harvest vegetables irrigated with urban wastewater and water from Microdams in Mekelle and Southern zones of Tigray, region, Ethiopia. Appl J Hyg. 2015;4:18–24. [Google Scholar]
  • 35.Bekele F, Tefera T, Biresaw G, Yohannes T. Parasitic contamination of Raw vegetables and fruits collected from selected local markets in Arba minch town, Southern Ethiopia. Infect Dis Poverty. 2017;6:1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Aksum E. Parasitological contamination of fresh vegetables and its prevalence in Dessie Town, Northeast Ethiopia. Res Net. 2018;8:27–33. [Google Scholar]
  • 37.Endale A, Tafa B, Bekele D, Tesfaye F. Detection of medically important parasites in fruits and vegetables collected from local markets in dire Dawa, Eastern Ethiopia. Glob J Med Res. 2018;18(1):29–36. [Google Scholar]
  • 38.Gesese A. Parasitological contamination of raw fruits and vegetables and associated factors at selected irrigation farms and local markets of Gondar town, Northwest Ethiopia. 2019.
  • 39.Bekele F, Shumbej T. Fruit and vegetable contamination with medically important helminths and protozoans in Tarcha town, Dawuro zone, South West Ethiopia. Res Rep Trop Med 2019:19–23. [DOI] [PMC free article] [PubMed]
  • 40.Alemu G, Mama M, Misker D, Haftu D. Parasitic contamination of vegetables marketed in Arba minch town, Southern Ethiopia. BMC Infect Dis. 2019;19:1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41.Fekadu E. Assessment of bacteriological and parasitological contaminants of selected vegetables collected from local markets in Harar Town, Eastern Ethiopia. Haramaya university; 2020. https://www.localhost:8080/xmlui/handle/123456789/3945.
  • 42.Bekele F, Shumbej T, Dendir A, Mesfin D, Solomon A, Jemal A, Alemayheu M. Contamination rate of commonly consumed fresh vegetables and fruits with parasites of medically importance in wolkite and Butajira towns of gurage Zone, Southern Ethiopia. Int J Public Health Sci. 2020;9(3):211–5. [Google Scholar]
  • 43.Gk G, Girmay T. Parasitic contamination of fresh vegetables in open air markets of Aksum, Ethiopia. 2020.
  • 44.Asfaw T, Genetu D, Shenkute D, Shenkutie TT, Amare YE, Yitayew B. Parasitic contamination and Microbiological quality of commonly consumed fresh vegetables marketed in Debre Berhan town, Ethiopia. Environ Health Insights. 2023;17:11786302231154755. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Gemechu T, Bona J, Aliyo A, Dedecha W, Ashenafi G. Assessment of intestinal parasites and its associated factors among fruits and vegetables collected from local markets of bule hora Town, Southeast Ethiopia. J Trop Med. 2023;2023(1):1861919. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Gurmassa BK, Gari SR, Solomon ET, Goodson ML, Walsh CL, Dessie BK, Alemu BM. Contribution of wastewater irrigated vegetables to the prevalence of soil-transmitted helminth infection among female farmers in addis Ababa, Ethiopia. Trop Med Health. 2024;52(1):41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Yenew C, Yeshiwas AG, Bayeh GM, Tsega TD, Tsega SS, Gebeyehu AA, Yemata GA, Anteneh RM, Ejigu AG, Ahmed AF. Strongyloides stercoralis contamination and risk factors in market vegetables: hidden dangers of communities living under poverty plate. J Health Popul Nutr. 2025;44(1):289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Mazzoni L, Ariza Fernández MT, Capocasa F. Potential health benefits of fruits and vegetables. In., vol. 11: MDPI; 2021: 8951.
  • 49.Slavin JL, Lloyd B. Health benefits of fruits and vegetables. Adv Nutr. 2012;3(4):506–16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50.Eslahi AV, Olfatifar M, Karim MR, AbuOdeh R, Modirian E, Houshmand E, Abdoli A, Samimi R, Sotoodeh S, Mahmoudi R. Global incidence of helminthic contamination of vegetables, cucurbits and fruits: a systematic review and meta-analysis. Food Control. 2022;133:108582. [Google Scholar]
  • 51.Karshima SN. Parasites of importance for human health on edible fruits and vegetables in nigeria: a systematic review and meta-analysis of published data. Pathogens Global Health. 2018;112(1):47–55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 52.Punsawad C, Phasuk N, Thongtup K, Nagavirochana S, Viriyavejakul P. Prevalence of parasitic contamination of Raw vegetables in Nakhon Si Thammarat province, Southern Thailand. BMC Public Health. 2019;19(1):34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 53.Rahmati K, Fallah M, Maghsood AH, Shamsi-Ehsan T, Matini M. The prevalence of parasitic contamination of vegetables consumed in Malayer City, West of Iran, in 2014. Avicenna J Clin Microbiol Infect. 2017;4(2):42380–42380. [Google Scholar]
  • 54.Robertson L, Gjerde B. Occurrence of parasites on fruits and vegetables in Norway. J Food Prot. 2001;64(11):1793–8. [DOI] [PubMed] [Google Scholar]
  • 55.Ezatpour B, Chegeni AS, Abdollahpour F, Aazami M, Alirezaei M. Prevalence of parasitic contamination of Raw vegetables in Khorramabad, Iran. Food Control. 2013;34(1):92–5. [Google Scholar]
  • 56.Muqbel AMQ, Binsaad AJA. Parasitic contamination of vegetables in selected local markets in aden governorate, Yemen. Electron J Univ Aden Basic Appl Sci. 2023;4(2):187–98. [Google Scholar]
  • 57.El-Sayed N, Gawdat S, El-Kholy H, Elmosalamy A. Parasitic contamination in five leafy vegetables collected from open marketplaces in Giza, Egypt. J Food Qual Hazards Control 2023.
  • 58.Osafo R, Balali GI, Amissah-Reynolds PK, Gyapong F, Addy R, Nyarko AA, Wiafe P. Microbial and parasitic contamination of vegetables in developing countries and their food safety guidelines. J Food Qual. 2022;2022(1):4141914. [Google Scholar]
  • 59.Dhiraputra C, Tiensasitorn C, Techachaiwiwat W, Jirapanakorn N, Kachintorn K, Danchaivijitr S. Bacterial contamination of vegetables served in hospitals. J Med Assoc Thai. 2005;88(10):S42–48. [PubMed] [Google Scholar]
  • 60.Saksena R, Malik M, Gaind R. Bacterial contamination and prevalence of antimicrobial resistance phenotypes in Raw fruits and vegetables sold in Delhi, India. J Food Saf. 2020;40(1):e12739. [Google Scholar]
  • 61.Morales-Figueroa G, Sánchez-Guerrero M, Castro-García M, Esparza-Romero J, López-Mata M, Quihui-Cota L. Occurrence of intestinal parasites in fruits and vegetables from markets of Northwest Mexico. J Food Qual Hazards Control.
  • 62.Animaw Z, Melese A, Bedane D, Tadesse B, Degarege D, Admasu F, Jegnie M, Emmanuel B. Prevalence, pattern and predictors of clinically important parasites contaminating Raw vegetables and fruits in ethiopia: a systematic review and meta-analysis. BMC Infect Dis. 2024;24(1):1146. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 63.Girma A, Aemiro A, Alamnie G, Mulie Y. Parasitic contamination and its associated factors in fruits and vegetables collected from ethiopia’s local markets: A systematic review and Meta-Analysis. Environ Health Insights. 2024;18:11786302241307882. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 64.Adenusi AA, Abimbola WA, Adewoga TO. Human intestinal helminth contamination in pre-washed, fresh vegetables for sale in major markets in Ogun State, Southwest Nigeria. Food Control. 2015;50:843–9. [Google Scholar]
  • 65.Chaabane-Banaoues MS, Lahmar R, Oumaima I, Mezhoud H, Babba H, Oudni-M’Rad H. Parasitological contamination of vegetables sold in Tunisian retail markets with helminth eggs and protozoan cysts. J Food Prot. 2020;83(7):1104–9. [DOI] [PubMed] [Google Scholar]
  • 66.Mohamed MA, Siddig EE, Elaagip AH, Edris AMM, Nasr AA. Parasitic contamination of fresh vegetables sold at central markets in Khartoum state, Sudan. Ann Clin Microbiol Antimicrob. 2016;15:1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 67.Khan W, Rafiq N, Nawaz M, Kabir M, Farooqi ZUR, Romman M, Parvez R, Alfarraj S, Noor A, Ujjan A. Parasitic contamination of fresh vegetables sold in open markets: a public health threat. Brazilian J Biology. 2021;82:e242614. [DOI] [PubMed] [Google Scholar]
  • 68.Said DES. Detection of parasites in commonly consumed Raw vegetables. Alexandria J Med. 2012;48(4):345–52. [Google Scholar]
  • 69.Tegen D, Damtie D, Hailegebriel T. Prevalence and associated risk factors of human intestinal protozoan parasitic infections in ethiopia: A systematic review and Meta-Analysis. J Parasitol Res. 2020;2020(1):8884064. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 70.Liyih M, Damtie D, Tegen D. Prevalence and associated risk factors of human intestinal helminths parasitic infections in ethiopia: a systematic review and meta-analysis. Sci World J. 2022;2022(1):3905963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 71.Girma A, Aemiro A. Prevalence and associated risk factors of intestinal parasites and enteric bacterial infections among selected region food handlers of Ethiopia during 2014–2022: a systematic review and meta-analysis. Sci World J. 2022;2022(1):7786036. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 72.Mengistu DA, Belami DD, Tefera AA, Alemeshet Asefa Y. Bacteriological quality and public health risk of ready-to-eat foods in developing countries: systematic review and meta analysis. Microbiol Insights. 2022;15:11786361221113916. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 73.Takeuchi K, Hassan AN, Frank JF. Penetration of Escherichia coli O157: H7 into lettuce as influenced by modified atmosphere and temperature. J Food Prot. 2001;64(11):1820–3. [DOI] [PubMed] [Google Scholar]
  • 74.Beuchat LR. Ecological factors influencing survival and growth of human pathogens on Raw fruits and vegetables. Microbes Infect. 2002;4(4):413–23. [DOI] [PubMed] [Google Scholar]
  • 75.Pintor-Cora A, Álvaro-Llorente L, Otero A, Rodríguez-Calleja JM, Santos JA. Extended-spectrum beta-lactamase-producing Enterobacteriaceae in fresh produce. Foods. 2021;10(11):2609. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 76.Uhlig E, Olsson C, He J, Stark T, Sadowska Z, Molin G, Ahrné S, Alsanius B, Håkansson Å. Effects of household washing on bacterial load and removal of Escherichia coli from lettuce and ready-to‐eat salads. Food Sci Nutr. 2017;5(6):1215–20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 77.Cardamone C, Aleo A, Mammina C, Oliveri G, Di Noto AM. Assessment of the microbiological quality of fresh produce on sale in Sicily, Italy: preliminary results. J Biol Research-Thessaloniki. 2015;22(1):3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 78.Büyükünal SK, Issa G, Aksu F, Vural A. Microbiological quality of fresh vegetables and fruits collected from supermarkets in Istanbul, Turkey. J Food Nutr Sci. 2015.
  • 79.Tambekar D, Mundhada R. Bacteriological quality of salad vegetables sold in Amravati City (India). 2006.
  • 80.Mahfuza I, Arzina H, Kamruzzaman MM, Afifa K, Afzal HM, Rashed N, Roksana H. Microbial status of street vended fresh-cut fruits, salad vegetables and juices in Dhaka City of Bangladesh. Int Food Res J 2016;23(5).
  • 81.Eni AO, Oluwawemitan IA, Solomon OU. Microbial quality of fruits and vegetables sold in Sango Ota, Nigeria. Afr J Food Sci. 2010;4(5):291–6. [Google Scholar]
  • 82.Goja AM, Mahmoud M. Microbial quality of some vegetables sold in ED DueimTwon, Sudan. Pakistan J Biol Sciences: PJBS. 2013;16(12):585–8. [DOI] [PubMed] [Google Scholar]
  • 83.Sabbithi A, Naveen Kumar R, Kashinath L, Bhaskar V, Sudershan Rao V. Microbiological quality of salads served along with street foods of Hyderabad, India. Int J Microbiol 2014;2014(1):932191. [DOI] [PMC free article] [PubMed]
  • 84.Hölzel CS, Tetens JL, Schwaiger K. Unraveling the role of vegetables in spreading antimicrobial-resistant bacteria: a need for quantitative risk assessment. Foodborne Pathog Dis. 2018;15(11):671–88. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 85.Adekanle M, Effedua H, Oritogun K, Adesiji Y, Ogunledun A. A study of microbial analysis of fresh fruits and vegetables, in Sagamu markets South-West, Nigeria. Agrosearch. 2015;15(2):1–12. [Google Scholar]
  • 86.Bahramian B, Afshari A, Kiani B, Sani MA, Hashemi M. The prevalence of foodborne parasites in Raw vegetables in iran: a comprehensive systematic review and meta-analysis. J Environ Health Sci Eng. 2021;19(2):2027–45. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 87.Su GLS, Mariano CMR, Matti NSA, Ramos GB. Assessing parasitic infestation of vegetables in selected markets in metro Manila, Philippines. Asian Pac J Trop Disease. 2012;2(1):51–4. [Google Scholar]
  • 88.Bilgiç F, ÖZTÜRK E, BABAT S, Babaoğlu A, ERDOĞAN D, Korkmaz M. Determination of parasitic contamination in vegetables collected from local markets in İzmir Province, Türkiye. Türkiye Parazitoloji Dergisi 2023;47(2). [DOI] [PubMed]
  • 89.Irma K-NG, Thierry E-BJ, Isaka K-N, Vanelle WS, Efietngab A-N, Emilie T-T, Judith T, Lucia N. Parasitological assessment of some fruits and vegetables commonly sold in retail outlets in the mfoundi division of Cameroon. Parasite Epidemiol Control. 2023;22:e00313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 90.Dankwa K, Siaw DO, Obboh EK, Singh B, Nuvor SV. Parasitic profile of fresh vegetables sold in selected markets of the cape Coast metropolis in Ghana. Annual Res Rev Biology. 2018;28(6):1–7. [Google Scholar]
  • 91.Idahosa OT. Parasitic contamination of fresh vegetables sold in Jos markets. Global J Med Res. 2011;11(1):21–5. [Google Scholar]
  • 92.MUKHTAR IMI, ELFAKI TEM, ABD ALLA AB, SAAD MBEA. Role of vegetables in the transmission of intestinal parasites in Khartoum central market, Khartoum state, Sudan. Eur Acad Res. 2016;3(11):11825–37. [Google Scholar]
  • 93.Abdi J, Farhadi M, Aghace S, Sayehmiri K. Parasitic contamination of raw vegetables in Iran: a systematic review and meta-analysis. 2014.
  • 94.Kudah C, Sovoe S, Baiden F. Parasitic contamination of commonly consumed vegetables in two markets in Ghana. Ghana Med J. 2018;52(2):88–93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 95.Taylor MA, Coop RL, Wall R. Veterinary parasitology: John Wiley & Sons; 2015.
  • 96.Al-Hindi AI, Elmanama AA, Khalaf S. Prevalence of intestinal parasites and microbial contamination in common edible vegetables used in Gaza Governorate, Palestine. J Food Saf Hygiene. 2016;2(1/2):21–5. [Google Scholar]
  • 97.Nyirenda S, Bukowa K, Banda W, Mbewe J, Hamankolo F, Banda F, Kwenda G, Mumba M, Zulu E. Parasitic contamination of common vegetables sold in Lusaka, Zambia. J Food Qual Hazards Control. 2021.
  • 98.Tefera T, Biruksew A, Mekonnen Z, Eshetu T. Parasitic contamination of fruits and vegetables collected from selected local markets of Jimma town, Southwest Ethiopia. Int Scholarly Res Notices. 2014;2014. [DOI] [PMC free article] [PubMed]
  • 99.Dawet A, Ipadeola R, Yakubu D, Danahap L, Agbalaka P. Parasitic contamination of some fruits, vegetables, and nuts sold in Jos, plateau State, Nigeria. Int Res J Public Environ Health 2019.
  • 100.González-Ramírez LC, Djabayan-Djibeyan P, Prato JG, Ríos CAG, Carrero JC, Trelis M, Fuentes MV. Field study of parasitic contamination of fruits, vegetables and leafy greens in the Ecuadorian Andes. F1000Research 2023;12. [DOI] [PMC free article] [PubMed]
  • 101.Nasiru M, Auta T, Bawa J. Geohelminth contamination of fruits and vegetables cultivated on land irrigated with waste-water in Gusau local government Area, Zamfara State, Nigeria. Zoologist (The). 2015;13:6–9. [Google Scholar]
  • 102.Akoachere J-FTK, Tatsinkou BF, Nkengfack JM. Bacterial and parasitic contaminants of salad vegetables sold in markets in Fako Division, Cameroon and evaluation of hygiene and handling practices of vendors. BMC Res Notes. 2018;11:1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 103.Muinde OK, Kuria E. Hygienic and sanitary practices of vendors of street foods in Nairobi, Kenya. Afr J Food Agric Nutr Dev. 2005;5(1).
  • 104.Akinde SB, Sunday AA, Adeyemi FM, Fakayode IB, Oluwajide OO, Adebunmi AA, Oloke JK, Adebooye CO. Microbes in irrigation water and fresh vegetables: potential pathogenic bacteria assessment and implications for food safety. Appl Biosaf. 2016;21(2):89–97. [Google Scholar]
  • 105.Meerburg B, Vermeer H, Kijlstra A. Controlling risks of pathogen transmission by flies on organic pig farms: a review. Outlook Agric. 2007;36(3):193–7. [Google Scholar]

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Supplementary Materials

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Data Availability Statement

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

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