The present systematic review and meta-analysis was designed to generate comprehensive data about the national prevalence of IPs in general and STHs in particular. Accordingly, studies assessing prevalence of IPIs, conducted in different regions of Ethiopia, were gathered and analyzed in order to estimate the national pooled prevalence. The findings provide useful epidemiological data to aid in the control of STHs. The review generated information about the distribution of the big three STHs: A. lumbricoides, hookworms and T. trichiura in Ethiopia which, in turn, helps to evaluate the success of existing control programs and to plan for the future. It also helps to implement targeted control activities. The overall pooled prevalence of IPs in the present review (52.0%) was similar with 47.6% prevalence in Afghanistan  but higher than the prevalence in Iran (38%) , Syria (42.5%) , Turkey (31.8–37.2%)  and Egypt (27%) . Variations in distribution of IPs among different geographical settings as well as type and level of control program implementations across countries might be responsible for these differences.
The pooled prevalence of hookworms in the present review (10.4%) was in line with review results from South America (11.9%) . It was lower than Ethiopian national estimate of 16% before 10 years  and a regionwide survey in Amhara region (20.6%)  pronouncing the impact of MDA and WASH activities since then. Subgroup analysis of the current review also shows highest prevalence of IPs in Amhara region. The prevalence was also lower than the pooled prevalence from Nigeria (23.0%)  and Rwanda (31.6%) . The commulative number of children included in the review from Nigeria were higher compared to the present review (34,518 vs 16,266) and naturally STHs are more abundunt in Nigeria as compared to Ethiopia. Moreover, we have included more recent surveys that the ongoing MDA and WASH programmes also impact the prevalence of hookworms unlike to reveiws from Rwanda which included studies starting from the year 1940 .
Implementation of intervention programs mainly improved healthcare coverage, bi-annual MDA and WASH has been thought to bring decreasing trend of both morbidity and prevalence of STH infections over time. As a result, hookworms show decreased prevalence between the years 2014–2018 (8.7%) as compared to that of the years 2000–2013 (11.7%). However, the trend in decreament was not significant (p = 0.138). This is against review results from Nepal where hookworm infections significantly decrease between the years 1990 and 2015 . Interventions for STH transmission in Ethiopia primarily target SAC. However, in rural areas where fields are fertilized with night soil, STH species like hookworms may heavily infect adults who, in turn, serve as sources of infection for SAC . Open defecation is common in rural commuities of Ethiopia that re-infection of treated children also contributed for non-decreasing trend of the parasite.
The pooled prevalence was higher than findings from nationwide surveys in Srilanka (1.2%)  and Cameroon (1.55%) . In both countries, authors used a single kato katz smear and there is also variation in geographical distribution as well as adoption and level of implementation of control programs across countries.
The pooled prevalence of A. lumbricoides in the present review (11.2%) was in line with findings from Cameroon (11.48%) . However, it was lower than results from Nigeria (44.6%) , Rwanda (38.6%) , South America (15.6%) , Amhara region of Ethiopia (16.8%)  and previous estimate in Ethiopia which was 37% . Local studies about mebendazole and albendazole efficiacy show that both drugs have more than 95% efficacy against A. lumbricoides that the ongoing MDA has substancially decreased the burden of the parasite in Ethiopia . However, the trend of A. lumbricoides was not uniformly decreasing between the years 2000 and 2018 (p = 0.610) with possible reason of poor WASH implementation in the country . The pooled prevalence of A. lumbricoides in the present review was higher than review result of 0.75% from Iran  and 2.8% from Srilanka .
The pooled prevalence of T. trichiura in the present review (3.6%) was inline with reviews from Amhara region (3.8%)  and Srilanka which was 4% . On the other hand, it was lower than review results from South America (12.5%) , Nigeria (31.9%) , Cameroon (18.22%) , Rwanda (27%)  and previous estimates in Ethiopia (30%) . The pooled prevalence of T. trichiura in the present review was higher than review result of 0.12% from Iran . Meta-regression analysis by year of study show that T.trichiura has almost constant prevalence between the years 2000 and 2018 in Ethiopia. Both Albendazole and mebendazole, drugs used for MDA, have poor efficacy against T.trichiura contributing for non-decreasing trend of the parasite prevalence .