Background Gastrointestinal (GI) infections exert a significant public health burden on UK healthcare services and the community. Evidence suggests an association between ethnicity and health; however, we do not know the extent of inequalities in GI infection/disease in the UK. This systematic review aimed to identify studies that ascertain differences in the incidence and prevalence of GI infections within and between UK ethnic groups and explore possible explanations for heterogeneity observed within the literature.

Methods Medline In-Process & Other Non-Indexed Citation, Web of Science, CINAHL Plus and grey literature were searched from 1980 to 2022 on 21st June 2022 for studies reporting an association between ethnicity and GI infections in UK population samples. Two reviewers independently screened the articles and conducted quality appraisals; data extraction was undertaken by one reviewer and verified by two reviewers. A narrative synthesis was undertaken to synthesise the study findings. (PROSPERO CRD 42021240714). Harvest plots supported the textual synthesis to investigate potential sources of heterogeneity such as age, GI infection and ethnicity measurement.

Results The searches identified 10018 studies, of which; 16 met the inclusion criteria. 14 out of 16 studies found a difference in the prevalence of GI infections between different ethnic groups. UK ethnic minorities, predominantly men and children of Asian ethnicity, had an increased risk of infection than the white British majority in 14 studies; the Pakistani ethnic group had a higher risk of infection than comparator groups in four out of 16 studies. Studies reported that age and sex confounded the relationship between ethnicity and GI infections. The country of birth, socioeconomic status and geographic location of ethnic minority groups mediated this association and significantly explained the heterogeneity observed across the studies.

Conclusion This systematic review elucidates the need for more extensive UK quantitative evidence examining the association between ethnicity and GI infections. Insights into the association between GI infections and ethnicity can help address policy actions to mitigate the inequalities identified within and between UK ethnic groups.