Abstract
BackgroundCryptosporidiosis is an emerging infectious disease of public health significance worldwide. The burden of disease caused by Cryptosporidium varies between and within countries/areas. To have a comprehensive understanding of epidemiological status and characteristics of human Cryptosporidium infection in China since the first report in 1987, a retrospective epidemiological analysis was conducted by presenting differences in the prevalence of Cryptosporidium by province, year, population, living environment and season and possible transmission routes and risk factors as well as genetic characteristics of Cryptosporidium in humans.Methodology/Principal findingsA systematic search was conducted to obtain epidemiological papers of human Cryptosporidium infection/cryptosporidiosis from PubMed and Chinese databases. Finally, 164 papers were included in our analysis. At least 200,054 people from 27 provinces were involved in investigational studies of Cryptosporidium, with an average prevalence of 2.97%. The prevalence changed slightly over time. Variable prevalences were observed: 0.65–11.15% by province, 1.89–47.79% by population, 1.77–12.87% and 0–3.70% in rural and urban areas, respectively. The prevalence peak occurred in summer or autumn. Indirect person-to-person transmission was documented in one outbreak of cryptosporidiosis in a pediatric hospital. 263 Cryptosporidium isolates were obtained, and seven Cryptosporidium species were identified: C. hominis (48.3%), C. andersoni (22.43%), C. parvum (16.7%), C. meleagridis (8.36%), C. felis (3.04%), C. canis (0.76%) and C. suis (0.38%).Conclusions/SignificancesThis systematic review reflects current epidemiological status and characteristics of Cryptosporidium in humans in China. These data will be helpful to develop efficient control strategies to intervene with and prevent occurrence of human Cryptosporidium infection/cryptosporidiosis in China as well as have a reference effect to other countries. Further studies should focus on addressing a high frequency of C. andersoni in humans and a new challenge with respect to cryptosporidiosis with an increasing population of elderly people and patients with immunosuppressive diseases.
Highlights
Cryptosporidium species are common protozoan parasites that infect the epithelial cells of the intestinal tract of humans and a variety of animals worldwide
Further studies should focus on addressing a high frequency of C. andersoni in humans and a new challenge with respect to cryptosporidiosis with an increasing population of elderly people and patients with immunosuppressive diseases
Cryptosporidium is defined as one of the second highest priority organisms/biological agents by the National Institutes of Health (NIH) of the USA and cryptosporidiosis is recognized as the major cause of diarrhea in patients with AIDS and life-threatening diarrhea has been reported in this population [1]
Summary
Cryptosporidium species are common protozoan parasites that infect the epithelial cells of the intestinal tract of humans and a variety of animals worldwide. Diarrhea is the common clinical symptom of cryptosporidiosis in infected hosts, varying depending on their health status. Cryptosporidium is defined as one of the second highest priority organisms/biological agents by the National Institutes of Health (NIH) of the USA and cryptosporidiosis is recognized as the major cause of diarrhea in patients with AIDS and life-threatening diarrhea has been reported in this population [1]. The burden of disease from cryptosporidiosis varies substantially between and within countries/areas. The burden of disease caused by Cryptosporidium varies between and within countries/ areas. To have a comprehensive understanding of epidemiological status and characteristics of human Cryptosporidium infection in China since the first report in 1987, a retrospective epidemiological analysis was conducted by presenting differences in the prevalence of Cryptosporidium by province, year, population, living environment and season and possible transmission routes and risk factors as well as genetic characteristics of Cryptosporidium in humans
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