Abstract
Microsporidia are a diverse parasite phylum infecting host from all major taxa in all global biomes. This research was conducted to conclude the prevalence of microsporidia in China. All published articles up to February 16, 2018 were considered, including descriptive, cross-sectional, case-control and epidemiology studies. A total of 1052 articles were separated after literature search. After a strict selection according to our criteria, 82 articles were included in qualitative synthesis and ultimately 52 studies were included in quantitative synthesis. Three species of microsporidia were confirmed to exist in China, including Enterocytozoon bieneusi (E. bieneusi), Nosema and Encephalitozoon cuniculi (E. cuniculi). The highest overall estimated prevalence of E. bieneusi in humans was 8.1%, which was observed in acquired immunodeficiency syndrome patients (AIDS). Moreover, the prevalence of E. bieneusi in animals including the cattle, dogs, pigs, deer, sheep and goats were analyszed in this study. The overall estimated prevalence of E. bieneusi acquired by using the random effects model in meta-analysis in cattle, dogs, pigs, sheep and goats and deer was 20.0% (95% confidence intervals: 0.133–0.266, I2 = 98.031%, p < 0.0001), 7.8% (95% CI: 0.050–0.106, I2 = 60.822%, p = 0.0537), 45.1% (95% CI: 0.227–0.674, I2 = 98.183%, p < 0.0001), 28.1% (95% CI: 0.146–0.415, I2 = 98.716%, p < 0.0001) and 19.3% (95% CI: 0.084–0.303, I2 = 96.995%, p < 0.0001) respectively. The overall detection rate of E. bieneusi in water acquired by using the random effects model in meta-analysis was 64.5% (95% CI: 0.433–0.857, I2 = 98.486%, p < 0.0001). Currently, 221 genotypes of E. bieneusi, 1 genotype of E. cuniculi and 6 Nosema were detected in China. The most prevalent genotype of E. bieneusi was genotype D, followed by BEB6 and EbpC.
Highlights
Microsporidia, classified as highly specialized fungi, are unicellular and obligate intracellular opportunistic pathogens which can infect a wide range of vertebrate and invertebrate hosts such as fish, insects, farm animals, and companion pets[1,2]
This study was carried out a systematic review with meta-analysis of microsporidia studies in vertebrate and invertebrate hosts and Chinese population distributed in different regions in China
A total of 1050 articles were separated after literature search of 8 databases (Pubmed: 19, Embase: 60, Web of Science: 151, Cochrane library: 0, CNKI: 403, Wanfang: 289, VIP: 128, CBM: 0), with 2 articles coming from other sources, and 82 articles were included in qualitative synthesis (Fig. 1)
Summary
Microsporidia, classified as highly specialized fungi, are unicellular and obligate intracellular opportunistic pathogens which can infect a wide range of vertebrate and invertebrate hosts such as fish, insects, farm animals, and companion pets[1,2]. Most microsporidial infections have been reported to occur in severely immunocompromised individuals, mainly HIV/AIDS patients, but cases in HIV-negative people, including travelers and elderly people, are continually increasing These pathogens could cause a variety of systemic and nonsystemic diseases, and the most common clinical manifestation is chronic diarrhea. PCR amplification and staining techniques have been the most common approaches for detection, when sequence analysis of the internal transcribed spacer (ITS) has been widely used in characterizing the molecular epidemiology[9] To this end, this study was carried out a systematic review with meta-analysis of microsporidia studies in vertebrate and invertebrate hosts and Chinese population distributed in different regions in China. According to this systematic review, we can improve awareness about microsporidia prevalence in various regions of China, but we will be able to implement better preventive and treatment strategies
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