A retrospective epidemiological analysis of human Cryptosporidium infection in China during the past three decades (1987-2018)

Abstract

Background Cryptosporidiosis 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 findings A 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%).

Identification of Uncommon Cryptosporidiumviatorum (a Novel Subtype XVcA2G1c) and Cryptosporidium andersoni as Well as Common Giardia duodenalis Assemblages A and B in Humans in Myanmar

“…C. parvum and C. hominis are recognized as the main causative agents (> 90%) in reported human cases of Cryptosporidium infection (Squire and Ryan, 2017;Liu et al, 2020). However, in the present study, two unusual Cryptosporidium species were identified: C. andersoni (n = 2) and C. viatorum (n = 1).…”

“…Children are reported to have a statistically significantly higher prevalence than adults: such as 2.56% versus 1.89% for Cryptosporidium spp. in China (Liu et al, 2020); 53.2% versus 22.2% for G. duodenalis in Uganda (Johnston et al, 2010). Meanwhile, some studies reported significant difference in prevalence of both parasites between diarrheal and non-diarrheal children, such as 16.3% versus 3.1% for Cryptosporidium spp.…”

“…The role of water and food in the epidemiology of the two parasitic diseases is now well recognized. To date, waterborne and foodborne outbreaks of cryptosporidiosis (>524 and >26) (Liu et al, 2020) and giardiasis (>344 and >38) had been reported worldwide (Karanis et al, 2007;Baldursson and Karanis, 2011;Efstratiou et al, 2017;Ryan et al, 2019). Based on clinical and public health importance, Cryptosporidium and Giardia are listed on the Environmental Protection Agency (EPA) microbial contaminant candidate list of concern for waterborne transmission (https://www.…”

Cryptosporidium spp. and Giardia duodenalis emissions from humans and animals in the Three Gorges Reservoir in Chongqing, China

“…To date, Cryptosporidium spp. and G. duodenalis have been found in more than 27 provincial administrative regions in China ( Yang et al, 2017 ; Liu et al, 2020 ). However, there continues to be a critical lack of surveillance systems documenting and tracking protozoan infection and waterborne outbreaks in developing countries ( Baldursson & Karanis, 2011 ; Efstratiou, Ongerth & Karanis, 2017a ; Efstratiou, Ongerth & Karanis, 2017b ).…”

Peer Review #1 of "Cryptosporidium spp. and Giardia duodenalis emissions from humans and animals in the Three Gorges Reservoir in Chongqing, China (v0.1)"

“…To date, Cryptosporidium spp. and G. duodenalis have been found in more than 27 provincial administrative regions in China (Yang et al, 2017;Liu et al, 2020). However, there continues to be a critical lack of surveillance systems documenting and tracking protozoan infection and waterborne outbreaks in developing countries (Baldursson & Karanis, 2011;Efstratiou, Ongerth, & Karanis, 2017ab).…”