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

Liu, A. and Gong, B. and Liu, X. and Shen, Y. and Wu, Y. and Zhang, W. and Cao, J.

PLoS Negl Trop Dis (2020) 14: e0008146

DOI: 10.1371/journal.pntd.0008146

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%). CONCLUSIONS/SIGNIFICANCES: This 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.

Citation

Liu, A., Gong, B., Liu, X., Shen, Y., Wu, Y., Zhang, W., & Cao, J. (2020). A retrospective epidemiological analysis of human Cryptosporidium infection in China during the past three decades (1987-2018). PLoS Negl Trop Dis, 14(3), e0008146. https://doi.org/10.1371/journal.pntd.0008146 Male, Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Adolescent, Child, Child, Preschool, Infant, Young Adult, Risk Factors, Prevalence, China/epidemiology, Infant, Newborn, Disease Outbreaks, Disease Transmission, Infectious, Cryptosporidium/*isolation & purification, Communicable Diseases, Emerging/epidemiology/transmission, Cryptosporidiosis/*epidemiology/transmission

Keywords

• Male
• Adult
• Aged
• Aged
• 80 and over
• Female
• Humans
• Middle Aged
• Adolescent
• Child
• Child
• Preschool
• Infant
• Young Adult
• Risk Factors
• Prevalence
• China/epidemiology
• Infant
• Newborn
• Disease Outbreaks
• Disease Transmission
• Infectious
• Cryptosporidium/*isolation & purification
• Communicable Diseases
• Emerging/epidemiology/transmission
• Cryptosporidiosis/*epidemiology/transmission