Cryptosporidiosis is one of the leading causes of diarrhoeal illness and mortality induced by protozoan pathogens worldwide. As a largely waterborne disease, emphasis has been given to the study of Cryptosporidium spp. in surface waters, readily susceptible to pathogenic contamination. Conversely, the status of Cryptosporidium in potable groundwater sources, generally regarded as a pristine and "safe" drinking-water supply owing to (sub)-soil protection, remains largely unknown. As such, this investigation presents the first literature review aimed to ascertain the global prevalence of Cryptosporidium in groundwater supply sources intended for human consumption. Thirty-seven peer-reviewed studies were identified and included in the review. Groundwater sample and supply detection rates (estimated 10-20%) indicate Cryptosporidium is frequently present in domestic groundwater sources, representing a latent health concern for groundwater consumers. Specifically, sample (10.4%) and source (19.1%) detection rates deriving from comprehensive "temporal" investigations are put forward as representative of a contamination 'baseline' for Cryptosporidium in 'domestic' groundwater supplies. Proposed 'baseline' prevalence figures are largely applicable in preventive risk-based catchment and groundwater quality management including the formulation of Quantitative Microbial Risk Assessment (QMRA). Notwithstanding, a large geographical disparity in available investigations and lack of standardized reporting restrict the transferability of research findings. Overall, the mechanisms responsible for Cryptosporidium transport and ingress into groundwater supplies remain ambiguous, representing a critical knowledge gap, and denoting a distinctive lack of integration between groundwater and public-health sub-disciplines among investigations. Key recommendations and guidelines are provided for prospective studies directed at more integrative and multi-disciplinary research.

中文翻译：

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隐孢子虫 供人类消费的地下水供应中的污染物-对全球流行率，风险因素和知识缺口的描述性综述。

隐孢子虫病是全世界原生动物病原体引起的腹泻病和死亡率的主要原因之一。作为一种主要由水传播的疾病，人们已将重点放在隐孢子虫的研究上。在地表水中，很容易受到病原体污染。相反，由于（亚）土壤保护作用，饮用水中隐孢子虫的状况通常被认为是原始的和“安全的”饮用水供应，目前仍然未知。因此，本研究提出了第一篇文献综述，旨在确定供人类消费的地下水供应源中隐孢子虫的全球患病率。共确定了37项同行评审研究，并将其纳入该评价。地下水样本和供应检测率（估计为10-20％）表明，隐孢子虫经常存在于家用地下水源中，这对地下水消费者而言潜在的健康隐患。具体来说，提出了从全面的“时间”调查得出的样品（10.4％）和源（19.1％）的检出率，作为“国内”地下水供应中隐孢子虫污染“基准”的代表。拟议的“基准”患病率数据主要适用于基于预防风险的集水区和地下水质量管理，包括制定定量微生物风险评估（QMRA）。尽管如此，可用调查的地理差异很大，而且缺乏标准化的报告，限制了研究结果的可转移性。总体，隐孢子虫的运输和进入地下水供应的机制仍然是模棱两可的，这代表着一个关键的知识差距，并且表明在调查之间地下水与公共卫生子学科之间缺乏整合。为针对更综合和多学科研究的前瞻性研究提供了关键的建议和指南。