Background

Cryptosporidium is a protozoan parasite that can infect both humans and animals and cause cryptosporidiosis. We aimed to estimate the global prevalence of Cryptosporidium infection.

Methods

In this study, Web of Science, Medline and PubMed were searched for relative articles, published between January 1, 1960 and January 1, 2018. Included articles were restricted to English language and that sample size of articles was not less than 50. Studies with no information on the study period, location, method of diagnosis, sample size and number of infected people were excluded. Studies about outbreak, laboratory report or immunocompromised population were excluded as well. The quality of the included publications was assessed. The prevalence of cryptosporidiosis was estimated by DerSimonian–Laird random-effects model, after converting by the Freeman–Tukey type double arcsine transformation.

Findings

From 13,064 publications selected by literature search, 221 studies were included in the meta-analysis. The global pooled prevalence of Cryptosporidium infection was 7.6 % (95% CI: 6.9–8.5). The highest estimated prevalence of Cryptosporidium infection was in Mexico (69.6%, 95% CI 66.3–72.8), Nigeria (34.0%, 95% CI 12.4–60.0), Bangladesh (42.5%, 95% CI 36.1–49.0) and Republic of Korea (8.3%, 95% CI 4.4–13.2) among general residents, patients, school children and healthy population, respectively. The estimated prevalence was high in people from low-income country, people with gastrointestinal symptoms, people younger than 5 years old and residents not living in urban areas.

Conclusions

These estimates indicate the substantial prevalence of Cryptosporidium infection in the world, which may provide a theoretical basis for the formulation of the prevention strategy about Cryptosporidium.

中文翻译：

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全球人口中隐孢子虫感染的流行率：系统评价和荟萃分析。

背景

隐孢子虫是一种原生动物寄生虫，可以感染人类和动物并引起隐孢子虫病。我们旨在估计隐孢子虫感染的全球流行率。

方法

本研究在 Web of Science、Medline 和 PubMed 中检索发表于 1960 年 1 月 1 日至 2018 年 1 月 1 日之间的相关文章。纳入的文章仅限于英文，文章样本量不少于 50。没有排除关于研究时间、地点、诊断方法、样本量和感染人数的信息。关于爆发、实验室报告或免疫功能低下人群的研究也被排除在外。对纳入出版物的质量进行了评估。隐孢子虫病的流行率由 DerSimonian-Laird 随机效应模型估计，通过 Freeman-Tukey 型双反正弦变换进行转换。

发现

从通过文献检索选择的 13,064 篇出版物中，221 项研究被纳入荟萃分析。隐孢子虫感染的全球汇总流行率为 7.6%（95% CI：6.9-8.5）。隐孢子虫感染率估计最高的是墨西哥 (69.6%, 95% CI 66.3–72.8)、尼日利亚 (34.0%, 95% CI 12.4–60.0)、孟加拉国 (42.5%, 95% CI 36.1–49.0) 和共和国韩国 (8.3%, 95% CI 4.4–13.2) 分别在普通居民、患者、学童和健康人群中。来自低收入国家的人群、有胃肠道症状的人群、5 岁以下人群和非城市居民的估计患病率较高。

结论

这些估计表明隐孢子虫感染在世界范围内的流行程度很高，这可能为制定隐孢子虫的预防策略提供理论依据。