Balantioides coli is a protozoan that infects different hosts species, including humans, with zoonotic transmission. The parasite, which lives in the large intestine and in other organs, can lead to serious infections that may culminate in death. Information about human balantidiasis is generally still very scanty. In view of the above, the purpose of this study was to analyze the epidemiological, clinical and laboratory characteristics of human balantidiasis based on a systematic review and meta-analysis. The scientific articles were retrieved from various databases and were subjected to descriptive analyses, chi-squared tests, and summarized on a forest plot and the heterogeneity index (I²). A total of 103 articles were eligible and included in this review. Out of these 103 articles, 75 were clinical case reports and 28 were epidemiological studies, indicating a frequency of 997 (3.98%) people potentially infected with B. coli. The publication dates of the analyzed articles ranged from 1910 to 2020, but the majority (68.9%) were published between 1998 and 2020. A considerable number of these articles were published in South America and Asia, mostly in Brazil and India, respectively. However, in Africa, Ethiopia, was observed the higher number of infected people (47.5%). A significant association (p < 0.05) was identified between proximity to pigs and positivity for B. coli, since more than 16% infected people were in proximity with pigs and/or their excreta. Infection by the protozoan was classified mainly as intestinal, and the predominant symptom was dysentery. Extraintestinal infections were found in 27 individuals, with colonization of the genitourinary tract frequently highlighted. Direct examination (17.2%), followed by an association of direct examination and sedimentation (45.7%), were the most commonly performed parasitological techniques, and the most frequently diagnosed form was trophozoites, corresponding to 22.5% of cases. The most common treatment for parasitized individuals (11.8%) was an association of tetracycline drugs with nitroimidazole derivatives. The articles retrieved, mainly epidemiological ones, used in meta-analysis showed high heterogeneity (I²> 50%, p < 0.05), impairing the retrieval and comparison of results. Some articles were found to provide incomplete information, making it difficult to retrieve and analyze variables. However, this review enabled us to compile and restate factors that appear to be associated with cases of human balantidiasis.

Balantioides coli是一种原生动物，通过人畜共患传播感染不同的宿主物种，包括人类。这种寄生在大肠和其他器官中的寄生虫会导致严重的感染，最终可能导致死亡。关于人类龟头包虫病的信息通常仍然非常缺乏。鉴于上述情况，本研究的目的是基于系统评价和荟萃分析分析人类龟头包虫病的流行病学、临床和实验室特征。从各种数据库中检索科学文章，并进行描述性分析、卡方检验，并在森林图和异质性指数 (I ²）。共有 103 篇文章符合条件并纳入本综述。在这 103 篇文章中，75 篇是临床病例报告，28 篇是流行病学研究，表明有 997 人（3.98%）可能感染了大肠杆菌。所分析文章的发表日期从 1910 年到 2020 年不等，但大多数（68.9%）发表于 1998 年到 2020 年之间。其中相当多的文章发表在南美洲和亚洲，主要分别在巴西和印度。然而，在非洲，埃塞俄比亚被观察到感染人数更多（47.5%）。 在接近猪和大肠杆菌阳性之间确定了显着关联（p < 0.05），因为超过 16% 的感染者靠近猪和/或其排泄物。原虫感染以肠道感染为主，以痢疾为主要症状。在 27 个人中发现了肠外感染，经常突出显示泌尿生殖道的定植。直接检查 (17.2%)，其次是直接检查和沉淀相关联 (45.7%)，是最常用的寄生虫学技术，最常诊断的形式是滋养体，占病例的 22.5%。对寄生个体最常见的治疗方法 (11.8%) 是将四环素类药物与硝基咪唑衍生物联合使用。检索到的文章，主要是流行病学文章，用于荟萃分析显示高度异质性（I ²> 50%, p  < 0.05)，影响检索和比较结果。一些文章被发现提供了不完整的信息，使得检索和分析变量变得困难。然而，这项审查使我们能够汇编和重述似乎与人类龟头包虫病病例相关的因素。