Prevalence of Cryptosporidium infection in children from China: a systematic review and meta-analysis

Cryptosporidium is an important zoonotic pathogen that causes diarrhea in humans and animals, and a leading cause of diarrhea morbidity and mortality in children under 5 years old. However, the meta-analysis of Cryptosporidium infection in children in China has not been published. We searched the databases for articles published on the prevalence of Cryptosporidium infection in children in China since the inception of these databases to 31 October 2022. The prevalence of Cryptosporidium infection in children was estimated using a random effects model. The results showed that 111 datasets from 24 provinces were selected for the final quantitative analysis. The estimated pooled Cryptosporidium infection prevalence in children in China was 2.9% (3300/126,381). The highest prevalence rate was in southwestern China (4.8%, 365/7766). Subgroup analysis indicated that the Cryptosporidium infection rate in children aged < 3 years (4.9%, 330/8428) was significantly higher than that in children aged 3-6 years (2.5%, 609/26,080) and >6 years (2.6%, 647/27,586). Six Cryptosporidium species were detected in children in China from the selected studies. C. hominis was the dominant species (77.1%, 145/188) and the proportions of subgenotype IaA14R4 of C. hominis was highest (42.8%, 62/145). The findings suggest that Chinese children is in a low level of Cryptosporidium infection, however, the geographical distribution of the infection is extensive. We suggest that measures should be taken to ensure the healthy growth of Chinese children by improving the water environment, increasing public health facilities, strengthening children's health education, and developing sound Cryptosporidium infection control programs.