Water for Human Consumption in Rural Areas Worldwide: A Systematic Review of the Presence of Cryptosporidium spp. and Giardia spp.

Reports of gastrointestinal disease outbreaks caused by pathogenic protozoans in rural areas are still small in numbers. This study has evaluated, at global level, the parasitological contamination by Cryptosporidium spp. and Giardia spp., of water resources used as sources for human consumption in rural areas, spanning from 1994 to 2022. For such, a systematic review was conducted, following the PRISMA guidelines, applying a descriptive and statistical analysis to the data. A total of 29 eligible articles reported contamination in 90 different springs spread throughout six continents. It was possible to see a greater tendency of giardiasis outbreak occurrences in water coming from surface springs in countries with higher HDI (above 0.8), justified by the lack of data in countries with other HDIs. The water sources intended for human supply in rural areas are susceptible to parasitological contamination, especially in Asia and Oceania. In spite of the fact that there have been no reports regarding giardiasis outbreaks in the reviewed studies, it is important to notice that the concentration of pathogens may have been greater due to the low recovery of the methods of detection. Therefore, it is advisable to conduct more studies about the contamination of water resources in rural areas, as well as the adoption of prevention measures regarding waterborne diseases, such as boiling water.