Cryptosporidium and cryptosporidiosis: An update of Asian perspectives in humans, water and food, 2015–2025

Abstract

Cryptosporidium species are increasingly recognized as significant enteric pathogens, particularly within developing nations, where they pose serious public health challenges. This systematic review and meta-analysis examine a decade of research (2015–2025) to map the epidemiological footprint of Cryptosporidium across Asia, incorporating 228 studies from 28 countries and analyzing a collective sample of 327,783 specimens collected from humans, water, and food. The overall pooled prevalence was 8.1%, with Southeast Asia emerging as the region of highest concern. Among the affected populations, immunocompromised individuals and children demonstrated the highest vulnerability. Environmental contamination was especially pronounced in surface water sources, while vegetables, particularly those sold in wholesale markets, were the most contaminated food matrices. Molecular findings identified 23 distinct species, and several subtypes predominated by C. parvum (IIa, IId) and C. hominis (Ia, Ib). Notably, some water samples from mixed and surface water sources exhibited extraordinarily high oocyst concentrations, reaching up to 80,000 oocysts/l. Diagnostic approaches varied widely, with a considerable proportion of studies employing traditional non-molecular techniques, thereby highlighting the need for more advanced and standardized detection protocols. Despite regional disparities and methodological variability, the findings reveal a consistent pattern of widespread exposure and environmental circulation of Cryptosporidium species across the continent. This underscores an urgent need for multisectoral collaborations and interventions aimed at bolstering water and food safety infrastructure, enhancing diagnostic capacity, and strengthening public health systems to effectively manage and prevent cryptosporidiosis throughout Asia.