Risk factors for sporadic cryptosporidiosis: A systematic review and meta-analysis

IF 3 4区 环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES
Pauline Kooh , Anne Thébault , Vasco Cadavez , Ursula Gonzales-Barron , Isabelle Villena
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引用次数: 5

Abstract

Cryptosporidium spp. is an important cause of gastrointestinal disease worldwide, responsible for 69 million cases of illness in 2016. Information on the sources and transmission pathways of human cryptosporidiosis results mainly from outbreak investigations.

A systematic review and a meta-analysis of case-control and cohort studies were performed to determine the main risk factors associated with sporadic cryptosporidiosis. Suitable scientific articles were identified through a systematic literature search and subjected to a methodological quality assessment. From each study, odds ratio (OR) measures were extracted or calculated, as well as study characteristics such as population type, design, type of model and risk factor hierarchy. Mixed-effects meta-analysis models were adjusted by population type to appropriate data partitions.

From 1985 identified references, the quality assessment stage was passed by 57 cohort and case-control studies focusing on sporadic cryptosporidiosis. The eligible studies were conducted between 1983 and 2016 and provided 568 OR categorized for meta-analysis.

This meta-analysis identified travel, immunocompromising conditions, contact with infected humans, waterborne transmission (contact with recreational waters, wastewater, and consumption of untreated drinking water), contact with animals and food consumption as the relevant risk factors for sporadic cryptosporidiosis. With regards to food exposures, consumption of meat, dairy products (raw milk) and dishes consumed outside home were found significantly associated with cryptosporidiosis. The consumption of poorly washed fruits and vegetables significantly increases ORs. This meta-analysis reveals that some potential sources of Cryptosporidium such as shellfish or vegetables are under-investigated.

Future case-control studies for sporadic cryptosporidiosis should include population at risk, and investigate other potential sources in relation to the genotype and the subtype of Cryptosporidium spp.

散发性隐孢子虫病的危险因素:系统综述和荟萃分析
隐孢子虫是全球胃肠道疾病的重要病因,2016年导致6900万例疾病。关于人隐孢子虫病的来源和传播途径的信息主要来自疫情调查。对病例对照和队列研究进行了系统回顾和荟萃分析,以确定与散发性隐孢子虫病相关的主要危险因素。通过系统的文献检索确定合适的科学文章,并进行方法学质量评估。从每项研究中提取或计算比值比(OR),以及人群类型、设计、模型类型和风险因素层次等研究特征。混合效应荟萃分析模型按人口类型调整到适当的数据分区。从1985篇文献中,有57篇以散发性隐孢子虫病为重点的队列和病例对照研究通过了质量评价阶段。符合条件的研究于1983年至2016年进行,提供568个OR分类用于荟萃分析。本荟萃分析确定旅行、免疫损害条件、与受感染者接触、水媒传播(接触娱乐用水、废水和饮用未经处理的饮用水)、与动物接触和食物消费是散发隐孢子虫病的相关危险因素。在食物接触方面,发现肉类、乳制品(生奶)的消费和在家外食用的菜肴与隐孢子虫病有显著关联。食用洗得不好的水果和蔬菜会显著增加ORs。这项荟萃分析显示,一些潜在的隐孢子虫来源,如贝类或蔬菜,尚未得到充分的调查。未来散发隐孢子虫病的病例对照研究应包括高危人群,并调查与隐孢子虫基因型和亚型相关的其他潜在传染源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Microbial Risk Analysis
Microbial Risk Analysis Medicine-Microbiology (medical)
CiteScore
5.70
自引率
7.10%
发文量
28
审稿时长
52 days
期刊介绍: The journal Microbial Risk Analysis accepts articles dealing with the study of risk analysis applied to microbial hazards. Manuscripts should at least cover any of the components of risk assessment (risk characterization, exposure assessment, etc.), risk management and/or risk communication in any microbiology field (clinical, environmental, food, veterinary, etc.). This journal also accepts article dealing with predictive microbiology, quantitative microbial ecology, mathematical modeling, risk studies applied to microbial ecology, quantitative microbiology for epidemiological studies, statistical methods applied to microbiology, and laws and regulatory policies aimed at lessening the risk of microbial hazards. Work focusing on risk studies of viruses, parasites, microbial toxins, antimicrobial resistant organisms, genetically modified organisms (GMOs), and recombinant DNA products are also acceptable.
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