Epidemiology of Cryptosporidium Infection in Romania: A Review

Abstract

Since 1983, when the first report of a human Cryptosporidium spp. infection was published in Romania, and until now, many studies on cryptosporidiosis have been published in our country, but most of them are in the Romanian language and in national journals less accessible to international scientific databases. Although the infection was first recognized as a problem in children or immunocompromised people or more of a problem in low-income or underdeveloped global countries, we have shown in this review that it can also occur in people with normal immunological function and that the epidemiology of our country can provide a theoretical basis for the formulation of a Cryptosporidium spp. prevention strategy. In addition, 9.1% of healthy children and 73% of immunocompromised children were observed to have Cryptosporidium spp. infections. Higher rates have also been reported in immunocompromised adults (1.8–50%). Analyzing the prevalence of Cryptosporidium spp. infection in animals, we found values of 28.52% in cattle, 18% in buffalo calves, between 27.8 and 60.4% in pigs, 52.7% in dogs, and 29.4% in cats. Furthermore, in Romania, the burden of cryptosporidiosis, including acute infections and long-term sequelae, is currently unknown.

Evidence of the Zoonotic Transmission of Cryptosporidium among Children and Pets

“…Reference group marked as OR = 1; CI: confidence interval. 2 Pearson's chi-square. 3 NC: not calculated.…”

“…Infection typically occurs through the ingestion of oocysts found in the contaminated water and food sources in direct contact with infected individuals. The most prominent clinical symptom of cryptosporidiosis is diarrhea, which tends to be self-limiting in immunocompetent individuals but can become chronic and potentially life-threatening for immunosuppressed patients [1,2]. As a result, this pathogen garnered increased attention during the AIDS epidemic in the 1980s [3].…”

Prevalence and Genotyping of Water- and Food-Borne Parasitic Protozoans (Giardia duodenalis and Cryptosporidium spp.) in Hospitalized Patients from Northwestern Romania

“…The officially reported data are unreliable, as shown by the scientific literature published within the same time frame. Recent data obtained from children from the western part of the country indicate a prevalence of infection of 4.26% in 2010, and 7.54% in 2015 [33]. Between 2017 and 2020, in a laboratory from Eastern Romania, 390 samples (3.54%) were positive for gastro-intestinal parasites, with Cryptosporidium spp.…”

“…In Romania, screening for Cryptosporidium spp. is not included in coproparasitological standard examinations in clinical laboratories; therefore, most studies are surveys based on convenience sampling of hospitalized children or adults, mainly taking into account those suffering from diarrheic syndrome [33]. The officially reported data are unreliable, as shown by the scientific literature published within the same time frame.…”

Anti-Cryptosporidial Drug-Discovery Challenges and Existing Therapeutic Avenues: A “One-Health” Concern

“…The prevalence of Cryptosporidium spp. infection was found to be 28.52% in cattle, 18% in buffalo calves, between 27.8 and 60.4% in pigs, 52.7% in dogs, and 29.4% in cats [32]. Recently, C. parvum's presence in yaks has been reported in China, which may prove to be a serious food-safety threat, ultimately affecting public health [33].…”