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. 2020 Dec 5;48:97. doi: 10.1186/s41182-020-00278-9

Cryptosporidium animal species in Iran: a systematic review and meta-analysis

Mousa Motavalli Haghi 1, Zohreh Khorshidvand 1, Salman Khazaei 2, Faezeh Foroughi-Parvar 1, Hossein Sarmadian 3, Nastaran Barati 4, Fariborz Etemadifar 1, Reza Ghasemikhah 5,✉
PMCID: PMC7718689  PMID: 33292794

Abstract

Background

Cryptosporidiosis is an acute and short-term infection which can lead to severe diarrhea (intestinal cryptosporidiosis) associated with a persistent cough in the host with immune system defect. This systematic review and meta-analysis was conducted to estimate the prevalence of animal Cryptosporidium species and the corresponding epidemiological aspects in Iran.

Methods

In this study, all original research articles relating to the animal cryptosporidiosis in Iran were collected from reliable databases using keywords. A meta-analysis was conducted separately for each subgroup, and heterogeneity among the studies was performed using the Q and I2 tests. Furthermore, it should be noticed that the significance level in the statistical analysis with the Comprehensive Meta-analysis software was considered to be less than 0.05. Finally, meta-analysis results were shown in forest plot with a 95% CI.

Results

In total, 4795 studies were included in the initial screening. Duplicated or non-original studies and the ones which did not meet our considered criteria were excluded from the list. Out of the 100 articles included in our first list for the meta-analysis, 40, 16, 13, 10, 9, 7, and 5 were done on cattle and calves, birds, dogs, sheep, rodents, camels, and horses, respectively. The prevalence rate of cryptosporidiosis among the birds, horses, rodents, camels, dogs, cattle, and sheep in Iran was estimated to be 7.5%, 19.5%, 20.8%, 8.4%, 4.9%, 14.4%, and 9.1%, respectively.

Conclusion

The different Cryptosporidium species have been found in different regions of Iran. Geographical region, climate, and domestic animals are considered as factors responsible for animal cryptosporidiosis prevalence in the area. Moreover, this parasite is zoonotic which causes disease in animals as well as humans which can result in economic loss.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41182-020-00278-9.

Keywords: Cryptosporidium, Intestinal parasites, Animal, Systematic review, Iran

Introduction

Intestinal parasites are considered an important public health problem in humans and animals in developing and low-income countries [1–3]. Cryptosporidium is one of the most common intestinal protozoan parasites which is located in the phylum of Apicomplexa and causes cryptosporidiosis [2]. Cryptosporidium is spread easily in the environment due to its simple transmission via contaminated water, air, and dust. Cryptosporidiosis is considered as a major economic problem in many countries including Iran, and there are annually numerous reports of this infection in immunocompromised and young children [2–5]. Different methods have been used to detect the protozoan parasite including the molecular diagnostic method which is considered one of the most useful diagnostic tools.

This method has identified up to 30 species and more than 50 genotypes of Cryptosporidium [6–8]. Different species of Cryptosporidium have been reported in various hosts including birds, horses, cattle, sheep, camels, rodents, and dogs. Cryptosporidium parvum, C. hominis, C. canis, C. felis, C. meleagridis, and C. muris were distinguished from gastrointestinal diseases as well as diarrhea in humans [9]. However, the infection typically occurs in a short-term and acute form in immunocompromised and HIV-positive individuals. In these cases, it tends to remain in the lower intestine for up to 6 weeks with severe diarrhea and persistent cough [9]. This protozoan could develop its life cycle in one host without the requirement of other animals as intermediate or reservoir hosts [9, 10]. Despite the many studies which were conducted in Iran on investigating the prevalence of cryptosporidiosis in different animal hosts, these data have not shown the overall prevalence of animals in Iran. Since cryptosporidiosis causes irreversible economic damages to domestic animals, critical screening programs and epidemiological aspects should be considered by authorities. This systematic review and meta-analysis was conducted to estimate the prevalence of animal Cryptosporidium species and their epidemiological aspects in Iran.

Materials and methods

Study protocol

The present systematic review focused on the estimates of the prevalence of animal Cryptosporidium species according to the PRISMA guidelines for systematic review and meta-analysis [11] (Supplementary 1).

Search strategy

In order to select the suitable articles for this study, all records since 1991 up to February 2018 were investigated using seven international databases in English including PubMed, Web of Science, Scopus, Science Direct, and Google Scholar search engine as well as national databases in Persian including Magiran (http://www.magiran.com/) and Scientific Information Database (SID) (http://www.sid.ir/). Furthermore, references of each article were screened manually, and the authors were contacted for additional references.

The databases screening was performed using the following keywords: prevalence, Cryptosporidium, cryptosporidiosis, animal Cryptosporidium, Cryptosporidium species, C. parvum, C.hominis, animal, cattle, calf, sheep, goat, camel, horse, rodent, bird, chicken, epidemiology, Iran, serology, PCR, and molecular (Box 1).

Box 1.

Search strategy for MEDLINE (Mesh, Medical Subject Headings)

1: Prevalence [Text Word] OR Prevalence [Mesh Term]
2: Epidemiology [Text Word] OR Epidemiology [Mesh Term]
2: Cryptosporidium [Text Word] OR Cryptosporidium [Mesh Terms]
3: Cryptosporidiosis [Text Word] OR Cryptosporidiosis [Mesh Term]
4: Animal [Text Word] OR Animal [Mesh Term]
5: Cattle or Calf or Sheep or Goat or Camel or Horse or Rodent or Bird or Chicken
6: Iran
7: Serology [Text Word] OR Serology [Mesh Term]
8: PCR [Text Word] OR PCR [Mesh Term]
7: Microscopic [Text Word] OR Microscopic [Mesh Term]
5: Meta-analysis [Text Word] OR Meta-analysis [Mesh Terms]
6: 1 AND 2 AND 3 AND 4 AND 5 AND 6 AND 7
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Eligibility criteria

All original descriptive studies which investigated the prevalence of Cryptosporidium in animals in Iran, both in English and Persian, were included in this study. Duplicates, qualitative studies, review articles, case reports, case series, and studies out of Iran or those performed on humans were excluded. Finally, articles with epidemiological parameters of interest were selected, and a total of 100 collected articles fulfilled the considered criteria.

Quality assessment

The scoring system based on the 8-item modified Newcastle Ottawa Scale (NOS) for non-randomized studies was used for assessing the quality of the studies. In this system, each question has a score between 0 and 1, and the maximum point summation is 9. Studies with point summation 5 or less, 6–7, and 8–9 were considered low, moderate, and high quality, respectively [12].

Screening and data extraction

All records were evaluated based on their title and abstract and according to the inclusion and exclusion criteria by two researchers (MM and NB) independently. The kappa index showed an agreement of 91% between the findings of two researchers. The full-text version of the papers was obtained through library resources and online databases. Finally, the difference between records among the researchers was corrected by re-examining the articles. The agreement was reached by group discussion with a third researcher (SK).

Data extraction was conducted independently by two researchers (MM and NB) and imported to the pre-prepared form. Data including authors, year of study, publication year, kind of animal, geographical area of the study, number of examined, number of positive, prevalence rate, and type of host were extracted from articles.

Quality assessment studies

The methodological quality of the studies was examined based on the guidelines of the Newcastle and Ottawa Statements [12]. This guideline sets the criteria for selecting people to study, comparing and accepting them, as well as exposure and consequences where a maximum of 9 stars can be allocated to each study. Studies with 7 stars or more are classified as high-quality studies, and studies with 6 stars and less are considered as low-quality studies. Investigating the probability of an error in the results of the studies is performed separately by two researchers. The disagreement between the parties is resolved through negotiations.

Data analysis

The meta-analysis method was adopted to a 95% confidence interval (CI) in order to assess the pooled prevalence of Cryptosporidium infection in animals using the random effect model. Various subgroup analyses were separately conducted based on animal type and the associated species. Finally, meta-analysis results were displayed in forest plot (reported as effect estimates (ES) with a 95% CI). We also performed a sensitivity analysis to verify the stability of the data. In order to assess the sensitivity analysis, the effect estimate was estimated irrespective of one study at a time, and the robustness of the pooled estimate was assessed. Heterogeneity was calculated among the studies by the Q and I2 tests [6, 8]. Cochran’s Q test (Q statistic, p < 0.10) showed statistically significant heterogeneity, and I2 statistic (I2 > 50%) indicates a large heterogeneity. Statistical analysis and data analysis were performed using the second version of the Comprehensive Meta-analysis software. The significance level was considered to be less than 0.05.

Results

Description of studies

In total, 4795 studies were collected in the initial screenings from the published articles and their references in the screened databases up to February 2018. Specifically, 62, 124, 174, 62, 543, 10, and 3820 studies collected from PubMed, Web of Science, Scopus, Scientific Information Database, Magiran, Science Direct, and Google Scholar, respectively. A total of 1933 duplicated records and 5 studies which were not original articles (i.e., letter, commentary, review) were screened out. Regarding the relevance of the title and abstract to the purpose of the study, 2857 irrelevant studies were excluded. Accordingly, 2757 studies were retrieved for further assessment. Altogether, 100 articles were selected for the meta-analysis study. The display process and literature search results were presented respectively in Fig. 1 and Table 1.

Fig. 1.

Fig. 1

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Flowchart describing the study design process

Table 1.

Baseline characteristics of included studies

First author Publication year Province Animal Samples Positive samples Prevalence (%) Species Laboratory method
Nouri [13] 1991 Lorestan Sheep 276 37 13.4 Cryptosporidium spp. Microscopic
Rezaeian [14] 1993 Tehran Sheep 510 26 5.1 Cryptosporidium spp. Microscopic
Fasihi Harandi [15] 2006 Kerman Sheep 434 60 13.8 Cryptosporidium spp. Microscopic
Vahedi [16] 2008 Mazandaran Lamb 708 29 4.1 Cryptosporidium spp. Microscopic
Heidari [17] 2012 Hamadan Sheep 220 19 8.6 Cryptosporidium spp. Microscopic
Khezri [18] 2013 Kurdistan Lamb 850 87 10.2 Cryptosporidium spp. Microscopic
Gharekhani [19] 2013 Hamedan Esfahan, Yazd Fars, Bushehr Mazandaran Sheep 1749 198 11.3 Cryptosporidium spp. Microscopic
Shafieyan [20] 2014 Lorestan Sheep 345 20 5.8 Cryptosporidium spp. Microscopic
Sadeghi [21] 2015 Kurdistan Sheep 180 11 6.1 Cryptosporidium spp. Microscopic
Dalimi [6] 2017 Tehran Sheep 1300 22 1.7 C. andersoni, C. parvum Nested-PCR
Radfar [22] 2006 Kerman Calf 291 63 21.6 Cryptosporidium spp. Microscopic
Maleki [23] 2006 Lorestan Cattle 400 70 17.5 Cryptosporidium spp. Microscopic
Parsa [24] 2007 Azerbaijan Cattle 300 16 5.3 C. andersoni Microscopic
Azami [25] 2007 Isfahan Cattle 480 30 6.3 Cryptosporidium spp. Microscopic
Azizi [26] 2007 Chaharmahl Calf 400 72 18 Cryptosporidium spp. Microscopic
Yakhchali [27] 2007 Kurdistan Cattle 260 103 39.6 Cryptosporidium spp. Microscopic
Keshavarz [28] 2008 Qazvin Cattle 272 51 18.8 C. andersoni, C. parvum, C. bovis PCR-RFLP
Mohamadi [29] 2008 Ardabil Cattle 107 14 13.1 C. andersoni Nested PCR&RFLP
Ardabil Cattle 107 5 4.7 C. parvum Nested PCR&RFLP
Hassanpour [30] 2008 Azerbaijan Calf 482 31 6.4 Cryptosporidium spp. Microscopic
Fotouhi [31] 2008 Kerman Cattle 412 78 18.9 C. andersoni, C. parvum Microscopic
Vahedi [16] 2008 Mazandaran Calf 713 28 3.9 Cryptosporidium. spp. Microscopic
Shayan [32] 2008 Tehran Cattle 173 64 37 Cryptosporidium spp. Microscopic
Davoudi [33] 2009 Azerbaijan Calf 50 7 14 Cryptosporidium spp. Microscopic
Rat 40 80
Pirestani [34] 2009 Tehran Calf 573 69 12 Cryptosporidium spp. Microscopic
Ranjbar [35] 2009 Mazandaran Calf 150 11 7.3 Cryptosporidium spp. Microscopic
Fallah [36] 2009 Kurdistan Calf 412 35 8.5 Cryptosporidium spp. Microscopic
Baghban [37] 2009 Kohkiluyeh Calf 80 37 46.3 Cryptosporidium spp. Microscopic
Nourmohamadzadeh [38] 2010 Azerbaijan Calf 500 207 41.4 Cryptosporidium spp. Microscopic
Safavi Afshari [39] 2010 Khorasan Calf 112 82 73.2 Cryptosporidium spp. Microscopic
Ranjbar [40] 2011 Tehran Calf 200 35 17.5 Cryptosporidium spp. Microscopic
Changizi [41] 2011 Semnan Cattle 200 21 10.5 C. ryanae Microscopic
Bairami [42] 2011 Tehran Cattle 100 30 30 Cryptosporidium spp. PCR
Heidarnegadi [43] 2011 Khuzestan Cattle 45 29 64.4 Cryptosporidium spp. Microscopic
Ranjbar [44] 2013 Khorasan Calf 400 10 5.2 Cryptosporidium spp. Microscopic
Ghadrdan [45] 2011 Semnan Calf 50 8 16 Cryptosporidium spp. Microscopic
Heidari [46] 2012 Hamadan Cattle 477 76 15.9 Cryptosporidium spp. Microscopic
Ranjbar [47] 2012 Khorasan Calf 170 19 11.2 Cryptosporidium spp. Microscopic
Jafari [48] 2012 Hamedan Calf 195 25 12.8 Cryptosporidium spp. Microscopic
Asadpour [49] 2013 Khorasan Calf 300 45 15 C. parvum PCR-RFLP
Mirzai [50] 2013 Azerbaijan Cattle 246 55 22.4 C. andersoni, C. parvum Microscopic
Dalimi [51] 2013 Tehran Cattle 940 23 2.4 C. andersoni Nested PCR
Shafieyan [20] 2014 Lorestan Cattle 430 39 9.1 Cryptosporidium spp. Microscopic
Mojarad [52] 2014 Qazvin Cattle 158 26 16.5 Cryptosporidium spp. Microscopic
Bahrami [53] 2014 Khuzestan Calf 90 41 45.6 Cryptosporidium spp. Microscopic
Mahami oskouei [54] 2014 Ilam Cattle 217 8 3.7 C. parvum Nested PCR&RFLP
Mirzaghavami [55] 2015 Tehran Cattle 50 12 24 Cryptosporidium spp. Microscopic
Saki [1] 2017 Khuzestan Cattle 240 5 2.1 C. parvum Nested PCR&RFLP
Mosallanejad [56] 2010 Khuzestan Dog 93 4 4.3 C. parvum ELISA
Kake khani [57] 2011 Ilam Dog 112 8 7.1 Cryptosporidium spp. Microscopic
Heidari [17] 2012 Hamadan Dog 210 8 3.8 Cryptosporidium spp. Microscopic
Badrooj [58] 2012 Shiraz Dog 29 0 1.7 Cryptosporidium spp. PCR
Beiromvand [59] 2012 Khorasan Dog 77 4 5.2 Cryptosporidium spp. Microscopic
Mirzaei [60] 2013 Kerman Dog 548 11 2 Cryptosporidium spp. Microscopic
100 3 3 Cryptosporidium spp. Microscopic
Gharekhani [61] 2014 Hamedan Dog 210 8 3.8 Cryptosporidium spp. Microscopic
Arzamani [62] 2016 Khorasan Dog 32 1 3.1 Cryptosporidium spp. Microscopic
Tavalla [63] 2017 Khuzestan Dog 350 43 12.3 Cryptosporidium spp. PCR
Mohaghegh [64] 2017 Kermanshah Dog 301 72 23.9 Cryptosporidium spp. Microscopic
Ranjbar [9] 2018 Isfahan Dog 140 3 2.1 C. parvum PCR
Borji [65] 2009 Khorasan Camel 306 6 2 Cryptosporidium spp. Microscopic
Behzadi [66] 2009 Isfahan Camel 103 39 37.9 Cryptosporidium spp. Microscopic
Nazifi [67] 2009 Hormozgan Camel 65 11 16.9 Cryptosporidium spp. Microscopic
Sazmand [68] 2011 Yazd Camel 300 61 20.3 Cryptosporidium spp. Microscopic
Yakhchali [69] 2012 Azerbaijan Camel 170 17 10 Cryptosporidium spp. Microscopic
Radfar [70] 2012 Kerman Camel 85 2 2.4 C. parvum ELISA
Shahraki [71] 2015 Sistan Camel 184 1 0.5 C. parvum ELISA
Hamedi [72] 2003 Hormozgan Rat 63 11 17.5 Cryptosporidium spp. Microscopic
Shiraz i[73] 2009 Azerbaijan Rat 50 37 74 Cryptosporidium spp. Microscopic
Davoudi [32] 2010 Azerbaijan Rat 50 40 80 Cryptosporidium spp. Microscopic
Bahrami [74] 2012 Tehran Rat 77 21 27.3 C. parvum PCR-RFLP
Borji [75] 2013 Khorasan Hamster 100 44 44 Cryptosporidium spp. Microscopic
Mirzaghavami [56] 2015 Tehran Rat 180 23 12.8 Cryptosporidium spp. Microscopic
Saki [1] 2016 Khuzestan Rodent 100 3 3 C. parvum Nested PCR&RFLP
Valipour [76] 2016 Khuzestan Rat 42 3 7.1 Cryptosporidium spp. Microscopic
Mohebali [77] 2017 Azerbaijan Rodent 204 1 0.5 Cryptosporidium spp. Microscopic
Banani [78] 2000 Fars Chicken 1522 125 8.2 C. bailey ELISA
Mirzai [79] 2008 Kerman Pigeon 400 10 2.5 Cryptosporidium spp. Microscopic
Behzadi [67] 2009 Isfahan Ostrich 75 21 28 Cryptosporidium spp. Microscopic
Norolahi Fard [80] 2010 Khorasan Pigeon 200 5 2.5 Cryptosporidium spp. Microscopic
Shemshadi [81] 2010 Semnan Broiler 240 57 23.8 Cryptosporidium spp. Microscopic
Haghbin [82] 2010 Mazandaran Broiler 300 39 13 Cryptosporidium spp. Microscopic
Radfar [83] 2011 Khorasan Pigeon 102 3 2.9 Cryptosporidium spp. Microscopic
Heidarnegadi [42] 2011 Khuzestan Turkey 22 11 50 Cryptosporidium spp. Microscopic
Heidari [17] 2012 Hamadan Poultry 200 5 2.5 Cryptosporidium spp. Microscopic
Hamidinejat [84] 2014 Lorestan Chicken 1000 7 0.7 C. bailey PCR-RFLP
Hashemzade [85] 2014 Azerbaijan Bird 400 36 9 Cryptosporidium spp. Microscopic
Hashemzade [86] 2014 Azerbaijan Poultry 400 21 5.3 Cryptosporidium spp. Microscopic
Mirzaghavami [56] 2015 Tehran Pigeon 40 1 2.5 Cryptosporidium spp. Microscopic
Shemshadi [87] 2016 Rasht Duck 30 5 16.7 C. bailey Microscopic
Soltanialvar [88] 2016 Khuzestan Turkey 200 4 2 Cryptosporidium spp. Microscopic
Larki [89] 2017 Khuzestan Duck 41 11 26.8 Cryptosporidium spp. Microscopic
Naghibi [90] 2002 Khorasan Horse 300 80 26.7 Cryptosporidium spp. Microscopic
Tavassoli [91] 2005 Azerbaijan Horse 221 35 15.8 Cryptosporidium spp. Microscopic
Mirian [5] 2010 Tehran Horse 200 50 25 Cryptosporidium spp. Microscopic
Heidari [17] 2012 Hamedan Horse 158 20 12.7 Cryptosporidium spp. Microscopic
Ghadrdan [92] 2012 Khuzestan Horse 100 18 18 Cryptosporidium spp. Microscopic
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Within these 100 articles, 40, 16, 13, 10, 9, 7, and 5 studies were performed on cattle, birds, dogs, sheep, rodents, camels, and horses, respectively. The most frequent studies were performed on cattle and the least ones on horses. Considering the various projects in searching cryptosporidiosis on cattle in Iran, the distribution of positive cases relating to cattle is presented in Fig. 9. The quality assessment of studies using the guideline of the Newcastle Ottawa Scale showed that 27%, 65%, and 8% of the studies have low, medium, and high quality, respectively.

Fig. 9.

Fig. 9

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Incidence of Cryptosporidium infection in the Iranian cattle in different provinces [2]

Main analysis

The prevalence rate of cryptosporidiosis within a 27-year period for birds, horses, rodents, camels, dogs, cattle, and sheep in Iran using the random effect model was estimated to be 7.5% (95%, CI = 4.7%, 11.9%), 19.5% (95%, CI = 14.6%, 25.6%), 20.8% (95%, CI = 9.1–40.7%), 8.4% (95%, CI = 3.8%, 17.8%), 4.9% (95%, CI = 2.6%, 8.8%), 14.4% (95%, CI = 11%, 18.6%), and 9.1% (95%, CI = 8.4%, 9.9%), respectively. The forest plot diagrams of the current study are shown in Figs. 2, 3, 4, 5, 6, 7, and 8.

Fig. 2.

Fig. 2

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Forest plot diagram showing the prevalence rate of Cryptosporidium infection in birds of Iran

Fig. 3.

Fig. 3

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Forest plot diagram showing the prevalence rate of Cryptosporidium infection in horses of Iran

Fig. 4.

Fig. 4

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Forest plot diagram showing the prevalence rate of Cryptosporidium infection in rodents of Iran

Fig. 5.

Fig. 5

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Forest plot diagram showing the prevalence rate of Cryptosporidium infection in camels of Iran

Fig. 6.

Fig. 6

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Forest plot diagram showing the prevalence rate of Cryptosporidium infection in dogs of Iran

Fig. 7.

Fig. 7

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Forest plot diagram showing the prevalence rate of Cryptosporidium infection in cattle of Iran

Fig. 8.

Fig. 8

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Forest plot diagram showing the prevalence rate of Cryptosporidium infection in sheep of Iran

A wide variation was observed in the prevalence estimations among the various studies. The Q statistic, df, and I2 were as follows: 26.63, 15, and 43.74% for birds; 15.15, 8, and 47.18% for rodents; 11.15, 6, and 46.17% for camels; 58.85, 43, and 26.93% for cattle; and 16.64, 10, and 39.93% for sheep, respectively. Low heterogeneity was reported in studies which were conducted on horses as well as the ones on dogs. The statistic factors (Q statistic, df, and I2) were 3.86, 4, 0.00% for horses and 6.07, 12, and 0.00% for dogs.

The prevalence rate of Cryptosporidium infection in cattle is shown in Fig. 9. The most positive cases of cryptosporidiosis were reported in cattle of West Azerbaijan, Tehran, Khuzestan, Chaharmahal and Bakhtiari, Kohgiluyeh and Boyer-Ahmad, and Kerman provinces. Considerable positivity rates of cryptosporidiosis in cattle were identified in Razavi Khorasan, South Khorasan, Semnan, Hamadan, Alborz, and East Azerbaijan provinces. There were no positive reports of cryptosporidiosis in cattle in other provinces.

Discussion

Cryptosporidiosis is one of the most important zoonotic diseases which is reported in humans and animals with a worldwide distribution in more than 106 countries and especially in developing countries [91, 92]. To the best of our knowledge, this is the first systematic review and meta-analyses on the prevalence of animal cryptosporidiosis in Iran.

The present study showed that the average prevalence rate of cryptosporidiosis in birds was 7.5% in Iran. Additionally, the prevalence rate of cryptosporidiosis in animals in Ahvaz, southwestern of Iran was reported as 50% [86] while it was shown that in Gilan, north of Iran, this rate was 17% [84]. In a study by Jasim and Marhoon, it has shown that in Iraq, which is a neighboring region of Iran, the cryptosporidiosis prevalence rate in wild and domestic birds was 58.1% [93]. Even though this region is near the southwest of Iran, the prevalence was higher than in Iran. Moreover, a prevalence of 49% was shown in Mexico [94], and in Brazil, 76% of birds were infected by Cryptosporidium [95]. Changes in the prevalence seen in various reports indicate that the probability of transmitting the parasite is higher among animals living together on farms and next to each other compared to other studies that have examined individual specimens.

Preventive efforts by Iranian authorities related to awareness of zoonotic diseases, control of stray dogs, and a low population of pet dogs have increased the possibility of transmission of the disease from livestock [96]. On the one hand, the stray dogs are the largest group of dogs in both rural and urban areas in Iran which usually become infected by roaming in human neighborhoods and feeding on contaminated residues. On the other hand, domestic dogs are not restricted to the limited area of houses or farms. Stray dogs are allowed to wander around, so it increases the risk of zoonotic infections in rural habitats. In this study, the overall prevalence of cryptosporidiosis between dogs was found to be 4.9% in Iran. There are various reports of cryptosporidiosis prevalence in the different geographical regions of Iran. Mohaghegh et al. reported a prevalence of 21.7% and 25.4% of cryptosporidiosis respectively in domestic and stray dogs of Kermanshah [61]. Furthermore, the 12.3% prevalence rate of cryptosporidiosis in dogs was observed in Ahvaz [60]. These results are higher than the data which were obtained in other regions of Iran, specifically 5% in Chenaran, northeast of Iran [56]; 7% in Ilam [97]; 2% in Kerman, southeast of Iran [98]; 2.9% in Urmia, northwest of Iran [99]; 2.14% in Isfahan, center of Iran [62]; and 3.8% in Hamadan, west of Iran [17]. The high prevalence of cryptosporidiosis in some areas, for instance, Kermanshah Province, indicated that humans are at serious risk of Cryptosporidium infection. Furthermore, the infection can spread vastly and cause severe problems in the community.

Epidemiological studies on cryptosporidiosis infection indicated that the prevalence of Cryptosporidium species in dogs is very different in various countries changing from 0 to 52.7%. These differences might be attributed to several factors, such as geographical area, sample size, keeping a dog, correlation with other hosts (such as goat, sheep, horse, cattle, and pig), different species of Cryptosporidium, and sampling procedures as well as diagnostic methods [100, 101]. The current results imply that the prevalence rate of cryptosporidiosis in Iran is higher than in countries such as the Czech Republic with 1.4% [102], Thailand with 2.1% [103], Brazil with 2.4% [104], Japan with 3.9% [105], and Spain with 4.1% [106], but lower than in Nigeria with 18.5% [107] and Romania with 52.7% [108].

Rodents could be potential reservoir hosts for zoonotic cryptosporidiosis. During extensive epidemiological studies that have been performed throughout the world, infection in rodents was highly varied from 7.6% in Maryland [109] to 63% in United Kingdom [110]. Other studies showed different statistic in different countries. Specifically, 8.2% in northern Australia [111], 11/5% in China [112], 24.3% in Italy [113], 25.8% in Philippines [114], and 32.8% in the United States of America [115] were reported. The average prevalence rate of cryptosporidiosis in rodents in Iran was estimated as 20.8% in this study. Similar studies in different geographical regions of Iran showed diverse range of prevalence. The frequency of rodent’s cryptosporidiosis in Meshgin shahr, Tehran, Shooshtar, and Ahvaz was 0.5% [75], 27.3 % [71], 7.1% [74], and 3% [1], respectively. In the parasite investigation of rodents of Mashhad, none resulted to be were contaminated (0%) [72].

The average prevalence of cryptosporidiosis in sheep was found as 9.1%. Prevalence of cryptosporidiosis was reported as 1.69%, 5.8%. 6.1% and 8.6% in Tehran [20], Lorestan [18], Sanandaj [19] and Hamadan [15], respectively. Majewska et al found similar results in the west-central region of Poland (10.1%) [116] but lower rates were detected in Australia (24.5%) [117], and China (4.8%) [118].

The prevalence rate of cryptosporidiosis in cattle was 1.5% in Japan [119], 35.7% in Vietnam [120], 20.6% in Turkey [121], 40.6% in Canada [122], and 40.6% in the USA [123].

However, according to this systematic review and meta-analysis, the prevalence of cryptosporidiosis in cattle and calves was 14.4% in Iran, and the prevalence rate in various geographical regions was as follows: 2.1% in Ahvaz [73], 9.07% in Lorestan [18], 16.45% in Qazvin [26], 22.3% in the city of Urmia [48], and 28.3% in the city of Mashhad [47]. Furthermore, our study showed that the prevalence rate of cryptosporidiosis in camels and horses was 8.4% and 19.5%, respectively.

It was suggested in this study that the distribution of Cryptosporidium differs among geographical regions. Therefore, the study location might be one of the most determinant factors in cryptosporidiosis distribution. The highest prevalence rate (50%) of cryptosporidiosis was observed in Khuzestan Province [86]. This high prevalence might be attributed to the high temperature and humidity of the southwestern regions of Iran as well as the people’s lifestyle, who have a high level of seafood consumption compared to other regions. Additionally, the immigration of birds to the south of Khuzestan Province may transmit parasite protozoan infection.

Conclusion

The relatively high prevalence of cryptosporidiosis infection among animals in Iran, mostly among sheep, cattle, and calves, shows the enzootic status of cryptosporidiosis in the investigated areas and may be a threat to the inhabitants. Our data offer important information about the epidemiology of cryptosporidiosis among animals in Iran, which could be useful for managing and controlling programs for the disease. Further investigation and monitoring will be required to expand the surveillance and control policies in order to reduce the prevalence of Cryptosporidiosis among livestock and consequently decrease the economic damages and public health hazards in Iran.

Supplementary Information

Additional file 1. PRISMA Checklist. (22.3KB, docx)

Acknowledgements

Not applicable.

Abbreviations

HIV

Human immunodeficiency viruses

CI

Confidence interval

Authors’ contributions

This study was done by RG, ZK, SK, FFP, HS, NB, FE, and MMH. RG and MMH participated in the design of the study. Data collection was done by RG, FFP, and NB. Interpretation and manuscript preparation were conducted by MMH and RG. HS, RG, and MMH participated in the data editing. SK performed the statistical analysis. FE and ZK performed the coordination and helped with the drafting of the manuscript. The authors read and approved the final version of the manuscript.

Funding

Not funding

Availability of data and materials

Input data for the analyses are available from the corresponding author on request.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Additional file 1. PRISMA Checklist. (22.3KB, docx)

Data Availability Statement

Input data for the analyses are available from the corresponding author on request.

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