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Exposures associated with infection with Cryptosporidium in industrialised countries: a systematic review protocol

Lookup NU author(s): Professor Sarah O'Brien



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


BackgroundCryptosporidium is a protozoan parasite of humans and other animals worldwide and is one of the greatest contributors to human diarrhoeal illness. Transmission can occur indirectly via contaminated food or water, or directly via contact with animals or other infected people. Risk exposures are often identified from outbreak investigations, but a subset of cases remains unexplained, and sources for sporadic disease and pathways to infection are still unclear.Given the few systematic syntheses of reported evidence in industrialised populations, the aim of this review is to consolidate the literature to describe exposures associated with human cryptosporidiosis in industrialised countries, specifically including the UK, and describe any differences between outbreak-associated and sporadic disease.Methods/designWhere relevant, methods will follow the recommendations made in the Cochrane Handbook for Systematic Reviews of Interventions. Three steps will be used to identify the literature including electronic database searching using PubMed, Scopus, Embase and Web of Science; reference list trawling; and an exploration of the grey literature. Screening of results will be undertaken by two reviewers using pre-defined criteria. Studies conducted in industrialised countries and reporting on human subjects will be included. All observational studies will be included where they report exposures and relevant quantitative results.Data will be extracted using a standardised form. Study quality will be assessed using the ROBINS-I tool. Data will be summarised presenting the papers’ main findings including population under study, outcomes, and exposures, and whether these were considered outbreak or sporadic cases. A narrative summary will also be included. Where populations are appropriate, available data will be pooled in a meta-analysis combining the significant exposures across studies.DiscussionThis review aims to consolidate the evidence for transmission routes and exposures for Cryptosporidium in industrialised countries, with particular reference to how these may apply to the UK. In addition, the review will seek to describe differences between outbreak and sporadic cases. This will help to identify those most vulnerable, highlighting pathways where interventions and public health response may be appropriate.Systematic review registrationPROSPERO number CRD42017056589.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0731-8) contains supplementary material, which is available to authorized users.

Publication metadata

Author(s): McKerr C, O'Brien SJ, Chalmers RM, Vivancos R, Christley RM

Publication type: Article

Publication status: Published

Journal: Systematic Reviews

Year: 2018

Volume: 7

Online publication date: 02/05/2018

Acceptance date: 13/04/2018

Date deposited: 13/08/2019

ISSN (print): 2046-4053

Publisher: BioMed Central


DOI: 10.1186/s13643-018-0731-8

PubMed id: 29720280


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