Global prevalence of Giardia infection in nonhuman mammalian hosts: A systematic review and meta-analysis of five million animals.

backgroundMembers of the Giardia genus are zoonotic protozoan parasites that cause giardiasis, a diarrheal disease of public and veterinary health concern, in a wide range of mammal hosts, including humans. METHODOLOGY: We conducted a systematic review and meta-analysis to provide evidence-based data on the worldwide prevalence of Giardia infection in nonhuman mammals that can be used as scientific foundation for further studies. We searched public databases using specific keywords to identify relevant publications from 1980 to 2023. We computed the pooled prevalence estimates utilizing a random-effects meta-analysis model. Animals were stratified according to their taxonomic hierarchy, as well as ecological and biological factors. We investigated the influence of predetermined variables on prevalence estimates and heterogeneity through subgroup and meta-regression analyses. We conducted phylogenetic analysis to examine the evolutionary relationships among different assemblages of G. duodenalis. PRINCIPAL

findingsThe study included 861 studies (1,632 datasets) involving 4,917,663 animals from 327 species, 203 genera, 67 families, and 14 orders from 89 countries. The global pooled prevalence of Giardia infection in nonhuman mammals was estimated at 13.6% (95% CI: 13.4-13.8), with the highest rates observed in Rodentia (28.0%) and Artiodactyla (17.0%). Herbivorous (17.0%), semiaquatic (29.0%), and wild (19.0%) animals showed higher prevalence rates. A decreasing prevalence trend was observed over time (β = -0.1036477, 95% CI -0.1557359 to -0.0515595, p < 0.000). Among 16,479 G. duodenalis isolates, 15,999 mono-infections belonging to eight (A-H) assemblages were identified. Assemblage E was the predominant genotype (53.7%), followed by assemblages A (18.1%), B (14.1%), D (6.4%), C (5.6%), F (1.4%), G (0.6%), and H (0.1%). The highest G. duodenalis genetic diversity was found in cattle (n = 7,651, where six assemblages including A (13.6%), B (3.1%), C (0.2%), D (0.1%), E (81.7%), and mixed infections (1.2%) were identified. CONCLUSIONS/SIGNIFICANCE: Domestic mammals are significant contributors to the environmental contamination with Giardia cysts, emphasizing the importance of implementing good management practices and appropriate control measures. The widespread presence of Giardia in wildlife suggests that free-living animals can potentially act as sources of the infection to livestock and even humans through overlapping of sylvatic and domestic transmission cycles of the parasite.