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Review

The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010–2021 in Asia

by
Adedolapo Aminat Rauff-Adedotun
1,
Farah Haziqah Meor Termizi
1,
Nurshafarina Shaari
2 and
Ii Li Lee
2,*
1
School of Biological Sciences, Universiti Sains Malaysia, Kuala Lumpur 11800, Malaysia
2
Kulliyyah of Medicine & Health Sciences, Universiti Islam Antarabangsa Sultan Abdul Halim Mu’adzam Shah, Kuala Ketil 09300, Malaysia
*
Author to whom correspondence should be addressed.
Biology 2021, 10(10), 990; https://doi.org/10.3390/biology10100990
Submission received: 25 August 2021 / Revised: 22 September 2021 / Accepted: 24 September 2021 / Published: 30 September 2021
(This article belongs to the Special Issue Blastocystis in Health and Disease)
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Abstract

:

Simple Summary

Blastocystis spp. are unicellular parasites that infect the gastrointestinal tract of humans and animals. Their occurrence in the environment had been detected in water sources, thus causing contamination. The presence of the parasites in humans, animals and environmental sources in Asia were reviewed according to countries in Asia, different categories of human and animal populations, and environmental sources including water samples, food and ambient air. The coexistence of the parasites poses a public health concern as the parasites are commonly found in most studies. Hence, there is a growing interest in the study of Blastocystis spp. Due to the isolation of Blastocystis spp. from living and non-living sources, a collaborative, multisectoral and transdisciplinary approach known as One Health is proposed for future study of Blastocystis spp. in order to achieve optimal health outcomes through the recognition of interconnection between people, animals and their shared environment.

Abstract

Blastocystis spp. are controversial unicellular protists that inhabit the gastrointestinal tract of humans and a wide range of animals worldwide. This review provides an overview of the prevalence and distribution of Blastocystis spp. and their subtypes throughout Asia. Research articles reporting on the presence of Blastocystis spp. in locations within Asia, between 1 January 2010, and 10 May 2021, were obtained from Scopus, PubMed, and Google Scholar. In 427 articles, the prevalence of Blastocystis spp. in 31 countries within the last decade was revealed. Isolates were found in humans, various mammals, birds, reptiles, insects, water sources, vegetables, and ambient air. Prevalence of Blastocystis spp. varied widely across host categories. Subtypes identified throughout Asia were STs 1–14, and ST18–22 (novel subtypes). ST1, ST2, ST3, ST4 were the most frequently isolated in humans; ST5 in pigs; ST10 and ST14 in goats, sheep, and cattle; and ST6 and ST7 in chickens. ST1 and ST3 were most common in water samples. ST1, ST2, ST3, ST4, ST5 and ST6 were shared by humans, animals, and water sources. There is a growing interest in the study of Blastocystis spp. and their subtypes in Asia. Due to the isolation of Blastocystis spp. from biotic and abiotic sources in Asia, the application of the One Health (OH) approach to the study of Blastocystis spp. is proposed for improved perception of this organism.

Graphical Abstract

1. Introduction

Blastocystis spp. are anaerobic unicellular eukaryotes that are widespread among humans and animals around the world [1,2,3]. They reside in the gastrointestinal tract wherein their role in gut health and disease is unresolved [4]. Several attempts were made at the classification of Blastocystis spp. by means of physiological and morphological characteristics [5], however, its place as a member of the phylum stramenopiles was revealed by Silberman et al. [6] based on phylogenetic analysis of the small subunit ribosomal rRNA (SSU rRNA) gene.
Blastocystis spp. exhibit morphological and genetic polymorphism [7]. The six morphological forms described in the literature are vacuolar, granular, amoeboid, cyst, multivacuolar and avacuolar [8]; each of these forms show substantial variations in size [9]. Discerning one Blastocystis spp. isolate from another by morphological means alone poses a big challenge as isolates from different hosts appear similar [1].
Differences in the nucleotide sequences of the SSU rRNA gene of Blastocystis spp. isolates demonstrate the organism’s substantial genetic heterogeneity [10,11]. According to a consensus on the terminology of Blastocystis spp. subtypes proposed by Stensvold et al. [10], Blastocystis spp. isolates are referred to as Blastocystis spp. ‘subtypes’ (STs). These designations are based on the differences among the SSU rRNA gene sequences; and by 2013, 17 different STs (ST1 to ST17) of Blastocystis spp. had been acknowledged [11]. Eleven additional STs (ST18 to ST28) have been proposed since then, although the validity of four of these STs (ST18 to ST20, and ST22) are being contested [12]. Infections with Blastocystis spp. ST1 to ST9 and ST12 have been reported in humans [13,14]. All Blastocystis spp. STs have, however, been widely isolated from non-human hosts, with the exception of ST9, whose first identification in a non-human host was by Noradilah et al. [15] in chickens reared by aborigines of rural Malaysian communities.
Blastocystis spp. are transmitted through the fecal-oral route via the ingestion of feces-contaminated food and water, with the cyst form as the only transmissible form [9,14,16]. Molecular epidemiological studies have revealed possible human-to-human, foodborne, waterborne and zoonotic transmission [17,18,19,20,21,22,23,24,25,26,27]. For example, Eroglu and Koltas [19] reported the isolation of Blastocystis spp. subtype 1 from Blastocystis spp. positive patients, their pets and the tap water they drank from. Likewise, the presence of Blastocystis spp. subtype 4 in humans, the animals they reared and the rivers they visited regularly were observed in a rural community in Nepal by Lee et al. [18]. It is also worth mentioning that Blastocystis spp. are included as waterborne pathogens in the World Health Organization’s publications on drinking water quality [28], implying possible public health concerns.
Globally, increasing interactions between humans and animals (domestic, livestock, wildlife) at close proximity cannot be overemphasized. The rapid growth perceived in areas of agriculture, urbanization, industrialization, and international travel and trade have all contributed greatly to these interactions [29,30]. A human-animal-environment interface has emerged from the dynamic relationships between humans and animals; a clear understanding of the risks at this interface would allow better public health outcomes [29]. This is the One Health (OH) holistic approach, which considers health in the context of human, animal and environmental relationships [31]. It urges the use of interdisciplinary collaborative effort to attain optimal health for humans, animals, plants, and the environment. Bearing in mind that the role of Blastocystis spp. in the host gut, whether as mutualists, commensals, or pathogens, has yet to be ascertained [32]; the study of this organism from an ecological standpoint is required.
Studies abound on the prevalence of Blastocystis spp. from around the world revealing the various host groups and geographic distribution of this intestinal protist. The growing use of polymerase chain reaction (PCR)-based approaches has, equally, broadened the understanding of genetic diversity and transmission of Blastocystis spp. Over the last decade, Blastocystis spp. research in Asia has noticeably intensified. Rauff-Adedotun et al. [33] observed an increase in the studies of Blastocystis spp. infection in animals in Southeast Asia over the last decade. This research direction is deemed timely considering the role of agriculture, industrialization and globalization on the rapid economic growth that is taking place in the Asian region; as well as the resulting large and growing human and livestock populations, high levels of interspecies interaction, and large-scale ecological change.
This article serves as a summary of the prevalence of Blastocystis spp. and the distribution of its subtypes in humans, animals, environmental, and food sources across Asia in the last decade.

2. Materials and Methods

Articles on Blastocystis spp. research carried out within the continent of Asia were searched for in three electronic databases: Scopus, PubMed, and Google Scholar. The search covered articles published between 1 January 2010, and 10 May 2021. Duplicate articles from the three databases were removed; experiental studies, case reports, review articles, articles that did not report a positivity percentage and articles with unclear/confusing information were also excluded. Articles on the prevalence/occurrence and/or subtypes of Blastocystis spp. in both life and non-life sources undertaken within Asia were selected. The information extracted from each article included country of study, method(s) of detection of Blastocystis spp., host(s) of study, number of samples examined, number of samples positive, subtypes identified with corresponding numbers of isolates, author(s) and publication dates. Studies were retrieved on Blastocystis spp. in humans, various animal hosts, water sources, vegetables, and ambient air.
A total of 427 manuscripts met inclusion criteria, these studies were for 31 Asian countries/regions (Bangladesh, Cambodia, China, India, Indonesia, Iran, Iraq, Israel, Japan, Jordan, Korea, Laos, Lebanon, Malaysia, Myanmar, Nepal, Pakistan, Philippines, Qatar, Russia, Saudi Arabia, Singapore, Syria, Taiwan, Thailand, Turkey, Cyprus, United Arab Emirates, Uzbekistan, Vietnam, and Yemen). Blastocystis spp. have been identified in humans, different kinds of animals, leafy vegetables, water, and ambient air using conventional microscopy, in vitro cultivation, and molecular methods.

3. Blastocystis spp. Infection in Humans

Investigations on human Blastocystis spp. infections were on children, high school and college students, hospital patients/patients referred to medical laboratories for tests, patients with gastrointestinal disorder (GID) and other conditions, immunocompromised individuals, different categories of workers, and apparently healthy and general populations from urban and rural settings alike. Irrespective of these human host groups, Blastocystis spp. were the common organisms detected in studies describing gastrointestinal tract organisms in humans; and Blastocystis spp. ST1, ST2 and ST3 were the most frequently isolated.
The presence of Blastocystis spp. has been reported in infants, kindergarten, and school-aged children in Asia in the past ten years (Table 1). However, the participants were either asymptomatic or their clinical conditions were not available. The majority of the studies were from Iran, Thailand, Malaysia, Turkey, and Indonesia; prevalence rates reported ranged from 1.2% to 83.7%. Only about 24% of these studies reported on Blastocystis spp. subtypes. Subtypes identified were ST1, ST2, ST3, ST4, ST5, ST6 and ST7.
Prevalence and subtypes of Blastocystis spp. in immunocompromised individuals in Asia are summarized in Table 2. This category comprised mostly cancer, HIV/AIDS, and pulmonary tuberculosis patients. Reported prevalence rates were generally not above 30% except 54.8% in immunocompromised children with diarrhea in Indonesia, and 42.2% and 53.6% prevalence in HIV/AIDS cases and pulmonary tuberculosis patients respectively in Uzbekistan. Blastocystis spp. subtypes 1, 2, 3, 4, 5, and 7 were identified.
It is noted that hematologic and non-hematologic (cranial) cancers with Blastocystis spp. infections are most commonly reported in children [82,83,84,85]. Whereas, colorectal, stomach, esophagus and non-gastrointestinal cancer such as lung, liver, breast, ovarian, hematologic and other cancers were detected in adults. Among the 10 studies focused on cancer patients, six studies clearly stated that cancer patients were receiving chemotherapy treatment [82,83,84,85,87,88]. One study recruited cancer patients who have not received any chemotherapy [89]. While the remaining two were classified as follow-up cases [90] and in- or out-patient cases [91], respectively. It is noted that the highest prevalence of Blastocystis spp. infection in cancer patients is detected in those who have not received chemotherapy [89] as compared to the other six studies. This could be due to the existing immunocompromised condition of the cancer patients that allowed an opportunistic infection to occur.
Patients with different gastrointestinal complaints and disorders such as constipation, abdominal pain, diarrhea, irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) have been examined for Blastocystis spp. infection with positive results recorded as shown in Table 3. The prevalence rate was as low as 0.5%, with the highest being 67.1% and all isolates belonged to Blastocystis spp. subtypes 1, 2, 3, 4, 5, 6, and 7.
The occurrence of Blastocystis spp. in mental rehabilitation centers was documented by several authors from Iran only (Table 4). Prevalence ranged from 4% to 55.2%; and out of all nine of these studies, only one reported the use of molecular methods wherein ST1, ST3 and ST9 were identified.
Studies on the status of Blastocystis spp. infection in hospital in- and out-patients are shown in Table 5. The diseases/illnesses of these patients were, however, not stated in the reports. Nonetheless, they did not show any gastrointestinal-related symptoms and volunteered as healthy participants in the gastrointestinal studies. As a result of their involvement, though asymptomatic, they were detected positive for Blastocystis spp. infection. Infection rate as low as 0.02% was recorded in 23,278 Saudi Arabian patients, while all (100%) of 15 hospital patients without any gastrointestinal complaints were found positive for Blastocystis spp. Asides Blastocystis spp. subtypes 1, 2, and 3 which were the most commonly observed, STs 6 and 7 were also commonly identified while STs 4 and 5 were few.
Table 6 is a summary of Blastocystis spp. infection in students and working populations in Asia between 2010 and 2021.
Food handlers and immigrant workers were commonly screened in Iran and Qatar, respectively. In addition to Blastocystis spp. subtypes 1, 2, and 3; ST6 was isolated from chicken slaughterhouse staff in Lebanon [199], and ST5 in pig handlers in Thailand [214].
The majority of the studies on Blastocystis spp. infections in humans in Asia within 2010 and 2021 were on general populations of apparently healthy status; such participants comprised urban dwellers, rural dwellers, and healthy control for immunocompromised persons. As depicted in Table 7, low prevalence rates of less than 5% and rates as high as 50% were reported from the different countries where these studies were undertaken, and various techniques were used for the detection of this protist. Blastocystis spp. subtypes reported were STs1-7 and ST10, whose only record was from Lebanon.
The presence of Blastocystis spp. in various other human categories that do not quite fit into those discussed above is summarized in Table 8.

4. Blastocystis spp. Infection in Animals

In Asia, Blastocystis spp. infection have been documented in hoofed mammals (Table 9), carnivores (Table 10), non-human primates (NHPs) (Table 11), birds (Table 12), rodents (Table 13), reptiles (Table 14), insects and some other mammalian groups (Table 15).
The prevalence of Blastocystis spp., reported in the last ten years, varied widely among the ungulates. Infection was mostly reported in livestock animals such as cattle, goats, sheep and pigs. Blastocystis spp. ST10 and ST14 were the most frequently isolated from deer, alpacas, cattle, yaks, sheep and goats, while ST1 and ST5 were the most common in pigs.
Blastocystis spp. has been isolated from carnivores, both domestic and wild, in Asia. Prevalence ranged from 0.6% to 100%, with STs 1–8 and ST10 being identified. NHPs have been commonly described to harbor Blastocystis spp., with a reported prevalence reaching a 100%. Genetic analyses have recognized ST1, ST2, and ST3 as being the most common in this group of mammals. Interestingly, Blastocystis spp. ST9 was isolated from ring-tailed lemur from China [250].
Blastocystis spp. infections in birds have been reported. Prevalence varied widely, however, subtype identification revealed ST6, S7, ST8 as the most frequently isolated. The isolation of Blastocystis spp. ST9 in chicken in Malaysia [15] is peculiar. Diverse genera of rodents have been found as hosts to Blastocystis spp. Although STs 1, 3, 5, 7 and 13 have been reported, ST4 and ST17 were the most frequently identified.
A few studies have reported on the infection of reptiles with Blastocystis spp. with the highest sample size being 19. Prevalence ranged from 26.3% to 100%, no subtype has yet been mentioned. Although studies are still few, cockroaches have been found as hosts to Blastocystis spp. Two out of six studies have described infection to the subtype level, ST2 was identified in China [418] while ST3 was identified in Malaysia [438].
Other animals found as hosts to Blastocystis spp. are the gray kangaroo, red-necked wallaby, sugar glider, rabbit, and hedgehog.

5. Blastocystis spp. in Food and Environmental Sources

In the past decade, the presence of Blastocystis spp. has been reported in tap water, river water, seawater, wells, fishponds, wastewater, food and even ambient air in Asia. The prevalence rate ranged from 2.1% to 100% in the various water sources, and 2.8% to 10.2% in leafy vegetables (Table 16). The only study on Blastocystis spp. in ambient air reported a prevalence of 1.4%. Blastocystis spp. subtype identification is only available for water sources. STs 1, 2, 3, 4, 6, 8, 10 have so far been recorded from water samples; and although the prevalence of ST3 was highest, ST1 was the most widespread subtype.

6. Distribution of Blastocystis spp. by Country

From 2010 till now, the identification of Blastocystis spp. has been described for a total of 31 Asian countries. Out of these 31, genetic characterization and Blastocystis spp. subtype identification was available for 22 countries. Figure 1 reveals the distribution of the subtypes of Blastocystis spp. in these countries with a glimpse of subtypes shared by humans, animals, and water sources. Blastocystis spp. ST1 was the most widespread subtype, found in all of the 22 countries.

7. Discussion

Blastocystis spp. have been reported in over 50% of the countries in the continent of Asia. Although the most documented hosts to infection were humans and several animal species, this organism has also been detected in water sources, vegetables, and ambient air.
Variation of prevalence rates was seen within and between the various human host categories. Although authors have described both significant and insignificant differences between Blastocystis spp. infection in patients with and without known disease conditions, this variation could be a result of the methods employed in the detection of Blastocystis spp. Blastocystis spp. STs 1–7 have been identified in humans in Asia. ST1, ST2, ST3 and ST4 were more widespread and more frequently isolated than ST5, ST6 and ST7. This finding is in agreement with studies from other parts of the world [2,13,452,453].
The isolation of Blastocystis spp. STs 1–14, and ST18–22 (novel subtypes) were reported in animal hosts. ST1, ST2, ST3, ST4, ST5, ST6 and ST7 were found common to humans and animals. ST9 was observed in ring-tailed lemurs and chickens in China [250] and Malaysia [15] respectively; however, no article included in this review reported on the identification of ST9 in humans in these countries. The characteristic presence of ST5 in pigs, ST10 and ST14 in goats, sheep and cattle, and ST6 and ST7 in chickens underscore suggestions that these STs are specific to the respective animal hosts. Also, reports of isolation of ST5 in pig handlers [214] and ST6 in chicken slaughterhouse staff [199] are pointers to possible zoonotic transmission.
Where stated, cysts were the Blastocystis spp. forms observed in vegetables and water samples. The presence of cysts in the life cycle of Blastocystis spp. enable their existence outside of human and animal hosts; also, the chloroform-resistant nature of these cysts probably explains the presence of Blastocystis spp. even in treated water.

8. Conclusions

The growing interest in the study of Blastocystis spp. as an area of research is very obvious and fundamental to unraveling the much that is hitherto unknown of the epidemiology, biology and pathogenicity of this protist. Blastocystis spp. have been isolated from biotic and abiotic sources in Asia. Considering that humans and animals are in constant interactions with their environment, epidemiological studies of Blastocystis spp. from an ecological perspective are essential. In essence, continuous surveillance of human and animal hosts alongside their food and water sources and other possible sources of infection such as soil across different geographical locations and climatic conditions is needed. The use of molecular detection methods in epidemiological studies are recommended to provide information on Blastocystis spp. STs in as many regions as possible. Incorporating the One Health (OH) method into epidemiological studies will equip researchers and other stakeholders with information on the possible influence of ecosystems on Blastocystis spp., it will further elucidate transmission routes and provide clues required to break the transmission of this protist successfully. Morphological studies of Blastocystis spp. in various host species and environmental sources are insufficient but essential; electron microscopy could help to accentuate structural details of isolates from various hosts and the differences or similarities between them, and contribute to the understanding of a proper, more detailed Blastocystis spp. lifecycle.

Author Contributions

Conceptualization, I.L.L., F.H.M.T. and N.S.; writing-original draft preparation, A.A.R.-A.; writing-review and editing, I.L.L., F.H.M.T. and N.S.; All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by Short Term Grants of UniSHAMS (100–161(RMU)01/STG/2020 Bil. (62)).

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

All data generated or analyzed during this study are included in this published article.

Conflicts of Interest

The authors declare no conflict of interest.

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Biology 10 00990 g001 550
Figure 1. Distribution of Blastocystis spp. subtypes in Asia (2010–2021).
Figure 1. Distribution of Blastocystis spp. subtypes in Asia (2010–2021).
Biology 10 00990 g001
Table
Table 1. Prevalence and subtype distribution of Blastocystis spp. in children in Asia (2010–2021).
Table 1. Prevalence and subtype distribution of Blastocystis spp. in children in Asia (2010–2021).
CountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Bangladesh5679795 (14.0)NACM, 1VCBarua et al. [34]
Israel45,9785422 (11.8)NACM, IVCBen-Shimol et al. [35]
China1701 (0.5)NAMOLZhang et al. [36]
China60987 (14.3)ST1, ST2, ST3MOLQi et al. [37]
China46671 (15.2)ST1, ST3, ST6, ST7IVC, MOLNing et al. [38]
Cambodia30815 (4.9)NACMLiao et al. [39]
India19532 (16.4)NACNRayan et al. [40]
Indonesia492147 (29.9)ST1, ST2, ST3IVC, MOLYoshikawa et al. [41]
Indonesia9933 (33.3)ST1, ST2, ST3MOLZulfa et al. [42]
Indonesia14158 (41.1)ST1, ST3, ST4IVC, MOLSari et al. [43]
Indonesia21915 (6.8)NACMSubahar et al. [44]
Indonesia15744 (28.0)NACMSari et al. [45]
Iran124,3663986 (3.2)NACMAshtiani et al. [46]
Iran86436 (4.1)ST1, ST2, ST3CM, IVC, MOLNiaraki et al. [47]
Iran36611 (3.1)NACMMahmoudvand et al. [48]
Iran65037 (5.7)NACMAbdi et al. [49]
Iran1100149 (13.5)NACMDaryani et al. [50]
Iran35015 (4.3)NACMHazrati Tappeh et al. [51]
Iran85426 (3.0)NACMNorouzi et al. [52]
Iran20035 (17.5)NACMBabakhani et al. [53]
Iran40085 (21.3)NACMBahmani et al. [54]
Iran3069 (2.9)NACMSaki and Amraee [55]
Iran146531 (2.1)NACMTurki et al. [56]
Iraq1074 (3.7)NACMMahdi and Al-Saadoon [57]
Lebanon249157 (63.0)ST1, ST2, ST3MOLOsman et al. [58]
Malaysia7166 (93.0)NACMAbd. Ghani and Yusof [59]
Malaysia30077 (25.7)NAIVCAbdulsalam et al. [60]
Malaysia30765 (21.2)NACMAl-Harazi et al. [61]
Malaysia3424 (1.2)NACMSinniah et al. [62]
Malaysia1760186 (10.6)ST1, ST2, ST3, ST4, ST5IVC, MOLNithyamathi et al. [63]
Malaysia1162 (1.7)NACMTang and Kamel [64]
Malaysia9277 (83.7)NACMAdli et al. [65]
Nepal3424 (1.2)NACMMukhiya et al. [66]
Saudi Arabia128911 (0.9)NACMAl-Mohammed et al. [67]
Saudi Arabia58110 (1.7)NACMBakarman et al. [68]
Thailand2039 (4.4)NACMSuntaravitun and Dokmaikaw [69]
Thailand1909626 (32.8)NACMSanprasert et al. [70]
Thailand370118 (31.9)ST1, ST2, ST6MOLThathaisong et al. [71]
Thailand23329 (12.5)ST1, ST2, ST3IVC, MOLPipatsatitpong et al. [72]
Thailand29910 (3.3)NACMPunsawad et al. [73]
Thailand26346 (17.5)NACM, IVCAssavapongpaiboon et al. [74]
Thailand33144 (13.3)ST1, ST3IVC, MOLBoondit et al. [75]
Thailand2023 (1.5)NACMKitvatanachai and Rhongbutsri [76]
Thailand27437 (13.5)NACMPopruk et al. [77]
Turkey19528 (14.4)NACMGüdücüoğlu et al. [78]
Turkey32877 (23.5)NACMHamamci et al. [79]
Turkey46835 (7.4)ST1, ST2, ST3, ST7CM, IVC, MOLSankur et al. [80]
Turkey11817 (0.6)NACMCalik et al. [81]
Turkey21997 (44.3)ST1, ST2, ST3, ST4MOLDogan et al. [82]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 2. Prevalence and subtype distribution of Blastocystis spp. in immunocompromised individuals in Asia (2010–2021).
Table 2. Prevalence and subtype distribution of Blastocystis spp. in immunocompromised individuals in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Cancer patients (children)Iran5211 (21.2)NACMSalehi Kahish et al. [83]
Cancer patients (children)Iran20024 (12.0)ST1, ST2, ST3, ST7MOLAsghari et al. [84]
Cancer patients (children)Iran5211 (21.2)NACMSalehi Kahyesh et al. [85]
Cancer patients (children)Iran895 (5.6)NACMZabolinejad et al. [86]
Cancer patientsIran6716 (23.9)NACM, MOLMahmoudvand et al. [87]
Cancer patientsChina38127 (7.1)ST1, ST3MOLZhang et al. [88]
Cancer patientsMalaysia6113 (21.3)NAIVCChandramathi et al. [89]
Cancer patientsSaudi Arabia13838 (27.5)ST1, ST2, ST5MOLMohamed et al. [90]
Cancer patientsTurkey23225 (10.8)ST1, ST2, ST3CM, IVC, MOLYersal et al. [91]
Cancer patientsTurkey20129 (14.4)ST1, ST2, ST3CM, MOLMulayim et al. [92]
HIV/AIDS casesChina32412 (3.7)ST1, ST3, ST4, ST7, ST12MOLTeng et al. [93]
HIV/AIDS casesChina720154 (21.4)NAIVCTian et al. [94]
HIV/AIDS casesChina30249 (16.2)NAIVCTian et al. [95]
HIV/AIDS casesChina7911 (13.9)NAIVCTian et al. [96]
H IV/AIDS casesChina39827 (6.8)NAMOLZhang et al. [97]
HIV/AIDS casesChina31112 (3.9)ST1, ST3, ST4, ST7MOLZhang et al. [98]
HIV/AIDS casesChina50521 (4.2)NAMOLZhu-Hua et al. [99]
HIV/AIDS casesIndia45213 (2.9)NACMRamana et al. [100]
HIV/AIDS casesIndia20014 (7.0)NACMKhalil et al. [101]
HIV/AIDS casesIran317 (22.6)NACMBerenji et al. [102]
HIV/AIDS casesIran6010 (16.7)NACMYosefi et al. [103]
HIV/AIDS casesIran35614 (3.9)NACMAgholi et al. [104]
HIV/AIDS casesIran1022 (1.9)NACMMasoumi-Asl et al. [105]
HIV/AIDS casesIran732 (2.7)NACMAnvari-Tafti et al. [106]
HIV/AIDS casesIran26851 (19.0)ST1, ST2, ST3, ST4MOLPiranshahi et al. [107]
HIV/AIDS casesLaos13736 (26.3)NACMPaboriboune et al. [108]
HIV/AIDS casesNepal1469 (6.2)NACMSherchan et al. 2012 [109]
HIV/AIDS casesNepal1121 (0.9)NACMGhimire et al. [110]
HIV/AIDS casesTurkey657 (10.8)NACMZorbozan et al. [111]
HIV/AIDS casesUzbekistan500211 (42.2)NA Davis et al. [112]
TuberculosisIran16119 (11.8)ST1, ST2, ST3CM, MOLTaghipour et al. [113]
TuberculosisIran16119 (11.8)NACMTaghipour et al. [114]
Pulmonary tuberculosisUzbekistan300161 (53.6)NA Davis et al. [112]
Pulmonary tuberculosisChina36923 (6.2)NACM, 1VCLi et al. [115]
Pulmonary tuberculosisChina36923 (6.2)NACM, 1VCLi et al. [116]
pulmonary tuberculosisIran509 (18.0)NACMTaghipour et al. [117]
Renal transplant recipientsIran1507 (4.7)NACMAzami et al. [118]
Immunocompromised children with diarrheaIndonesia4223 (54.8)NAIVCIdris et al. [119]
Immunocompromised children with diarrheaTurkey626 (9.7)NACMCaner et al. [120]
Immunocompromised patientsIran26511 (4.2)NACMRasti et al. [121]
Immunocompromised patientsIran20462 (30.4)NACMIzadi et al. [122]
Immunodeficient patientsIran19032 (16.8)NACMEsteghamati et al. [123]
Immunosuppressive drugs recipientIran49449 (10.3)NACMMirzaei et al. [124]
Immunocompromised patientsSaudi Arabia1367 (5.2)NACMAl-Megrin et al. [125]
Common variable immune deficiency (CVID) syndrome patientsTurkey373 (8.1)NACMUysal et al. [126]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 3. Prevalence and subtype distribution of Blastocystis spp. in humans with gastrointestinal symptoms in Asia (2010–2021).
Table 3. Prevalence and subtype distribution of Blastocystis spp. in humans with gastrointestinal symptoms in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Children with diarrheaChina85026 (3.1)NAMOLZhang et al. [36]
Children with diarrheaIndonesia5736 (63.1)ST1, ST2, ST3, ST4MOLZulfa et al. [42]
Children with diarrheaTurkey604 (6.7)NACMMaçin et al. [127]
Children with diarrheaIran4008 (2.0)NACMAsadi et al. [128]
Children with diarrheaQatar58027 (4.7)NAMOLBoughattas et al. [129]
Children with diarrheaNepal5885 (0.9)NACMDahal et al. [130]
Children with diarrheaIran16037 (23.1)NACMKhalili et al. [131]
Children with GIDIran50081 (16.2)NACMKiani et al. [132]
Children with GIDThailand8213 (15.9)NACM, IVCAwae et al. [133]
Children with GIDRussia127362 (4.9)ST1, ST2, ST3, ST4, ST7CM, MOLSigidaev et al. [134]
Children with GIDTurkey8418 (21.4)ST1, ST3, ST4MOLDogan et al. [82]
Patients with diarrheaIndonesia38922 (5.7)NACMOyofo et al. [135]
Patients with diarrheaChina27113 (4.8)NAMOLZhang et al. [136]
Patients with diarrheaKorea1178 (6.8)NAMOLWon et al. [137]
Patients with diarrheaIran13428 (20.9)ST1, ST2, ST3CM, MOLJalallou et al. [138]
Patients with diarrheaIran20231357 (67.1)NACMNajafi et al. [139]
Patients with GIDIran1301350 (26.9)NACMKiani et al. [140]
Patients with GIDIran28765 (22.7)ST1, ST2, ST3, ST5IVC, MOLMoosavi et al. [141]
Patients with GIDIran23*23ST1CM, MOLShahbazi et al. [142]
IBD patientsIran719 (12.7)ST1, ST3IVC, MOLMirjalali et al. [143]
Adolescents with IBSIndonesia13750 (36.5)ST1, ST2, ST3MOLKesuma et al. [144]
IBS patientsIndia15050 (33.3)ST1, ST3CM, IVC, MOLDas et al. [145]
IBS patientsIran10015 (15.0)NACMShafiei et al. [146]
IBS patientsIran12224 (19.7)ST1, ST3, ST4, ST5MOLKhademvatan et al. [147]
IBS patientsIraq7838 (48.7)NACM, IVCSayal et al. [148]
IBS patientsThailand6611 (16.7)NAIVCSurangsrirat et al. [149]
Patients with GIDIraq57998 (16.9)NACM, IVCMerza et al. [150]
Patients with GIDIraq24992 (36.9)NACMMutlag et al. [151]
Patients with GIDThailand55 (100.0)ST3, ST6, ST7CM, IVC, MOLSanpool et al. [152]
Patients with diarrheaTurkey27216 (5.9)NACM, MOLKoltas et al. [153]
Patients with GIDTurkey49089 (18.2)NACM, IVCAykur et al. [154]
Patients with GIDTurkey14,246689 (4.8)NACMUsluca et al. [155]
Patients with GIDTurkey2334134 (5.7)NACMCekin et al. [156]
Patients with GIDIran15216 (10.5)ST1, ST2, ST3CM, IVC, MOLBeiromvand et al. [157]
Patients with diarrheaSingapore1931 (0.5)NACM, MOLFeurle et al. [158]
Patients with GIDSaudi Arabia11415 (13.2)NACMHawash et al. [159]
Patients with GIDTurkey5624136 (2.4)NACMAlver et al. [160]
Patients with GIDTurkey17756778 (4.4)NACMİnceboz et al. [161]
Patients with GIDIran67038 (5.7)NAIVCRostami Nejad et al. [162]
Patients with GIDPakistan33959 (17.4)NACMHaider et al. [163]
Patients with GIDTurkey29 *29ST1, ST2, ST3, ST4CM, MOLSakalar et al. [164]
* Study was carried out on Blastocystis sp. positive hosts, CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable, GID—Gastrointestinal disorder, IBD—Inflammatory bowel disease, IBS—Irritable bowel syndrome.
Table
Table 4. Prevalence and subtype distribution of Blastocystis spp. in mental rehabilitation centers in Asia (2010–2021).
Table 4. Prevalence and subtype distribution of Blastocystis spp. in mental rehabilitation centers in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Mentally disabled childrenIran36220 (5.5)NACMSharif et al. [165]
Mentally disabled children and adultsIran2259 (4.0)NACMHazrati Tappeh et al. [166]
Psychiatric patientsIran6515 (23.1)NACMKhalili et al. [167]
Mentally disabled individualsIran17329 (16.8)NACMSaeidinia et al. [168]
Mentally disabled individualsIran13312 (9.0)NACMShokri et al. [169]
Mentally disabled individuals and elderly peopleIran24381 (33.3)NACMRasti et al. [170]
Mentally disabled individualsIran12638 (30.2)NACMMohammadi-Meskin et al. [171]
Mental retardation center personnelIran3712 (32.4)NACMMohammadi-Meskin et al. [171]
Schizophrenic male patientsIran5832 (55.2)ST1, ST3, ST9CM, MOLSheikh et al. [172]
CM—Conventional microscopy, MOL—Molecular technique, NA—Not applicable.
Table
Table 5. Prevalence and subtype distribution of Blastocystis spp. in patients of health institutions in Asia (2010–2021) who volunteered in gastrointestinal studies.
Table 5. Prevalence and subtype distribution of Blastocystis spp. in patients of health institutions in Asia (2010–2021) who volunteered in gastrointestinal studies.
CountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
China1263 (2.4)ST5MOLZhu et al. [173]
China19821 (10.6)ST1, ST3, ST6, ST7MOLKang et al. [174]
Iran67023 (3.4)NAIVCRostami Nejad et al. [162]
Iran1232154 (12.6)NACMAbdipour et al. [175]
Iran1383239 (17.3)ST1, ST2, ST3CM, MOLBahrami et al. [176]
Iran98413 (1.3)NACMGholipoor et al. [177]
Iran41739 (9.4)NACMViesy et al. [178]
Iran51133 (6.5)ST2, ST3, ST5MOLBadparva et al. [179]
Iran42060 (14.3)ST2, ST3CM, MOLShaker et al. [180]
Iran80239 (4.9)ST1, ST2, ST3, ST7MOLHaghighi et al. [181]
Iran42060 (14.3)NACMShaker et al. [182]
Iran112065 (5.8)NACMTork et al. [183]
Iran4788247 (5.2)NACMAsfaram et al. [184]
Iran21066 (31.4)ST1, ST2, ST3, ST4, ST5, ST6MOLBafghi et al. [185]
Iran13335 (26.3)ST1, ST2, ST3, ST5IVC, MOLMoosavi et al. [141]
Iran4427407 (9.2)NA Karimazar et al. [186]
Iraq300146 (48.7)NACMAbdul Ridha and Faieq, [187]
Iran618146 (23.6)ST1, ST2, ST3CM, IVC, MOLSalehi et al. [188]
Iran48169 (14.4)ST1, ST2, ST3, ST4, ST5MOLKhademvatan et al. [189]
Iran25041 (16.4)ST1, ST2, ST3CM, IVC, MOLSardarian et al. [190]
Iran20063 (31.5)NACM, IVCHamidi et al. [191]
Iran5000784 (1.6)NACMJavadi et al. [192]
Iran86468 (7.9)ST1, ST2, ST3CM, IVC, MOLDelshad et al. [193]
Iran56610 (1.8)NACMNorouzi et al. [194]
Iran10013 (13.0)ST1, ST2, ST6CM, MOLSharifi et al. [195]
Iran1878152 (8.1)ST1, ST2, ST3, ST7CM, MOLSalehi et al. [196]
Lebanon4023 (57.5)ST1, ST2, ST3MOLGreige et al. [197]
Lebanon22042 (19.1)ST1, ST2, ST3, ST4CM, MOLEl Safadi et al. [198]
Lebanon5027 (54.0)ST1, ST2, ST3MOLGreige et al. [199]
Saudi Arabia23,2785 (0.02)NACMImam et al. [200]
Saudi Arabia1303 (2.3)NACMHassen Amer et al. [201]
Saudi Arabia1262133 (10.5)ST1, ST2, ST3IVC, MOLMohamed et al. [202]
Thailand14,325199 (1.4)NACMLaodim et al. [203]
Thailand56256 (9.9)ST1, ST3, ST6, ST7IVC, MOLJantermtor et al. [204]
Thailand1515 (100.0)ST1, ST3, ST6, ST7CM, IVC, MOLSanpool et al. [152]
Turkey1926 (3.1)NACMCekin et al. [156]
Turkey20,94813,245 (63.2)NACMPolat et al. [205]
Turkey50,185275 (0.5)NACMBeyhan et al. [206]
Turkey4030476 (11.1)ST1, ST2, ST3CM, MOLSarzhanov et al. [207]
Turkey6757160 (2.4)NACMSelek et al. [208]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 6. Prevalence and subtype distribution of Blastocystis spp. in students and working populations in Asia (2010–2021).
Table 6. Prevalence and subtype distribution of Blastocystis spp. in students and working populations in Asia (2010–2021).
HostCountry/RegionNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
AdolescentsIndonesia7020 (28.6)ST1, ST3MOLKesuma et al. [144]
High school students foreignTurkey19263 (32.8)NA Yaman et al. [209]
College studentsChina53 *53ST1, ST3, ST4, ST6, ST7IVC, MOLZhan et al. [210]
College students of practical parasitology coursesIran1759 (5.1)NACMFallahi et al. [211]
Students who did not take any practical parasitology coursesIran1355 (3.7)NACMFallahi et al. [211]
University studentsThailand1025416 (40.6)ST1, ST2, ST3CM, IVC, MOLSrichaipon et al. [212]
Working childrenIran17557 (32.6)NACMSalemi et al. [213]
Caregivers in a childcare centerThailand256 (24.0)ST1, ST2, ST3IVC, MOLPipatsatitpong et al. [72]
Cattle breedersLebanon4021 (52.5)ST1, ST2, ST3MOLGreige et al. [197]
Chicken slaughterhouse staffLebanon5028 (56.0)ST1, ST2, ST3, ST6MOLGreige et al. [199]
Pig handler and individuals who lived near pig farmsThailand15410 (6.5)ST1, ST3, ST5MOLPintong et al. [214]
Pig handler and individuals who lived near pig farmsThailand11715 (12.8)ST1, ST2, ST3MOLUdonsom et al. [215]
Food handlersIran2103 (1.4)NACMKheirandish et al. [216]
Food handlersIran102140 (3.9)NACMMotazedian et al. [217]
Food handlersIran104129 (2.8)NACMSharif et al. [218]
Food handlersIran800194 (24.3)NACMHeydari-Hengami et al. [219]
Food handlersIran10187 (7.2)NACMKhodabakhsh Arbat et al. [220]
Food handlersIran153044 (2.9)NACMShahnazi et al. [221]
food handlersIran81618 (2.2)NACMKheirandish et al. [222]
Food handlersJordan9016 (0.7)NACMAbdel-Dayem et al. [223]
Military personnelIraq43736 (8.2)NACMDowns et al. [224]
GardenersThailand25323 (9.1)NACMKitvatanachai and Rhongbutsri, [225]
Immigrant workersThailand6006 (1.0)NACMSangwalee et al. [226]
Immigrant workersQatar608432 (71.1)ST1, ST2, ST3MOLAbu-Madi et al. [227]
Immigrant workersQatar735479 (65.2)NACM, MOLAbu-Madi et al. [228]
Settled immigrantQatar9208398 (4.3)NACMAbu-Madi et al. [229]
Newly arrived immigrantsQatar2486137 (5.5)NAMOLAbu-Madi et al. [230]
Settled immigrantsQatar29,2861010 (3.5)NAMOLAbu-Madi et al. [231]
Resident workersQatar77239 (5.1)NACMAbu-Madi et al. [232]
WorkersSaudi Arabia1238245 (19.8)NACMWakid [233]
New employees in a tertiary health care centerSaudi Arabia2490314 (12.6)NA Ahmed et al. [234]
Foreign laborersTaiwan7360190 (2.6)NACMHsieh et al. [235]
ForeignersTaiwan287533 (1.1)NACMHsieh et al. [236]
Indonesian immigrant workersTaiwan12828 (21.9)ST1, ST2, ST3CM, MOLChen et al. [237]
Sanitary and Non-sanitary Institutions’ workersTurkey2443175 (7.2)NACMKaraman et al. [238]
Migrant workersMalaysia22068 (30.9)ST1, ST2, ST3IVC, MOLSahimin et al. [239]
* Study was carried out on Blastocystis spp. positive hosts, CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 7. Prevalence and subtype distribution of Blastocystis spp. in apparently healthy general populations in Asia (2010–2021).
Table 7. Prevalence and subtype distribution of Blastocystis spp. in apparently healthy general populations in Asia (2010–2021).
CountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Bangladesh14051 (36.4)NACMNoor et al. [240]
Cambodia21840 (18.4)NACMSchär et al. [241]
Cambodia210116 (55.2)ST1, ST2, ST3MOLWang et al. [242]
China497215 (43.3)NACMHe et al. [243]
China5939494 (8.3)NAMOLChen et al. [244]
China26,8862 (0.01)NACMUmar et al. [245]
China10231 (0.1)NACMJiang [246]
China671019 (0.3)NACMZhang et al. [247]
China30367 (22.1)NAIVCTian et al. [95]
China29464 (21.8)NAIVCTian et al. [96]
China1499 (6.0)NAMOLZhang et al. [136]
China36628 (7.6)NACM, 1VCLi et al. [115]
China28913 (4.5)ST1, ST3, ST4MOLGong et al. [248]
China50748 (9.5)ST1, ST2, ST3, ST4MOLDeng et al. [249]
China1118390 (34.9)ST2, ST5MOLMa et al. [250]
Cyprus23064 (27.8)ST1, ST2, ST3, ST4, ST6, ST7MOLSeyer et al. [251]
India279105 (37.6)NAMOLPadukone et al. [252]
India20016 (8.0)NACMKhalil et al. [101]
India10015 (15.0)ST1, ST3CM, IVC, MOLDas et al. [145]
India2313 (56.5)NAMOLLappan et al. [253]
Indonesia64615 (2.3)NACMWiria et al. [254]
Indonesia545 (9.3)NAIVCYulfi et al. [255]
Indonesia424146 (34.4)NACMSungkar et al. [256]
Indonesia539 (17.0)NACMHayashi et al. [257]
Iran5073368 (7.3)NACMTurgay et al. [258]
Iran39916 (4.0)NACMMahmoudi et al. [259]
Iran13040 (30.1)ST1, ST2, ST3CM, IVC, MOLBeiromvand et al. [157]
Iran203 (15.0)NACMBerenji et al. [102]
Iran16635 (21.1)ST1, ST2, ST3IVC, MOLMirjalali et al. [143]
Iran18117 (9.4)NACMTaghipour et al. [114]
Iran2255 (2.2)NACMAzami et al. [118]
Iran16635 (21.1)ST1, ST2, ST3CM, MOLJalallou et al. [138]
Iran1470 (0.0)NACMAnvari-Tafti et al. [106]
Iran12221 (17.2)ST1, ST3, ST4, ST5MOLKhademvatan et al. [147]
Iran1006 (6.0)NACMShafiei et al. [146]
Iran676 (9.0)NACM, MOLMahmoudvand et al. [87]
Iran25041 (16.4)ST1, ST2, ST3CM, IVC, MOLSardarian et al. [190]
Iran141047 (3.3)ST3, ST4, ST5, ST7CM, MOLKhoshnood et al. [260]
Iran655180 (27.5)NACMPestehchian et al. [261]
Iran574354 (0.9)NACMSadeghi et al. [262]
Iran573930 (0.5)NACMSadeghi and Borji [263]
Iran2838139 (5.0)NACMBadparva et al. 2014 [264]
Iran1060145 (13.7)NACMMahni et al. [265]
Iran88055 (6.3)NACMTork et al. [266]
Iran65248 (7.4)NACMJafari et al. [267]
Iran561159 (28.4)NACMHemmati et al. [268]
Iran55493 (16.8)NACM, IVCRiabi et al. [269]
Iran34585 (24.6)ST1, ST2, ST3CM, IVC, MOLMardani Kataki et al. [270]
Iran861114 (13.2)NACMAbbaszadeh Afshar et al. [271]
Iran73263 (6.3)NACMSobati [272]
Iran18445 (24.5)ST1, ST2, ST3MOLShirvani et al.[273]
Iran28320 (7.1)NACMBarati et al.[274]
Iran2838129 (4.5)NACMBadparva et al. [264]
Iran565144 (25.5)NACMBairami Kuzehkanani et al. [275]
Iran1025182 (17.8)NACMSarkari et al. [276]
Iran150013 (0.9)NACMSharifdini et al. [277]
Iran4788277 (5.8)NACMPagheh et al. [278]
Iran100846 (4.6)NACMBeiromvand et al. [279]
Iran228081 (3.6)NACMTaherkhani et al. [280]
Iraq781 (1.3)NACM, IVCSayal et al. [148]
Korea32429 (9.0)ST1, ST2, ST3MOLKim et al. [281]
Laos66991 (13.6)NACMSayasone et al. [282]
Laos30545 (14.8)NACMRibas et al. [283]
Laos6032 (51.7)ST1, ST2, ST3, ST7CM, IVC, MOLSanpool et al. [284]
Lebanon7477178 (2.3)NACMAraj et al. [285]
Lebanon306195 (63.7)ST1, ST2, ST3, ST10MOLKhaled et al. [286]
Malaysia774 (5.2)NACMSinniah et al. [287]
Malaysia500102 (20.4)NACMAnuar et al. [17]
Malaysia24345 (18.5)ST1, ST2, ST3MOLMohammad et al. [288]
Malaysia466191 (41.0)NACM, IVC, MOLNoradilah et al. [289]
Malaysia253103 (40.7)NAIVCMohammad et al. [290]
Malaysia473191 (40.4)ST1, ST2, ST3, ST4MOLNoradilah et al. [291]
Malaysia466191 (41.0)NACM, IVC, MOLNoradilah et al. [292]
Malaysia25345 (17.8)ST1, ST2, ST3MOLMohammad et al. [293]
Malaysia41618 (4.3)NACMMuslim et al. [294]
Myanmar17216 (9.3)ST1, ST3, ST4MOLGong et al. [248]
Nepal24163 (26.1)ST1, ST2, ST4IVC, MOLLee et al. [295]
Philippines11036 (32.7)NAIVCSantos and Rivera [296]
Philippines1271166 (13.0)ST1, ST2, ST3, ST4, ST5IVC, MOLBelleza et al. [297]
Philippines3529 (82.9)ST1, ST3, ST4MOLAdao et al. [298]
Philippines1271165 (13.0)NAIVCBelleza et al. [299]
Philippines412242 (58.7)NAMOLWeerakoon et al. [300]
Saudi Arabia14096 (68.6)NACMAlDahhasi et al. [301]
Saudi Arabia8012 (15.0)ST1, ST2, ST5MOLMohamed et al. [90]
Saudi Arabia504 (8.0)NACMHawash et al. [302]
Saudi Arabia902 (2.2)NACMHawash et al. [159]
Saudi Arabia795131 (16.5)NACMAlqumber [303]
Saudi Arabia795209 (26.3)NACMAlqumber [303]
Thailand2491 (0.4)NACMKaewpitoon et al. [304]
Thailand606 (10.0)NAIVCSurangsrirat et al. [149]
Thailand47558 (12.2)NACM, IVCKaewjai et al. [305]
Thailand23025 (10.8)ST1, ST3, ST4MOLPopruk et al. [306]
Thailand104729 (2.8)NACMPrommi et al. [307]
Thailand17841 (23.0)ST1, ST2 ST3, ST4, ST6, ST7MOLYowang et al. [308]
Thailand32413 (4.0)NACMPunsawad et al. [309]
Thailand22013 (5.9)ST2, ST3, ST6MOLPalasuwan et al. [310]
Thailand2472 (0.8)NACMKitvatanachai et al. [311]
Thailand2534 (1.6)NACMBoonjaraspinyo et al. [312]
Thailand2241 (0.4)NACMSuntaravitun and Dokmaikaw [313]
Thailand73357 (7.8)NAIVCWongthamarin et al. [314]
Thailand20777 (37.2)ST1, ST2, ST3, ST4MOLPopruk et al. [315]
Turkey304 (13.0)NACM, MOLKarasartova et al. [316]
Turkey15016 (10.7)NACMKaradag et al. [317]
Turkey10530 (28.6)NAIVCDogruman-Al et al. [318]
Turkey27,664581 (2.1)NACMKoksal et al. [319]
Turkey17630 (17.0)NACMAlver et al. [160]
Turkey16,4452602 (15.8)NACMÇetinkaya et al. [320]
Turkey17,7111353 (7.6)NACMDüzyol et al. [321]
Turkey25154 (21.5)NACMKurt et al. [322]
Turkey6267968 (15.4)NACMYılmaz et al. [323]
Turkey87,100640 (0.7)NA Gülmez et al. [324]
Turkey111,889306 (0.3)NACMKirkoyun Uysal et al. [325]
Turkey73531884 (63.6)NACMÖncel [326]
Turkey20093 (46.5)ST1, ST2, ST3, ST7MOLMalatyalı et al. [327]
Turkey69,63318,460 (26.5)NACMTaş Cengiz et al. [328]
Turkey10410 (9.6)ST1, ST2, ST3, ST6MOLGulhan et al. [329]
Turkey5628 (50.0)ST1, ST2, ST3, ST4, ST5, ST6, ST7MOLKoltas and Eroglu [330]
United Arab Emirates13359 (44.4)ST1, ST2, ST3MOLAbuOdeh et al. [331]
Uzbekistan30031 (10.3)NACMToychiev et al. [332]
Uzbekistan55099 (18.0)NACMDavis et al. [112]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 8. Prevalence and subtype distribution of Blastocystis spp. in various human categories in Asia (2010–2021).
Table 8. Prevalence and subtype distribution of Blastocystis spp. in various human categories in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Acute appendicitis patientsTurkey1368 (5.9)NACMHatipoğlu et al. [333]
Adult male prison inmatesMalaysia29443 (14.6)ST1, ST3, ST6CM, IVC, MOLAngal et al. [334]
Adults with intestinal parasitic infectionMalaysia3517 (48.0)NAIVCChandramathi et al. [335]
Asymptomatic Blastocystis positive patientsIran25 *25ST1, ST2, ST3, ST7MOLRezaei Riabi et al. [336]
Asymptomatic Blastocystis positive patientsIran34 *34ST2, ST3CM, MOLShahbazi et al. [142]
Chronic spontaneous urticaria (adults)Turkey387 (18.4)NACMVezir et al. [337]
Chronic spontaneous urticaria (children)Turkey7613 (17.1)NACMVezir et al. [337]
Urticarial patientsTurkey13316 (12.0)ST1, ST2, ST3CM, MOLAydin et al. [338]
Cirrhotic patientsTurkey378 (21.6)ST1, ST2, ST3MOLYildiz et al. [339]
Diarrheic and non-diarrheic patientsIran40058 (14.5)ST1, ST2, ST3IVC, MOLAlinaghizade et al. [340]
Dengue patientsMalaysia8921 (23.6)ST1, ST3, ST4, ST6IVC, MOLThergarajan et al. [341]
Dialysis patientsTurkey14234 (23.9)NACMKaradag et al. [317]
Giardia intestinalis positive patientsIndia25821 (8.1)NACMRoy et al. [342]
Hemodialysis patientsIran888 (9.0)NACMBarazesh et al. [343]
Immunocompromised and controlIran64157 (8.9)NACMMahmoudi et al. [259]
Orphanage (orphansand childcare workers)Thailand34394 (27.4)NACM, IVCPipatsatitpong et al. [344]
Patients suspected to have intestinalparasitesTurkey91838 (4.2)NACMKoltas et al. [345]
Patients with chronic renal failureSaudi Arabia508 (16.0)NACMHawash et al. [302]
Patients with chronic viral Hepatitis CRussia327108 (33.0)ST3, ST5, ST6CM, MOLSigidaev et al. [134]
Patients with Erythema NodosumTurkey812 (2.5)NA Ozbagcivan et al. [346]
Patients with gastrointestinal and/or dermatologic symptomsTurkey37,1082537 (6.8)NACMTunalı et al. [347]
Patients with intestinal protozoan infectionsIran755 (6.7)NACMJafari et al. [348]
Patients with systemic lupus erythematosus (SLE)Malaysia1871 (0.5)NAnot statedTeh et al. 2018 [349]
Post-traumatic splenectomized patientsTurkey3012 (40.0)ST1, ST3CM, MOLKarasartova et al. [316]
Pregnant womenTurkey10014 (14.0)ST1, ST2, ST3CM, IVC, MOLMalatyalı et al. [350]
Symptomatic Blastocystis positive patientsIran30 *30ST1, ST2, ST3, ST6MOLRezaei Riabi et al. [336]
Ulcerative colitis patients with refractory symptomsChina496 (12.2)NACMTai et al. [351]
Ulcerative colitis patients responsive to treatmentChina731 (1.4)NACMTai et al. [351]
Visceral Leishmaniasis casesIndia2314 (60.9)NAMOLLappan et al. [253]
* Study was carried out on Blastocystis spp. positive hosts, CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 9. Prevalence and subtype distribution of Blastocystis spp. in ungulates in Asia (2010–2021).
Table 9. Prevalence and subtype distribution of Blastocystis spp. in ungulates in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Artiodactyla
AlpacaChina1412 (85.7)ST10, ST14, ST18MOLZhao et al. [352]
AlpacaChina274 (14.8)ST10, ST14MOLLi et al. [353]
AlpacaChina36687 (23.8)ST5, ST10, ST14MOLMa et al. [354]
AlpacaChina114 (36.4)ST10, ST14MOLDeng et al. [3]
BlesbuckChina21 (50.0)ST5MOLLi et al. [353]
BuffaloIndia11 (100.0)NACMSreekumar et al. [355]
BuffaloNepal194 (21.1)ST4IVC, MOLLee et al. [18]
BushbuckChina188 (61.5)ST10, ST14MOLZhao et al. [352]
CamelChina105 (50.0)ST1, ST10MOLZhao et al. [352]
CamelChina4014 (35.0)ST2, ST10, ST14MOLZhang et al. [14]
CattleLebanon254161 (63.4)ST1, ST2, ST3, ST5, ST7, ST10, ST14MOLGreige et al. [197]
CattleMalaysia2910 (34.5)NAIVCHemalatha et al. [356]
CattleMalaysia31 (33.3)ST10MOLMohammad et al. [288]
CattleMalaysia1106 (5.4)NAIVCAbd Razak et al. [357]
CattleMalaysia8035 (43.8)ST1, ST3, ST4, ST5, ST10, ST14MOLKamaruddin et al. [358]
CattleNepal61 (16.7)UnknownIVC, MOLLee et al. [18]
CattleThailand4221 (50.0)ST10, ST12MOLUdonsom et al. [215]
CattleTurkey809 (11.3)ST10, ST14MOLAynur et al. [359]
CattleIndonesia50072 (14.4)NACMHastutiek et al. [360]
CattleIndonesia100100 (100.0)NACMSusana et al. [361]
CattleIndonesia108108 (100.0)ST10CM, IVC, MOLSuwanti et al. [362]
CattleIran19819 (9.6)ST3, ST5, ST6MOLBadparva et al. [363]
CattleIran7525 (33.3)ST5, ST10CM, MOLSharifi et al. [195]
CattleIran4014 (35.0)ST3, ST10, ST14CM, MOLRostami et al. [364]
CattleJapan13372 (54.1)ST10, ST14MOLMasuda et al. [365]
CattleChina52654 (10.3)ST4, ST5, ST10, ST14MOLZhu et al. [366]
CattleChina14714 (9.5)ST3, ST10, ST14MOLWang et al. [367]
CattleChina5715 (26.3)ST10, ST14MOLZhang et al. [14]
CattleKorea1512101 (6.7)ST1, ST5, ST10, ST14MOLLee et al. [368]
CattleUnited Arab Emirates225 (22.7)ST10MOLAbuOdeh et al. [369]
Deer (Caspian red deer)Iran11 (100.0)NACMMirzapour et al. [370]
Deer (Javan rusa)Malaysia5014 (28.0)ST10MOLMohammad et al. [371]
Deer (Mousedeer)Malaysia41 (25.0)Unknown (Clade IV)IVC, MOLMohd Zain et al. [372]
Deer (Sambar deer)Malaysia144 (28.6)NAIVCHemalatha et al. [356]
Deer (Sika deer)Malaysia5016 (32.0)ST10MOLMohammad et al. [371]
Deer (Red deer)China52 (40.0)ST10MOLLi et al. [353]
Deer (Red deer/Wapiti)China31 (33.3)ST10MOLZhao et al. [352]
Deer (Reindeer)China1047 (6.7)ST10, ST13MOLWang et al. [373]
Deer (Fallow deer)China21 (50.0)ST10MOLZhao et al. [352]
Deer (White-lipped deer)China11 (100.0)ST10MOLZhao et al. [352]
Deer (Sika deer)China83 (37.5)ST10MOLZhao et al. [352]
Deer (Sika deer)China8212 (14.6)ST10, ST14MOLWang et al. [373]
Deer (Sika deer)China111 (9.1)ST1MOLDeng et al. [3]
Deer (Sika deer)China7606 (0.8)ST10, ST14MOLNi et al. [374]
Deer (Spotted deer)Bangladesh301 (3.3)ST14MOLLi et al. [375]
Deer (Water deer)Korea12551 (40.8)ST4, ST14MOLKim et al. [376]
ElandChina96 (66.7)ST10, ST14MOLZhao et al. [352]
GayalBangladesh41 (25.0)ST14MOLLi et al. [375]
GiraffeChina102 (20.0)ST12MOLZhao et al. [352]
GoatChina789458 (58.0)ST1, ST3, ST4, ST5, ST10, ST14MOLSong et al. [377]
GoatChina7812 (0.3)ST1MOLLi et al. [378]
GoatChina5928 (47.5)ST10, ST14MOLZhang et al. [14]
GoatNepal4003 (0.8)NACMGhimire and Bhattarai [379]
GoatMalaysia23673 (30.9)ST1, ST3, ST6, ST7MOLTan et al. [380]
GoatMalaysia318 (25.8)ST4, ST8, ST10MOLNoradilah et al. [15]
GoatMalaysia6514 (21.5)NAIVCAbd Razak et al. [357]
GoatMalaysia2013 (65.0)NAIVCHemalatha et al. [356]
GoatNepal291 (3.4)ST4IVC, MOLLee et al. [18]
GoatPhilippines61 (16.7)ST14IVC, MOLAdao et al. [381]
GoatThailand3836 (94.7)ST10, ST12, ST14MOLUdonsom et al. [215]
Goral (Himalayan)Nepal191 (5.3)NACMAdhikari et al. [382]
GuanacoChina2014 (70.0)ST10, ST22MOLZhao et al. [352]
GuarMalaysia103 (30.0)NAIVCHemalatha et al. [356]
OryxChina21 (50.0)ST10MOLZhao et al. [352]
OryxChina111 (9.1)ST5MOLLi et al. [353]
PigCambodia7333 (45.2)ST5MOLWang et al. [242]
PigChina560419 (74.8)ST1, ST3, ST5, ST10MOLSong et al. [383]
PigChina686 (8.8)ST5MOLWang et al. [367]
PigChina801174 (21.7)ST1, ST3, ST5MOLWang et al. [384]
PigChina866433 (50.0)ST1, ST3, ST5MOLHan et al. [385]
PigChina396170 (42.9)ST1, ST5MOLZou et al. [386]
PigIndia11 (100.0)NACMSreekumar et al. [355]
PigIndia9085 (94.4)NACMArpitha et al. [387]
PigIndonesia9381 (87.1)ST1, ST2, ST5, ST7IVC, MOLYoshikawa et al. [41]
PigIndonesia10063 (63.0)NACMMahendra et.al. [388]
PigIndonesia10069 (69.0)NACMWidisuputri et al. [389]
PigKorea646390 (60.4)ST1, ST2, ST3, ST5MOLPaik et al. [390]
PigNepal114 (36.4)ST4IVC, MOLLee et al. [18]
PigPhilippines4936 (73.5)ST1, ST2, ST3, ST5MOLAdao et al. [391]
PigPhilippines9920 (20.2)ST1, ST5, ST7IVC, MOLAdao et al. [381]
PigPhilippines12247 (38.5)NACM, IVCDe La Cruz et al. [392]
PigPhilippines10014 (14.0)ST1, ST5IVC, MOLEvidor and Rivera [393]
PigPhilippines1012 (2.0)NACMMurao et al. [394]
PigThailand10232 (31.4)ST1, ST3, ST12, ST14MOLSanyanusin et al. [395]
PigThailand9032 (35.6)ST1, ST3, ST5MOLPintong et al. [214]
PigThailand8740 (46.0)ST1, ST5MOLUdonsom et al. [215]
PigMalaysia1010 (100.0)NAIVCHemalatha et al. [356]
PigVietnam1212 (100.0)ST5MOLAlfellani et al. [396]
SheepIran15029 (19.3)ST7, ST10CM, MOLRostami et al. [364]
SheepChina83250 (6.0)ST5, ST10, ST14MOLLi et al. [378]
SheepChina1096 (5.5)ST1, ST5, ST10, ST14MOLWang et al. [367]
SheepChina3816 (42.1)ST2, ST10, ST14MOLZhang et al. [14]
SheepChina7842 (53.8)ST2, ST10, ST14MOLZhang et al. [14]
SheepUnited Arab Emirates117 (63.6)ST10, ST14MOLAbuOdeh et al. [369]
SheepMalaysia3822 (57.9)NAIVCHemalatha et al. [356]
SheepMalaysia202 (10.0)NAIVCAbd Razak et al. [357]
Small ruminantsIndia10715 (14.0)NACMArpitha et al. [387]
TakinChina4928 (57.1)ST10, ST12, ST14MOLZhao et al. [352]
WaterbuckChina33 (100.0)ST12, ST14MOLZhao et al. [352]
WaterbuckChina21 (50.0)ST21MOLZhao et al. [352]
WaterbuckBangladesh71 (14.3)ST10MOLLi et al. [375]
Wild boarSouth Korea43345 (10.4)ST5MOLLee et al. [397]
Wild BoarIran2511 (44.0)NACMYaghoobi et al. [398]
Wild BoarIran11 (100.0)NACMMirzapour et al. [370]
YakChina1027278 (27.1)ST10, ST12, ST14MOLRen et al. [399]
YakChina10239 (38.2)ST2, ST10, ST14MOLZhang et al. [14]
YakChina63 (50.0)ST10, ST14MOLZhao et al. [352]
Perissodactyla
HorseChina329 (28.1)ST2, ST10MOLZhang et al. [14]
HorseChina41 (25.0)ST10MOLZhao et al. [352]
Wild AssChina52 (40.0)ST10, ST12MOLZhao et al. [352]
PonyChina61 (16.7)ST10MOLZhao et al. [352]
ZebraChina71 (14.3)ST10MOLLi et al. [353]
Proboscidea
ElephantBangladesh31 (33.3)ST11MOLLi et al. [375]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 10. Prevalence and subtype distribution of Blastocystis spp. in carnivorous animals in Asia (2010–2021).
Table 10. Prevalence and subtype distribution of Blastocystis spp. in carnivorous animals in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNumber of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Artic foxChina2134 (1.9)ST1, ST4, ST7MOLWang et al. [373]
BearChina123 (25.0)ST17MOLDeng et al. [3]
BearChina31245 (14.4)ST1MOLNi et al. [374]
CatChina3462 (0.6)ST1MOLLi et al. [400]
CatIndonesia9048 (53.3)NAMOLPatagi et al. [401]
CatIran14020 (14.3)NACMKhademvatan et al. [402]
CatIran11921 (17.7)ST1, ST3, ST4, ST10, ST14MOLMohammadpour et al. [403]
CatSouth Korea1581 (0.6)ST4MOLKwak and Seo [404]
CatMalaysia6012 (20.0)ST1MOLFarah Haziqah et al. [405]
CatTurkey33 (100.0)ST3MOLEroglu and Koltas [19]
Common raccoonIran305 (6.7)ST1, ST2, ST3MOLMohammad Rahimi et al. [406]
DogChina1364 (2.9)ST1, ST4MOLWang et al. [373]
DogChina65135 (5.4)ST1, ST3, ST10MOLLiao et al. [407]
DogIndia8019 (24.0)ST1, ST4, ST5, ST6MOLWang et al. [408]
DogIran30159 (19.6)NACMMohaghegh et al. [409]
DogIran55229 (5.2)NACMMirbadie et al. [410]
DogIran15429 (18.8)ST2, ST3, ST4, ST7, ST8, ST10MOLMohammadpour et al. [403]
DogTurkey44 (100.0)ST1, ST2MOLEroglu and Koltas [19]
DogPhilippines14521 (14.5)ST1, ST2, ST3, ST4, ST5IVC, MOLBelleza et al. [297]
DogMalaysia8440 (47.6)ST1, ST3, ST4, ST8, ST10MOLNoradilah et al. [15]
DogThailand131 (7.7)ST3MOLUdonsom et al. [215]
DogCambodia801 (1.3)ST2MOLWang et al. [408]
DogChina71 (14.3)ST10MOLLi et al. [353]
LeopardChina32 (66.7)ST1, ST5MOLDeng et al. [3]
MeerkatIran11 (100.0)NACMMirzapour et al. [370]
MeerkatChina21 (50.0)ST5MOLLi et al. [353]
Panda (Giant panda)China8110 (12.3)ST1MOLDeng et al. [411]
Panda (Red panda)China232 (8.7)ST1MOLDeng et al. [411]
Raccoon dogChina403 (7.5)ST3MOLWang et al. [373]
Tiger (Siberian tiger)China131 (7.7)ST10MOLLi et al. [353]
Tiger (White tiger)China91 (11.1)ST10MOLLi et al. [353]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 11. Prevalence and subtype distribution of Blastocystis spp. in non-human primates in Asia (2010–2021).
Table 11. Prevalence and subtype distribution of Blastocystis spp. in non-human primates in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNumber of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Primates
LangurBangladesh53 (60.0)ST1, ST13MOLLi et al. [375]
Grey langurBangladesh21 (50.0)ST1MOLLi et al. [375]
White-cheeked gibbonChina41 (25.0)ST1MOLMa et al. [250]
White-cheeked gibbonChina44 (100.0)ST2, ST3MOLDeng et al. [3]
Ring-tailed lemurChina62 (33.3)ST2, ST4MOLLi et al. [353]
Ring-tailed lemurChina167 (43.8)ST3, ST5, ST9MOLMa et al. [250]
Ring-tailed lemurChina136 (46.2)ST1, ST2MOLDeng et al. [3]
MacaqueChina9785 (87.6)ST1, ST2, ST3, ST5, ST7MOLZanzani et al. [412]
MacaqueChina18512 (7.0)ST1, ST2, ST3MOLZhu et al. [173]
Macaque (experimental)China505235 (46.5)ST1, ST2, ST3MOLLi et al. [413]
Rhesus macaqueBangladesh6220 (32.3)ST1, ST2, ST3MOLLi et al. [375]
Rhesus macaqueChina2928 (96.6)ST1, ST2, ST3, ST19MOLZhao et al. [352]
Rhesus macaqueChina1710 (58.8)ST1MOLDeng et al. [3]
Rhesus macaqueChina186 (33.3)ST2, ST3MOLMa et al. [250]
Japanese macaqueChina336 (18.2)ST2, ST3MOLMa et al. [250]
MacaquePhilippines505 (10.0)NACMCasim et al. [414]
Long-tailed macaqueThailand628263 (41.9)ST1, ST2, ST3IVC, MOLVaisusuk et al. [415]
Crab-eating macaqueChina133 (23.1)ST2, ST3MOLMa et al. [250]
OrangutanIndonesia26236 (13.7)NACMLabes et al. [416]
OrangutanMalaysia105 (50.0)NAIVCHemalatha et al. [356]
Vervet monkeyIran403 (7.5)NACMDalimi et al. [417]
Vervet monkeyBangladesh73 (42.9)ST2, ST3, ST13MOLLi et al. [375]
Hamadryas baboonSaudi Arabia823349 (42.4)NACMAlqumber [303]
Hamadryas baboonChina2313 (56.5)ST1, ST3MOLZhao et al. [352]
ChimpanzeeChina108 (80.0)ST2MOLZhao et al. [352]
ChimpanzeeChina153 (13.3)ST1, ST5MOLMa et al. [250]
Francois’ leaf monkeyChina11 (100.0)ST2MOLZhao et al. [352]
Francois’ leaf monkeyChina32 (66.7)ST1MOLMa et al. [250]
MandrillChina41 (25.0)ST3MOLZhao et al. [352]
MandrillChina159 (60.0)ST1, ST4MOLMa et al. [250]
De Brazza’s monkeyChina54 (80.0)ST1, ST10MOLZhao et al. [352]
De Brazza’s monkeyChina55 (100.0)ST1, ST2MOLMa et al. [250]
Golden snub-nosed monkeyChina4641 (89.1)ST1, ST13MOLZhao et al. [352]
Snub-nosed monkeyChina229 (40.9)ST1, ST2MOLMa et al. [250]
Golden monkeyChina3718 (48.6)ST1, ST2, ST3MOLMa et al. [418]
Squirrel monkeyChina9319 (20.4)ST17MOLDeng et al. [3]
Common squirrel monkeyChina309 (30.0)ST1, ST5MOLMa et al. [250]
Red-faced spider monkeyChina42 (50.0)ST2, ST3MOLMa et al. [250]
MonkeyPhilippines44 (100.0)ST1, ST2, ST3MOLRivera [21]
Non-human primatesMalaysia3085 (1.6)NACMAdrus et al. [419]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 12. Prevalence and subtype distribution of Blastocystis spp. in birds in Asia (2010–2021).
Table 12. Prevalence and subtype distribution of Blastocystis spp. in birds in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNumber of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
DuckPhilippines313 (9.6)ST7, B. pythoniIVC, MOLAdao et al. [381]
BirdsTurkey55 (100.0)ST1, ST2MOLEroglu and Koltas [19]
ChickenChina466 (13.0)ST6, ST7MOLWang et al. [373]
ChickenPhilippines345 (14.7)ST7, MixedIVC, MOLAdao et al. [381]
ChickenIndia2420 (83.3)NACMSreekumar et al. [355]
ChickenIndia17050 (29.4)NACMArpitha et al. [387]
ChickenIndonesia3813 (34.2)ST7IVC, MOLYoshikawa et al. [41]
ChickenLebanon22371 (31.8)ST6, ST7MOLGreige et al. [199]
ChickenMalaysia10427 (26.0)ST1, ST3, ST6, ST7, ST9MOLNoradilah et al. [15]
ChickenMalaysia151 (6.7)ST6MOLMohammad et al. [288]
ChickenMalaysia10727 (25.2)NAIVCFarah Haziqah et al. [420]
ChickenMalaysia17947 (26.3)ST1, ST6, ST7, ST8IVC, MOLFarah Haziqah et al. [421]
Crested ibisChina636 (9.5)NACMZhang et al. [422]
Crow (Hooded)Iran14464 (44.4)ST13, ST14IVC, MOLAsghari et al. [423]
DuckMalaysia208 (40.0)ST1, ST2, ST3, ST7MOLNoradilah et al. [15]
Green-naped lorikeetChina21 (50.0)ST10MOLLi et al. [353]
OstrichChina93 (33.3)ST5, ST10, ST20MOLZhao et al. [352]
OstrichChina196 (31.6)ST5MOLDeng et al. [3]
OstrichMalaysia3737 (100.0)ST6IVC, MOLChandrasekaran et al. [424]
OstrichMalaysia3737 (100.0)NAIVCHemalatha et al. [424]
OstrichChina32 (66.7)ST5MOLLi et al. [353]
Green peafowlChina121 (8.3)ST3MOLDeng et al. [3]
Green peafowlChina151 (6.7)ST8MOLDeng et al. [411]
Indian peafowlChina203 (15.0)ST7, ST8MOLLi et al. [353]
PigeonChina344 (11.8)ST8MOLDeng et al. [3]
PigeonChina471 (2.1)ST6MOLWang et al. [373]
PigeonIran15667 (42.9)ST13IVC, MOLAsghari et al. [423]
PoultryIran13221 (15.9)ST7, ST10, ST14CM, MOLRostami et al. [364]
Red crowned craneChina436 (14.0)ST6, ST7MOLWang et al. [373]
Red-crowned craneChina21 (50.0)ST14MOLLi et al. [353]
Ruddy shelduckChina112 (18.2)ST8MOLDeng et al. [411]
SwanMalaysia207 (35.0)ST1, ST3MOLNoradilah et al. [15]
Black swanChina384 (10.5)ST8MOLDeng et al. [411]
TurkeyIndia43 (75.0)NACMSreekumar et al. [355]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 13. Prevalence and subtype distribution of Blastocystis spp. in rodents in Asia (2010–2021).
Table 13. Prevalence and subtype distribution of Blastocystis spp. in rodents in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNumber of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Flying squirrelChina20763 (30.4)ST1, ST3, ST13MOLXiao et al. [425]
Eastern chipmunkChina1718 (4.7)ST4MOLChai et al. [426]
Eurasian red squirrelChina727 (9.7)ST4MOLChai et al. [426]
Black great squirrelChina11 (100.0)ST4MOLDeng et al. [3]
Red giant flying squirrelChina11 (100.0)ST4MOLDeng et al. [3]
Indian palm squirrelUnited Arab Emirates42 (50.0)ST4MOLAbuOdeh et al. [369]
Shrew-faced squirrelUnited Arab Emirates11 (100.0)ST17MOLAbuOdeh et al. [369]
Chinese striped hamsterChina9812 (12.2)ST4MOLChai et al. [426]
ChinchillaChina723 (4.2)ST4, ST17MOLChai et al. [426]
ChinchillaChina64 (66.7)ST17MOLDeng et al. [3]
Guinea pigChina9012 (13.3)ST4MOLChai et al. [426]
Patagonian maraChina153 (20.0)ST4MOLLi et al. [353]
Rat (Mus musculus)China1084 (3.7)ST4MOLWang et al. [373]
Laboratory ratsChina35529 (8.2)ST4, ST7MOLLi et al. [427]
Rat (Rattus exulans)Indonesia7710 (13.0)ST4IVC, MOLYoshikawa et al. [41]
RatIndonesia986 (6.0)NACMPrasetyo [428]
Rat (Rattus exulans)Indonesia6711 (16.4)ST4MOLKatsumata et al. [429]
RodentsIran523 (5.8)NACMSeifollahi et al. [430]
Rat (Rattus norvegicus)Iran12720 (15.8)ST1, ST3, ST4MOLMohammadpour et al. [403]
Rat (Rattus norvegicus)Malaysia9548 (51.0)NACMPremaalatha et al. [431]
Rat (Rattus norvegicus)Malaysia290133 (45.9)ST1, ST4, ST5, ST7IVC, MOLFarah Haziqah et al. [432]
Wild rats (Rattus novercious)Japan4812 (25.0)ST4MOLKatsumata et al. [429]
Swiss-Webster miceIran501 (2.0)NACMKalani et al. [433]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 14. Prevalence and subtype distribution of Blastocystis spp. in reptiles in Asia (2010–2021).
Table 14. Prevalence and subtype distribution of Blastocystis spp. in reptiles in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNumber of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Squamata
Cobra snakeIran11 (100.0)NACMMirzapour et al. [370]
Albino pythonIran11 (100.0)NACMMirzapour et al. [370]
Water monitor lizardMalaysia61 (1.6)Unknown (Clade VIII)IVC, MOLMohd Zain et al. [372]
Testudines
African spurred tortoiseUnited Arab Emirates195 (26.3)UnknownMOLAbuOdeh et al. [369]
Greek tortoiseUnited Arab Emirates21 (50.0)UnknownMOLAbuOdeh et al. [369]
IguanaUnited Arab Emirates11 (100.0)UnknownMOLAbuOdeh et al. [369]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 15. Prevalence and subtype distribution of Blastocystis spp. in insects and other animal groups in Asia (2010–2021).
Table 15. Prevalence and subtype distribution of Blastocystis spp. in insects and other animal groups in Asia (2010–2021).
HostCountryNo. of Samples ExaminedNumber of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
Blattodea
CockroachChina11696 (82.8)ST2MOLMa et al. [418]
CockroachThailand9209 (1.0)NACMChamavit et al. [434]
CockroachThailand45018 (4.0)NACMDokmaikaw and Suntaravitun [435]
Cockroach (Blatella germanica)Turkey13857 (41.0)NACMOguz et al. [436]
Cockroach (Blatella germanica)Iran4965 (1.0)NACMMotevalli-Haghi et al. [437]
Cockroach (Periplaneta americana)Malaysia15161 (40.4)ST3IVC, MOLFarah Haziqah et al. [438]
Diprotodontia
Gray kangarooChina118 (72.7)ST10MOLZhao et al. [352]
Red-necked wallabyChina152 (13.3)ST11MOLLi et al. [353]
Sugar gliderIndonesia100100 (100.0)NACM, IVCNatalia et al. [439]
Lagomorpha
New Zealand white rabbitChina2157 (3.3)ST4MOLWang et al. [373]
RabbitChina6166 (1.0)NAMOLLi et al. [440]
RabbitUnited Arab Emirates31 (33.3)ST14MOLAbuOdeh et al. [369]
Eulipotyphla
HedgehogIran11 (100.0)NACMMirzapour et al. [370]
CM—Conventional microscopy, IVC—In vitro cultivation, MOL—Molecular technique, NA—Not applicable.
Table
Table 16. Prevalence and subtype distribution of Blastocystis spp. in food and environmental sources in Asia (2010–2021).
Table 16. Prevalence and subtype distribution of Blastocystis spp. in food and environmental sources in Asia (2010–2021).
CountryFood/Environmental SourceNo. of Samples ExaminedNo. of Positive Samples (%)Subtypes (STs) IdentifiedMethod(s)References
IranTreated wastewater125 (41.7)ST2, ST6, ST8F, MOLJavanmard et al. [441]
MalaysiaRiver water480133 (27.7)NAMB, IVCIthoi et al. [442]
MalaysiaDrinking water treatment plants8522 (25.9)NAIMS, CMRichard et al. [443]
MalaysiaRiver water1414 (100.0)ST1, ST2, ST3MF, MOLNoradilah et al. [444]
Various water sources ST1, ST2, ST3, ST4, ST8, ST10
MalaysiaRiver water73 (42.9)NAMF, IVCNoradilah et al. [23]
Village water sources161 (6.3)
NepalRiver water44 (100.0)ST1, ST4C, MOLLee et al. [18]
PhilippinesWastewater (influent)317 (23.0)ST1, ST2C, IVC, MOLBanaticla and Rivera, [445]
Wastewater (effluent)312 (7.0)ST1, ST2
TurkeyTap water253 (12.0)ST1MOLEroglu and Koltas, [19]
TurkeyStreams and drinking water22847 (20.6)NACMKaraman et al. [446]
TurkeyRiver water1959 (4.6)ST1, ST3C, MOLKoloren et al. [447]
Sea water481 (2.1)ST1
TurkeySurface water754 (5.3)ST1, ST3C, MOLKolören and Karaman [448]
Saudi ArabiaLeafy vegetables47013 (2.8)NAS, CMAl-Megrin [27]
IranFresh vegetables24010 (4.2)NAS, CMIsazadeh et al. [449]
SyriaFresh vegetables12813 (10.2)NAMOLAl Nahhas and Aboualchamat [450]
KoreaAmbient air711 (1.4)NAMOLHan et al. [451]
C—Centrifugation, CM—Conventional microscopy, F—Filtration, IMS—Immunomagnetic separation technique, IVC—In vitro cultivation, MB—Membrane filtration, MOL—Molecular technique, S—Sedimentation, NA—Not applicable.
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Rauff-Adedotun, A.A.; Meor Termizi, F.H.; Shaari, N.; Lee, I.L. The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010–2021 in Asia. Biology 2021, 10, 990. https://doi.org/10.3390/biology10100990

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Rauff-Adedotun AA, Meor Termizi FH, Shaari N, Lee IL. The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010–2021 in Asia. Biology. 2021; 10(10):990. https://doi.org/10.3390/biology10100990

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Rauff-Adedotun, Adedolapo Aminat, Farah Haziqah Meor Termizi, Nurshafarina Shaari, and Ii Li Lee. 2021. "The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010–2021 in Asia" Biology 10, no. 10: 990. https://doi.org/10.3390/biology10100990

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