title: Cryptosporidiosis: A Disease of Tropical and Remote Areas in Australia.
abstract: Cryptosporidiosis causes gastroenteritis and is transmitted to humans via contaminated water and food, and contact with infected animals and people. We analyse long-term cryptosporidiosis patterns across Australia (2001-2012) and review published Australian studies and jurisdictional health bulletins to identify high risk populations and potential risk factors for disease. Using national data on reported cryptosporidiosis, the average annual rate of reported illness was 12.8 cases per 100 000 population, with cycles of high and low reporting years. Reports of illness peak in summer, similar to other infectious gastrointestinal diseases. States with high livestock densities like New South Wales and Queensland also record a spring peak in illnesses. Children aged less than four years have the highest rates of disease, along with adult females. Rates of reported cryptosporidiosis are highest in the warmer, remote regions and in Aboriginal and Torres Strait Islander populations. Our review of 34 published studies and seven health department reports on cryptosporidiosis in Australia highlights a lack of long term, non-outbreak studies in these regions and populations, with an emphasis on outbreaks and risk factors in urban areas. The high disease rates in remote, tropical and subtropical areas and in Aboriginal and Torres Strait Islander populations underscore the need to develop interventions that target the sources of infection, seasonal exposures and risk factors for cryptosporidiosis in these settings. Spatial epidemiology can provide an evidence base to identify priorities for intervention to prevent and control cryptosporidiosis in high risk populations.
authors.affiliation: National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Aparna
authors.initials: A
authors.lastname: Lal
authors.affiliation: National Centre for Geographic & Resource Analysis in Primary Health Care (GRAPHC), Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Lisa Michelle
authors.initials: LM
authors.lastname: Cornish
authors.affiliation: National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Fearnley
authors.affiliation: National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Glass
authors.affiliation: National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Martyn
authors.initials: M
authors.lastname: Kirk
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population; D012621:Seasons; D019371:Topography, Medical; D014329:Tropical Climate; D014505:Urban Population; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples