Foodborne concerns of Blastocystis spp. in marine animals (fish, bivalves, and sponges): A systematic review and meta-analysis of global prevalence and subtypes distribution

Blastocystis spp. is a common intestinal parasite found in humans and various animals, including marine species like fish, bivalves, and sponges. While traditionally considered non-pathogenic, emerging evidence suggests potential foodborne concerns, especially for vulnerable populations. The present systematic review and meta-analysis reviewed four electronic databases (PubMed, Scopus, Google Scholar, and Web of Science) until June 13, 2024, for studies reporting the prevalence and subtypes (STs) distribution of Blastocystis spp. in marine animals, including fish, bivalves, and sponges, to assess foodborne concern and zoonotic importance. In the analysis of 11 studies involving 1329 marine animals from nine countries, five studies/datasets (742 samples) focused on fish, five studies/datasets (567 samples) on bivalves, and one (20 samples) on sponges. This review found that 12.4 % (95 % CI: 4.3–31 %) of marine animals globally were infected by Blastocystis spp., with bivalves showing the highest infection rate at 32 % (95 % CI: 13–59.7 %), exceeding sponges with a single study at 10 % (95 % CI: 2.5–32.4 %), and fish at 4.4 % (95 % CI: 2–9.3 %). Sensitivity analysis assessed changes in weighted prevalence after excluding certain studies. A subgroup analysis of Blastocystis spp. prevalence was conducted based on publication years, countries, continents, WHO regions, and sample sizes. The data collected indicated that marine animals serve as suitable reservoirs for various Blastocystis spp. STs (ST1-ST4, ST7, ST8, ST10, ST14, ST23, ST26, and ST44), with most (except for ST26 and ST44) having the potential for zoonotic transmission. Overall, the findings emphasize the potential for foodborne risk posed by Blastocystis spp. in marine animals and highlight the need for improved monitoring and control measures to ensure food safety.