Epidemiology of piroplasm infections in humans, animals, and tick vectors in China (1982–2022): a One Health systematic review

Piroplasmida, including Babesia and Theileria, are protozoan parasites that significantly affect human and livestock health, as well as agricultural and veterinary practices worldwide. The systematic review aimed to summarize and analyze the molecular characteristics of piroplasm infections in humans, animals, and tick vectors in China. Four databases – China National Knowledge Infrastructure (CNKI), China Wanfang, VIP Full Text, and PubMed-were systematically searched for articles published between 1982 and 2022. Studies were selected based on predefined inclusion and exclusion criteria. Data were extracted for molecular diagnostic methods, epidemiological surveys, and tick population monitoring. Geographical distribution and species diversity were also analyzed. A total of 124 articles met the inclusion criteria. The studies reported significant geographical variations in Babesia and Theileria species across 31 provinces, autonomous regions, and municipalities in China. Molecular diagnostics and surveillance strategies were identified as crucial for effective detection and management, particularly in rural and vulnerable populations. Tick vectors were highlighted as key factors in transmission dynamics. Piroplasm infections remain a major challenge in China, emphasizing the need for integrated control strategies. This review underscores the importance of adopting a One Health approach to address the interconnected health of humans, animals, and the environment.