Angiostrongylus cantonensis in the vector snails Pomacea canaliculata and Achatina fulica in China: a meta-analysis.

Angiostrongyliasis is a food-borne parasitic disease induced by the nematode Angiostrongylus cantonensis, and has been recognized as the main cause leading to human eosinophilic meningitis. Humans usually acquire infection by digestion of infected Pomacea canaliculata and Achatina fulica, the most predominant intermediate hosts found in China. This meta-analysis was aimed to assess the prevalence of A. cantonensis infection among these two snails in China in the past 10 years. Data were systematically collected in electronic databases such as PubMed, Web of Science, ScienceDirect, CNKI, SinoMed, VIP, CSCD, and Wanfang from 2005 to 2015. Thirty-eight studies with a total of 41,299 P. canaliculata and 21,138 Ac. fulica were included in the present study. The overall infection rate of A. cantonensis in China was estimated to be 7.6 % (95 % confidential interval (CI) = 0.063 to 0.090) in P. canaliculata and 21.5 % in Ac. fulica (95 % CI = 0.184 to 0.245), respectively. No significant difference was observed in prevalence rates among publication year and sample size for both snails. Also, it was found that the prevalence in Ac. fulica is significantly higher than that in P. canaliculata (odds ratio (OR) = 3.946, 95 % CI = 3.070 to 5.073). The present study reveals that snail infection with A. cantonensis is clearly prevalent in China. Further studies are required to improve strategies for control of infections of snails, particularly those of Ac. fulica, and to detect further factors and conditions such as geographic region, temperatures, and diagnosis method.