BACKGROUND: Babesiosis is a parasitic vector-borne disease of increasing public 
health importance. Since the first human case was reported in 1957, zoonotic 
species have been reported on nearly every continent. Zoonotic Babesia is 
vectored by Ixodes ticks and is commonly transmitted in North America by Ixodes 
scapularis, the tick species responsible for transmitting the pathogens that 
also cause Lyme disease, Powassan virus, and anaplasmosis in humans. Predicted 
climate change is expected to impact the spread of vectors, which is likely to 
affect the distribution of vector-borne diseases including human babesiosis.
METHODS: A scoping review has been executed to characterize the global evidence 
on zoonotic babesiosis. Articles were compiled through a comprehensive search of 
relevant bibliographic databases and targeted government websites. Two reviewers 
screened titles and abstracts for relevance and characterized full-text articles 
using a relevance screening and data characterization tool developed a priori.
RESULTS: This review included 1394 articles relevant to human babesiosis and/or 
zoonotic Babesia species. The main zoonotic species were B. microti, B. 
divergens, B. duncani and B. venatorum. Articles described a variety of study 
designs used to study babesiosis in humans and/or zoonotic Babesia species in 
vectors, animal hosts, and in vitro cell cultures. Topics of study included: 
pathogenesis (680 articles), epidemiology (480), parasite characterization 
(243), diagnostic test accuracy (98), mitigation (94), treatment (65), 
transmission (54), surveillance (29), economic analysis (7), and societal 
knowledge (1). No articles reported predictive models investigating the impact 
of climate change on Babesia species.
CONCLUSION: Knowledge gaps in the current evidence include research on the 
economic burden associated with babesiosis, societal knowledge studies, 
surveillance of Babesia species in vectors and animal hosts, and predictive 
models on the impact of climate change. The scoping review results describe the 
current knowledge and knowledge gaps on zoonotic Babesia which can be used to 
inform future policy and decision making.