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. 2023 Jul 8:10:20499361231185413.
doi: 10.1177/20499361231185413. eCollection 2023 Jan-Dec.

The global prevalence of human fascioliasis: a systematic review and meta-analysis

Luis Raúl Rosas-Hostos Infantes  1 , Guillermo Andres Paredes Yataco  1 , Yeimer Ortiz-Martínez  2 , Treana Mayer  3 , Angelica Terashima  4   5 , Carlos Franco-Paredes  6   7 , Esteban Gonzalez-Diaz  8 , Alfonso J Rodriguez-Morales  9   10   11 , D Katterine Bonilla-Aldana  12 , Lilian Vargas Barahona  13 , Alyssa A Grimshaw  14 , Daniel B Chastain  15 , Stefan Sillau  16 , Luis A Marcos  17 , Andrés F Henao-Martínez  18
Affiliations

The global prevalence of human fascioliasis: a systematic review and meta-analysis

Luis Raúl Rosas-Hostos Infantes et al. Ther Adv Infect Dis. .

Abstract

Background: Fascioliasis is a parasitic zoonosis that can infect humans and be a source of significant morbidity. The World Health Organization lists human fascioliasis as a neglected tropical disease, but the worldwide prevalence of fascioliasis data is unknown.

Objective: We aimed to estimate the global prevalence of human fascioliasis.

Data sources and methods: We performed a systematic review and prevalence meta-analysis. We used the following inclusion criteria: articles published in the English, Portuguese, or Spanish languages from December 1985 to October 2022 and studies assessing the prevalence of Fasciola in the general population with an appropriate diagnostic methodology, including longitudinal studies, prospective and retrospective cohorts, case series, and randomized clinical trials (RCTs). We excluded animal studies. Two reviewers independently reviewed the selected studies for methodological quality, performing critical standard measures from JBI SUMARI. A random-effects model was conducted of the summary extracted data on the prevalence proportions. We reported the estimates according to the GATHER statement.

Results: In all, 5617 studies were screened for eligibility. Fifty-five studies from 15 countries were selected, including 154,697 patients and 3987 cases. The meta-analysis revealed a pooled prevalence of 4.5% [95% confidence interval (CI): 3.1-6.1; I2 = 99.4%; T2 = 0.07]. The prevalence in South America, Africa, and Asia was 9.0%, 4.8%, and 2.0%, respectively. The highest prevalence was found in Bolivia (21%), Peru (11%), and Egypt (6%). Subgroup analysis showed higher prevalence estimates in children, in studies from South America, and when Fas2-enzyme-linked immunosorbent assay (ELISA) was used as a diagnostic method. A larger study sample size (p = 0.027) and an increase in female percentage (p = 0.043) correlated with a decrease in prevalence. Multiple meta-regression showed a higher prevalence for hyperendemic than hypoendemic (p = 0.002) or mesoendemic (p = 0.013) regions.

Conclusion: The estimated prevalence and projected disease burden of human fascioliasis are high. Study findings support that fascioliasis continues to be a globally neglected tropical disease. Strengthening epidemiological surveillance and implementing measures to control and treat fascioliasis is imperative in the most affected areas.

Keywords: F. gigantica; F. hepatica; epidemiology; human fascioliasis; meta-analysis; neglected tropical disease; prevalence; systematic review.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: We declare no competing interests related to this work. Dr. Sillau reported receiving grants from the Alzheimer’s Association, the Benign Essential Blepharospasm Research Foundation, the Colorado Department of Public Health, the Davis Phinney Foundation, the Hewitt Family Foundation, the Michael J. Fox Foundation, the National Institutes of Health, the National Institute of Nursing Research, the Patient-Centered Outcomes Research Institute, and the Rocky Mountain Alzheimer’s Disease Center outside the submitted work. Dr. Henao-Martínez reported being the recipient of a K12-clinical trial award as a co-principal investigator for the Expanded Access IND Program (EAP) to provide the Yellow Fever vaccine (Stamaril) to Persons in the United States outside the submitted work. The Editor in Chief and Associate Editor of Therapeutic Advances in Infectious Disease are authors of this paper. Therefore, the peer review process was managed by alternative members of the Editorial Board and the submitting Editors had no involvement in the decision-making process. No other disclosures were reported.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram.
Figure 2.
Figure 2.
Forest plot of global estimated prevalence of fascioliasis by study.
Figure 3.
Figure 3.
Heat map of unique datasets from each country depicting the prevalence of fascioliasis.
See this image and copyright information in PMC

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