Epidemiology of human fascioliasis across Africa for the period 2000–2022: a systematic review

Background: Human fascioliasis, caused by the trematodes Fasciola hepatica and Fasciola gigantica, is a neglected tropical disease that impacts approximately 17 million people worldwide. It’s prevalent in areas with significant livestock farming where animals consume contaminated freshwater plants. The disease poses a substantial health burden for over 90,000 disability-adjusted life years due to abdominal complications. This systematic review aims to synthesize data on the prevalence of human fascioliasis in Africa during 2000–2022. Methods: We systematically searched databases including PubMed, Web of Science, and CAB Direct, identifying 126 publications on human fascioliasis. Following a thorough screening of titles, abstracts, and full texts, 33 articles were selected for meta-analysis. Statistical analyses were conducted using Microsoft Excel to calculate prevalence rates and evaluate variance through bimodal distribution and heterogeneity using the I2 index. Results: Among 271 articles, only 33 met the inclusion criteria for the meta-analysis, representing 12.17% of the literature in Africa. The pooled prevalence estimate was 0.032% (IVhet PPE: 0.032% [95% CI 1.4–6.53]), with Egypt exhibiting the highest prevalence rate. These findings highlight significant gaps in diagnostic capabilities and reporting, complicating management efforts for human fascioliasis in Africa. Conclusions: This review reveals a high prevalence of human fascioliasis in specific sub-Saharan countries, largely attributable to inadequate diagnostic practices. The inconsistent spatial distribution of available data underscores the overall neglect of this disease. The authors advocate for enhanced epidemiological studies to better understand the distribution and risk factors linked to fascioliasis in Africa, emphasizing the need for rigorous research addressing these critical knowledge gaps.