Global Prevalence and Heterogeneity of Fasciola Infection in Cattle: A Systematic Review and Meta-Analysis of 49 Million Animals over the Past Three Decades

Abstract

Fascioliasis, caused by Fasciola hepatica and Fasciola gigantica, is a major veterinary and zoonotic disease affecting cattle production systems worldwide. Despite extensive research, prevalence estimates vary considerably across geographic regions and study methodologies, necessitating a systematic synthesis to inform evidence-based control strategies and public health interventions. A systematic review and meta-analysis were conducted of studies reporting Fasciola prevalence in cattle from 1996 to 2024. A random-effects meta-analysis was performed on 338 studies encompassing approximately 49 million cattle samples. Subgroup analyses were performed to examine variations by continent, diagnostic method, Fasciola species, study period, sample size, and climate zone. Meta-regression identified sources of heterogeneity, and publication bias was assessed using Egger’s test. Certainty of evidence for the principal pooled outcomes was assessed using the GRADE framework. The global pooled prevalence of Fasciola infection in cattle was 26.5% (95% CI: 24.0–29.1), with very high heterogeneity (I2 = 99.5%). Significant geographic variation was observed, with Europe showing the highest prevalence (42.1%, 95% CI: 33.1–51.1), followed by Oceania (38.9%, 95% CI: 24.3–53.6), America (31.4%, 95% CI: 24.5–38.4), and Africa (24.3%, 95% CI: 21.1–27.5), and Asia showed the lowest (18.3%, 95% CI: 13.9–22.8). The diagnostic method emerged as the most important source of heterogeneity (R2 = 26.3%), with ELISA detecting a substantially higher prevalence (49.0%, 95% CI: 41.8–56.2) than post-mortem examination (19.2%, 95% CI: 16.2–22.3). F. hepatica exhibited a higher prevalence (33.1%, 95% CI: 27.9–38.2) than other species. No temporal trends were detected between the study periods. The climate zone explained 3.1% of the heterogeneity. Publication bias was not significant (Egger’s p = 0.157). Fasciolosis represents a substantial global burden in cattle populations, with its prevalence strongly influenced by diagnostic methodology and geographic location. The critical role of the choice of diagnostic method in prevalence estimation underscores the urgent need for standardized surveillance protocols. These findings have important implications for veterinary disease control programs and zoonotic disease prevention strategies in both endemic and emerging regions worldwide.