Seroprevalence and clinical correlates of fascioliasis among patients with hepatobiliary diseases in Urmia in Northwest Iran

Fascioliasis is an important hepatobiliary zoonotic infection in which freshwater snails are intermediate hosts and livestock are the main definitive hosts. Humans become infected incidentally by ingesting metacercariae on aquatic plants or in contaminated water. Several regions of Iran are considered endemic for this infection; however, no comprehensive study of human fascioliasis has yet been conducted among hepatobiliary patients in the Urmia area. This study aimed to determine the seroprevalence of fascioliasis among patients with liver diseases referred to Imam Khomeini Hospital, Urmia, from 29 October 2024 to 26 February 2025. In this cross-sectional study, 313 sera were collected from patients with liver diseases referred to Imam Khomeini Hospital, Urmia. All sera were tested​ by anti- Fasciola hepatica IgG ELISA kit, and demographic, behavioral, and clinical data were recorded and analyzed using SPSS software. Geographic distribution of seropositive cases was mapped using geographic information system (GIS) mapping. Of the 313 patients examined, four (1.3%) tested seropositive for Fasciola infection; three of the four had a history of biliary stone and three resided in rural areas. Because of the small number of seropositive cases, the analysis was descriptive and no formal tests of association were performed. A live adult Fasciola sp. was endoscopically retrieved from the common bile duct of one seropositive-eosinophilic patient confirming active infection in this patient during the chronic biliary phase. The seroprevalence of fascioliasis among liver-disease patients in Urmia was low (1.3%), but numerically higher than the 0.33% recently reported in a different population survey in the same province. Given the parasite’s chronic course, its capacity to mimic other hepatobiliary disorders, clinicians should maintain caution for sporadic cases.