Operational guidelines for the elimination of human fascioliasis as a public health problem in the Americas

Abstract

Fascioliasis is a parasitic disease that affects both people and a wide variety of animals, primarily herbivores. In Latin America and the Caribbean, it is caused by the trematode Fasciola hepatica. Fascioliasis is classified by the World Health Organization (WHO) as one of the neglected tropical diseases. The Pan American Health Organization (PAHO), as part of its commitment to achieving the goals of the 2030 Agenda for Sustainable Development and the Sustainable Health Agenda for the Americas 2018-2030, has launched an initiative to eliminate communicable diseases in the Region of the Americas, which includes among its objectives the elimination of fascioliasis as a public health problem in the Americas by 2030. These operational guidelines have been developed to provide information and guidance to support endemic countries in advancing towards and achieving that goal. They have been prepared with the support of technicians from the countries as well as expert professionals from the Region and the WHO Collaborating Centre on fascioliasis and its vector snails, attempting to incorporate current practices and considering the challenges and particularities of endemic areas. While fasciolosis in animals is a problem in many countries of the Region, leading to economic losses, human fascioliasis is limited to environments where the ethnographic characteristics and socio-economic determinants necessary for human infection are present. These operational guidelines focus on such areas, typically associated with small-scale farmers and rural communities, and are framed within the "One Health" approach, integrating different sectors involved, working together and synergistically to make interventions more effective and sustainable.