High endemicity of human fascioliasis between Lake Titicaca and La Paz valley, Bolivia.

Over a 6-year period, an epidemiological study of human infection by Fasciola hepatica in the Northern Bolivian Altiplano was carried out. Prevalences and intensities were analysed from coprological results obtained in 31 surveys performed in 24 localities and proved to be the highest known so far. The global prevalence was 15.4%, with local prevalences ranging from 0% to 68.2%. Significant differences between prevalence rates were detected and the highest prevalences were in subjects aged < 20 years. However, prevalences showed no gender difference. The global intensity (eggs per gram of faeces, epg) ranged from 24 to 5064 epg and showed arithmetic and geometric means respectively of 446 and 191 epg, with highest local arithmetic and geometric means of 1345 and 678 epg. Significant differences in mean egg output were detected between localities. The significantly higher F. hepatica egg counts shown by girls in school surveys is worth mentioning. Although the distributions of intensities according to age-groups did not show any significant difference, a decrease of egg output counts with an increase of age was detected. It is concluded that fascioliasis is a very important human health problem in this region.