Abstract
BACKGROUND: Infections with liver flukes (Clonorchis sinensis, Opisthorchis viverrini, and O. felineus) cause high burden. Mechanistic models have been employed to disentangle their transmission dynamics and guide the design of control strategies. However, no comprehensive review of these mechanistic models has yet been undertaken. METHODS: In this systematic review, we searched six major databases (PubMed, Web of Science, Korea Med, Cochrane, China National Knowledge Infrastructure [CNKI], and Wanfang Data) for studies published up to 14 May 2025, to identify and evaluate mechanistic models of liver fluke infections. We included all mechanistic transmission models for human liver flukes regardless of language or setting, while excluded non-mechanistic models, reviews, and empirical studies. RESULTS: Of the 533 records identified, 18 studies were eligible for analysis. Most studies focused on C. sinensis in China and O. viverrini in Lao People's Democratic Republic, primarily employing population-based model with ordinary differential equations. Findings consistently identified humans as the central reservoir sustaining transmission, while the role of animal reservoir hosts (e.g. cats and dogs) in transmission was less explored (in 6 out of 18 studies) and divergent in different models. Models incorporating host heterogeneity demonstrated the superiority of integrated control strategies-combining mass drug administration, health education, and environmental improvements over single intervention. High frequency, coverage and adherence of measures were shown to be critical for achieving control or even elimination targets. CONCLUSION: Results from mechanistic models support the implementation of One Health strategies to improve liver fluke control. This review identifies the need for integrative, data-driven One Health modeling frameworks that incorporate human, animal, and environmental transmission parameters, and address key sources of heterogeneity in host behavior, exposure, and transmission dynamics to support control targets.