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4 July 2025

Knowledge and Awareness of Bovine Fasciolosis Among Dairy Farm Personnel in the Eastern Cape Province, South Africa

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1
Department of Animal and Pasture Science, University of Fort Hare, Private Bag X 1314, Alice 5700, South Africa
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Dohne Agriculture Development Institute, P.O. Box X15, Stutterheim 4930, South Africa
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Centre for Global Change, University of Fort Hare, Private Bag X 1314, Alice 5700, South Africa
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Department of Agriculture and Animal Health, University of South Africa, Private Bag X 15, Johannesburg 1710, South Africa
Parasitologia2025, 5(3), 33;https://doi.org/10.3390/parasitologia5030033
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Abstract

Fascioliasis, a parasitic disease caused by liver flukes of the genus Fasciola, remains a significant threat to livestock productivity globally. Despite its economic and zoonotic importance, the knowledge levels of dairy farm personnel regarding this disease remain insufficiently explored in South Africa. This study assessed knowledge and awareness of bovine fasciolosis, including its etiology, risk factors, clinical signs, zoonotic implications, and control measures, among dairy farm personnel in the Eastern Cape Province. A structured questionnaire was randomly administered to 152 dairy farm workers. Descriptive statistics and Chi-square tests were used to examine associations between respondents’ demographic characteristics and their knowledge of fasciolosis. Most respondents were males (65.8%), aged 31–40 years (45.4%), with tertiary education (64%), over six years of experience (65%), and residing in inland regions (65.4%). A high proportion reported implementing pasture management practices such as irrigation (90.8%), pasture resting (69.8%), and rotation (94.7). Significant associations were found between geographic location and knowledge of Fasciola spp. as the causative agent, as well as awareness of swampy areas and water snails as key risk factors (p < 0.01). Educational level was significantly associated with awareness of the zoonotic potential of fasciolosis (p < 0.01), and regional location influenced knowledge on control practices (p < 0.01). These findings highlight persistent gaps in the understanding of bovine fasciolosis among dairy farm personnel, particularly in relation to causative agents, clinical signs, and zoonotic risk. Strengthening extension services, enhancing community awareness, and implementing targeted training programs are essential to address these knowledge gaps and improve disease control strategies in the Eastern Cape Province.

1. Introduction

Fasciolosis, caused by trematodes of the genus Fasciola, is one of the most economically significant parasitic diseases affecting livestock globally, particularly dairy cattle [1,2,3,4]. Chronic infections result in substantial health and production challenges, including poor body condition, weight loss, reduced fertility, and impaired immune function [3,5,6,7,8]. Milk yield losses attributed to fasciolosis range between 8% and 15%, translating to a reduction of approximately 0.7–4.2 kg of milk per cow per day [9,10]. Globally, the disease costs the livestock industry over US$3 billion annually due to productivity losses, treatment expenses, and liver condemnation at slaughter [10,11,12,13,14,15,16].
The prevalence of bovine fasciolosis is influenced by both animal management practices and environmental conditions [17,18,19,20,21,22,23]. Factors such as high rainfall, poor drainage, irrigation systems, and swampy or marshland pastures create ideal habitats for the intermediate snail host, facilitating the parasite’s life cycle and transmission [19,22]. These ecological conditions render fasciolosis endemic in many tropical and subtropical regions, including various provinces of South Africa.
In South Africa, fasciolosis has been widely reported in livestock across KwaZulu-Natal, Mpumalanga, Limpopo, Northwest, and the Eastern Cape provinces [13,24,25]. Beyond its economic impact, the disease is also recognized zoonosis, with growing public health significance, particularly in rural and peri-urban communities [26]. In the Eastern Cape Province, bovine fasciolosis is prevalent in dairy herds, with reported infection rates ranging between 16.3% and 37.7%, based on post-mortem examinations and coprological analyses [27,28]. This continued prevalence suggests potential deficiencies in awareness, preventive practices, and control strategies among dairy producers.
Despite its widespread distribution, limited information is available on the knowledge levels of dairy farm personnel regarding fasciolosis in South Africa. International studies have highlighted low levels of awareness and limited understanding among farmers and livestock handlers. For instance, [29] found that most smallholder farmers Laos lacked knowledge of Fasciola spp. and their impacts. Similarly, Schweizer, et al. [30] reported poor disease recognition and limited adoption of control strategies among Swiss farmers. In Australia, [31] observed relatively high awareness levels but noted suboptimal use of diagnostic testing and inconsistent anthelmintic treatment practices. Locally, a study by [31] in the Northwest Province of South Africa revealed a poor understanding among smallholder cattle farmers concerning the transmission and prevention of fasciolosis.
These findings underscore the urgent need to strengthen extension services, deliver targeted training, and implement awareness campaigns to build the capacity of dairy personnel to identify and manage fasciolosis. In the Eastern Cape, where dairy farming is a vital socio-economic activity, understanding personnel knowledge regarding the disease’s risk factors, clinical signs, zoonotic implications, and control measures is essential. Such baseline data is critical for designing evidence-based interventions that are tailored to local farming systems. Therefore, the objective of this study was to assess dairy farm personnel’s knowledge of the etiological agents, risk factors, clinical manifestations, zoonotic implications, and control strategies associated with bovine fasciolosis in the Eastern Cape Province, South Africa.

2. Materials and Methods

2.1. Ethical Consideration

Ethical clearance for this study was granted by the University of Fort Hare Research Ethics Committee (Ref: JAJ011SMPI01/19/A) on 21 November 2022. Prior to participation, written informed consent was obtained from all respondents in their preferred language. Participants were assured that their participation was voluntary and that all information collected during the interviews would be treated with strict confidentiality.

2.2. Study Area

The study was conducted in the Eastern Cape Province of South Africa, the country’s second largest province, with a population of approximately 6.5 million people (Figure 1). The province covers an area of 169,580 km2, representing 13.9% of South Africa’s total land area. Approximately 63% of the province’s population resides in rural areas and faces high levels of unemployment. The Eastern Cape is also the third-largest contributor to South Africa’s raw milk production, accounting for about 26%, following the Western Cape and KwaZulu-Natal [32,33]. For the purposes of this study, five district municipalities with high concentrations of dairy farms were selected: Amathole, Buffalo City Metropolitan, Chris Hani, Nelson Mandela Bay Metropolitan, and Sarah Baartman District.
Figure 1. Map of the Eastern Cape Province of South Africa showing the districts (Nelson Mandela Bay Metropolitan, Amathole, Buffalo City Metropolitan, Chris Hani, and Sarah Baartman), including local municipalities, and specific dairy farm sites surveyed during the study. (Letters A–O are the abbreviated names of the farms visited during the survey to keep them anonymous.)

2.3. Participant Selection

Participants were recruited using a snowball sampling approach. An initial list of dairy farm owners was obtained from the Milk Producers Organization, and thirty-six farm owners agreed to take part in the study. On each participating farm, 7 to 10 dairy personnel were targeted, including animal technicians, milkers, general workers, supervisors, and farm managers. In total, 152 respondents completed the questionnaire. Incomplete responses were excluded from the final analysis.

2.4. Data Collection

Data were collected from 152 respondents using a structured questionnaire, which comprised six key sections: (A) farmer’s demographic information, (B) dairy pasture feeding management, (C) knowledge of Fasciola pathogens, (D) knowledge about fasciolosis symptoms, (E) knowledge about risk factors, and (F) knowledge about disease control, treatment, and prevention. Ten trained interviewers administered the questionnaires to the respondents in their preferred language (English, IsiXhosa, or Afrikaans) between January and February 2023. In addition, the farm characteristics were documented and categorized by herd size: small (315–500 animals), medium (501–1500), and large (1501–4000). Farming systems were also classified as pasture-based (PB), total-mixed ration (TMR), and subsistence farming systems (SFS). Geographically, farms were grouped into two broad regions, coastal (high rainfall) and inland (low precipitation). Data were initially recorded on hard copy forms and later digitized using Microsoft Excel.

2.5. Statistical Analyses

Data were analyzed using R statistical software (version 4.1.2) [34]. Descriptive statistics were used to summarize the frequency distributions of categorical variables. Pearson’s chi-square tests were conducted to assess the associations between respondents ‘demographic characteristics and their knowledge of bovine fasciolosis, animal management practices, awareness of clinical signs, and understanding of risk factors. A knowledge score was calculated by assigning +1 for each correct answer and −1 for incorrect answer. The cumulative score was used to determine the overall knowledge levels: a positive score (≥1) indicated sufficient knowledge, whereas a negative score (<0) indicated insufficient knowledge of fasciolosis-related topics. Additionally, logistic regression analysis was performed to assess regional differences in respondents’ practices related to the treatment, control, and prevention of bovine fasciolosis.

3. Results

3.1. Socio-Demographic Characteristics and Knowledge of Fasciolosis

Most respondents were aged between 31–40 (45.4%) and predominantly male (65.8%). A significant proportion (64%) has attained tertiary education level and the majority were either farm managers (48.0%) or general workers (44.1%). In terms of work experience, 65% of respondents had more than six years of experience in dairy farming, followed by those with two years (10.5%), 5–6 years (9.9%), 2–4 years (8.6%), and less than 2 years (5.3%). Respondents from large-scale farms demonstrated significantly higher knowledge of the etiology (p < 0.01) and intermediate host/vector (p < 0.05) of bovine fasciolosis compared to those from medium and small-scale farms. Similarly, respondents aged below 40 years were more knowledgeable about the disease’s aetiologic agents (p < 0.01) and intermediate host (p < 0.01). A significantly greater proportion of respondents from coastal regions, where precipitation levels are typically higher, demonstrated better knowledge of both the etiology (p < 0.01) and intermediate host (p < 0.01) of fasciolosis compared to those from inland regions. Educational background also played a significant role: respondents who studied agriculture were more knowledgeable about the disease’s etiology (p < 0.01) and intermediate hosts (p < 0.01) of fasciolosis than those without agricultural training. Moreover, those with tertiary qualifications were more informed about the disease’s etiology (p < 0.01) and transmission cycle than respondents with only secondary or primary education (p < 0.01 for both), Table 1.
Table 1. Demographic information of respondents and farmers’ knowledge of parasite host and etiologic agents.

3.2. Factors Influencing Knowledge of Fasciolosis and Its Zoonotic Importance

A higher proportion of male respondents than females demonstrated knowledge of fasciolosis (p < 0.01) and its zoonotic potential (p < 0.01). Younger respondents, particularly those under 40 years of age, exhibited significantly greater awareness of fasciolosis (p < 0.01) and its zoonotic significance (p < 0.01) compared to older age groups. Educational attainment was a significant determinant of knowledge: respondents with tertiary education were more informed about both fasciolosis (p < 0.01) and its zoonotic implications (p < 0.01) than those with only primary or secondary schooling. Furthermore, respondents with a background in agricultural studies were significantly more knowledgeable about fasciolosis (p < 0.01) and its zoonotic nature (p < 0.01) compared to those without formal agricultural education. Experience in the dairy sector also emerged as a key factor; respondents with more than six years of dairy farming experience were significantly more likely to be knowledgeable about the disease and its zoonotic relevance (p < 0.01) than those with less experience. In terms of occupational roles, Animal Health Technicians (AHTs) exhibited the highest level of awareness regarding the zoonotic importance of fasciolosis (85.7%), followed by supervisors (75%), general workers (67.5%), and managers (46%) (p < 0.01) Table 2.
Table 2. Demographic information of respondents’ knowledge of fasciolosis and zoonotic potential of the disease.

3.3. Farm Management Practices and the Association with Fasciolosis Risk Knowledge

Most dairy farm personnel (86.2%) did not engage in mixed farming, with only a small proportion (13.8%) reporting the integration of crops and livestock. Most farms practiced pasture-based systems (96.7%), while only 3.3% utilized total mixed ration (TMR) feeding. Regarding pasture management, a significant proportion of respondents reported implementing irrigation (90.8%), seasonal drying-off practices (69.8%), and pasture rotation (94.7%), all of which are critical components of sustainable grazing systems. In terms of grazing duration, more than half (52.2%) of the respondents reported grazing their animals for less than a day before moving to fresh pastures, compared to 46.1% who grazed for a full day and only 1.7% who extended grazing beyond one day. Most respondents reported resting their pastures for periods ranging from 21 to 33 days (51.3%), while 28.9% allowed longer rest periods exceeding 33 days, and 18.8% rested pastures for 9 to 21 days. Importantly, knowledge of key risk factors associated with bovine fasciolosis, particularly the presence of swampy areas and freshwater snails, was significantly associated (p < 0.05) with all recorded farm management variables (Table 3).
Table 3. Associations between farm management and swampy areas and the presence of freshwater snails.

3.4. Knowledge of Clinical Signs of Bovine Fasciolosis

There were significant associations (p < 0.05) between geographic region and respondents’ knowledge of clinical signs of bovine fasciolosis. Specifically, more respondents from coastal regions correctly identified key clinical signs such as anemia (p < 0.01), weight loss and inappetence (p < 0.01), milk reduction (p < 0.01), and bottle jaw (p < 0.01) compared to their inland counterparts. Additionally, diarrhea was more frequently recognized as a clinical sign among coastal respondents. Notably, fewer respondents (p < 0.05) incorrectly identified unrelated symptoms such as coughing and nausea, suggesting Ca more accurate understanding of the disease’s clinical presentation in these areas. Furthermore, all the risk factors for fasciolosis, including environmental and animal-related factors, were significantly (p < 0.05) associated with the respondents’ knowledge across both coastal and inland regions (Table 4).
Table 4. Associations between regions (coastal and inland) and knowledge of clinical signs of fasciolosis.

3.5. Knowledge of Risk Factors Associated with Fasciolosis

As shown in Table 5, knowledge of fasciolosis risk factors varied significantly by region (p < 0.01). Most respondents (63.2%) identified summer as the season with the highest disease risk, followed by spring (27.6%). Fewer cited autumn (4.7%) or winter (4.7%), consistent with snail ecology favoring warm, moist conditions (Table 6). Respondents’ understanding of animal-level risk factors, such as age, body condition, and breed susceptibility, also showed significant associations (p < 0.01) (Table 7).
Table 5. Respondents’ knowledge of risk factors associated with fasciolosis between regions.
Table 6. Respondent’s knowledge of season as a risk factor associated with fasciolosis between the regions.
Table 7. Associations between age, body condition scores, breed, and regions.

3.6. Knowledge on Treatment, Control, and Prevention of Fasciolosis

Table 8 shows regional disparities in knowledge of treatment and control strategies. Awareness of deworming protocols, drug rotation, and preventive measures varied significantly between coastal and inland regions (p < 0.01). Knowledge of anthelmintic drugs also differed (p < 0.05). Multivariate analysis (Table 9) revealed that males were more likely to possess adequate knowledge (OR = 2.43; p < 0.01). Agricultural training (OR = 2.14; p < 0.01) and inland residence (OR = 1.15; p < 0.01) were also associated with higher knowledge levels.
Table 8. Respondent’s knowledge of disease treatment, common anthelminthic drugs, prevention, and control.
Table 9. Multivariable association between positive scores (1 Yes vs. No −1) and potential covariate demographic variables.

4. Discussion

Information on the knowledge of dairy farm personnel regarding Bovine fasciolosis remains limited. This study aimed to assess the level of knowledge among dairy farm personnel with respect to etiology, risk factors, and clinical signs, and control of bovine fasciolosis. The results help highlight the need for targeted awareness and intervention strategies to address knowledge gaps and strengthen disease management in dairy farming systems. The predominance of respondents under the age of 40 years may reflect increasing youth involvement in dairy sector. The majority of participants were male, which could be linked to the physically demanding nature of dairy farm work, an observation consistent with Olaogun, Fosgate, Byaruhanga and Marufu [31].
Similarly, Diniso and Jaja. Diniso and Jaja [35] also reported a predominance of young and male respondents in their dairy sector, attributing this to the physical strength and endurance required for such work. The high proportion of tertiary-educated respondents in the present study may be due to the inclusion of farm managers and supervisors, positions thart require formal qualifications. Most respondents had over six years of experience, suggesting sustained engagement of younger individuals in the dairy sector
Notably, younger respondents (under 40) demonstrated higher knowledge levels regarding bovine fasciolosis. This may be attributed to generational differences in access to education and information. Improved educational systems and more recent training may provide younger workers with more accurate and up-to-date knowledge about animal health and zoonotic diseases. Similar generational patterns in knowledge levels have been reported in other contexts, including China [36].
However, most respondents lacked awareness of the zoonotic potential of fasciolosis. This could reflect broader challenges, such as limited training, inadequate extension services, and low overall access to veterinary support. These findings align with those reported by Olaogun et al. [31], who found poor understanding of zoonotic diseases among smallholder farmers. Globally, fasciolosis is recognized as an emerging parasitic zoonosis, affecting an estimated 2.4 million people annually across 61 countries, with approximately 180 million people at risk [26,35]. Local farmers frequently report economic losses due to liver condemnation at abattoirs [13,37,38,39,40]. The knowledge gap observed in this study may stem from insufficient scientific understanding or a lack of disease-specific training, particularly concerning foodborne zoonoses (Thi et al. [41]). Comparable findings have been reported in Bangladesh and Germany, where respondents also had limited knowledge of fasciolosis as a zoonotic disease, despite acknowledging its impact on animal productivity [19,42].
Most respondents did not engage in mixed farming; however, those who did kept combinations such as sheep and dairy cattle, or dairy and beef animals. Such practices could increase helminthic infection risks and complicate control efforts [43,44]. These results align with findings from Kenya [45]). Approximately 90.8% of respondents reported irrigating pasture during winter to maintain forage quality. While beneficial for forage production, irrigation may sustain soil moisture levels conducive to Fasciola egg and larval survival, as well as suitable habitats for snail intermediate hosts [20,46]. Similar observations have been made in Germany and Australia [20,31]. The study revealed limited knowledge and several misconceptions regarding the primary causative agents (Fasciola hepatica and F. gigantica) and their intermediate hosts (freshwater or mud snails). Prior research in South Africa confirmed the prevalence of Pseudosuccinea columella and Radix natalensis, the latter being the principal intermediate host of F. gigantic, as well as Galba truncatula, common in cooler regions [47,48,49]. Poorly maintained drinking troughs and swampy grazing areas were cited as major contributors to snail populations ([27]). Alarmingly, some respondents misidentified the causative agents of fasciolosis as Escherichia coli O157:H7, Staphylococcus aureus, Cysticercosis, and Bovine tuberculosis [50,51], indicating a lack of disease-specific education [35]
Recognition of clinical signs varied significantly by region, with coastal respondents more accurately identifying symptoms such as anemia, weight loss, reduced milk yield, diarrhea, and “bottle jaw.” This regional variation may be influenced by more frequent veterinary services, greater exposure to extension activities, or local education programs. Environmental factors, especially swampy terrain, were significantly associated with knowledge levels, consistent with findings from Northwest Tunisia [52]. Respondents widely recognized that fasciolosis incidence increases in the summer months due to rainfall, humidity, and prolonged grazing, creating optimal conditions for disease transmission [6,27,53,54,55]. Although fasciolosis affects cattle of all ages, older and multiparous cows were perceived as more susceptible, possibly due to immune suppression during gestation, parturition, and lactation [56,57,58,59]. Respondents also acknowledged that fasciolosis is more common in cattle with poor body condition scores. This is supported by earlier studies showing higher parasite burdens in under-conditioned animals due to inappetence and anemia caused by chronic infection [27,60,61,62]. Further support comes from a South African study that reported high fluke intensity in cattle with poor body condition [27,61].
Interestingly, many respondents believed that Holstein-Friesland cattle are more susceptible to liver fluke infection. This perception may be valid, as a UK study estimated a true prevalence of F. hepatica infection in Holstein-Frieslands at 78.1% [9]. However, other studies from Peru and the UK found higher prevalence in other breeds, such as Brown Swiss [58,63]. These discrepancies may reflect differences in breed resilience, environmental conditions, or management practices. Notably, there are no local studies assessing farmer knowledge regarding breed susceptibility to fasciolosis. Significant associations were found between region and animal risk factors such as age, breed, and body condition score. These variations may stem from differences in access to veterinary support, training, and exposure to extension services, though literature on this topic in South Africa remains scarce. Most respondents indicated that sick animals were treated using a combination of anthelmintics, reflecting awareness of drug resistance risks associated with repeated use of a single compound [64]. This finding aligns with studies from Australia, the UK, and Germany [44,65]. Resistance to flukicides remains a global concern [31,64,66,67,68,69].
Respondents commonly used fluconazole, triclabendazole, and ivermectin, with triclabendazole being the preferred treatment. This is consistent with global recommendations, as triclabendazole is often considered the most effective flukicide against fasciolosis [31,70,71]. Rotational grazing was the most frequently cited preventive practice. This suggests that it is considered a practical and effective strategy for reducing infection rates in dairy herds. Similar findings have been reported in Australia, Germany, and South Africa [72,73,74]. Finally, respondents preferred surveillance as the primary strategy for fasciolosis control over chemotherapy or vector control. This preference reflects recognition of surveillance as a sustainable means of reducing fluke burden and improving animal health and productivity. Comparable strategies have been reported in both African and European contexts [40,75,76,77]. Although fluke control often emphasizes grazing management and flukicide use, snail control remains limited due to the environmental concerns associated with molluscicides. Alternative methods such as pasture drainage, while effective, are often impractical or prohibitively expensive in many low-resource settings [2,72,73,74].

5. Conclusions

The current study highlights both strengths and gaps in the knowledge of dairy farm personnel regarding bovine fasciolosis in South Africa. While the majority of respondents were aware of key risk factors and could identify at least three clinical signs of the disease, important deficiencies remain. Notably, “bottle jaw”, a hallmark indicator, was poorly recognized, and there was widespread unawareness of the zoonotic potential of fasciolosis. Additionally, misconceptions surrounding the causative agents, Fasciola hepatica and Fasciola gigantica, further underscore the need for targeted, disease-specific education. These findings emphasize the importance of ongoing training and retraining programs for farm personnel. Improving knowledge levels, coupled with greater access to veterinary extension services and the strategic use of anthelmintic drugs, could meaningfully shift the epidemiological trajectory of fasciolosis in endemic areas. To effectively reduce the incidence of liver fluke infections and enhance livestock productivity, it is essential to integrate comprehensive control measures into farm management systems. These include pasture management, flukicide rotation, and the adoption of targeted treatment protocols. A multi-faceted and well-informed approach is critical to strengthening fasciolosis control and promoting the sustainability of the dairy sector in South Africa.

Author Contributions

Investigating, data collection, analysis, and writing the original draft, Z.M.; Supervising, logistics, conceptualization, reviewing, and editing, I.F.J.; Review and editing, M.S.; Reviewing and editing, M.Y.; Review, editing, N.N.; Review, editing, J.O. All authors have read and agreed to the published version of the manuscript.

Funding

United Nations Children’s Fund (UNICEF) funded this research, and researchers also received financial support from the University of Fort Hare.

Institutional Review Board Statement

Ethical clearance for the study was reviewed and obtained from JAJ011SMPI01/19/A at the University of Fort Hare.

Data Availability Statement

Data may be provided on request to the corresponding authors.

Acknowledgments

This paper is part of the first author’s PhD program. The authors thank the United Nations Children’s Fund (UNICEF) for funding the research, and dairy farm personnel from five district municipalities for their full participation in the research.

Conflicts of Interest

The authors declare no conflicts of interest.

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