Intestinal trematode infections are of significant public health importance in endemic areas, especially in Southeast Asia. The epidemiological studies are scarce and asymptomatic infections are usually not recorded. In India, the hospitalbased reports, mainly from Bihar, Uttar Pradesh, West Bengal and Assam, reveal that the intestinal trematodes of human pathogenic importance are Fasciolopsis buski, Metagonimus species, and Gastrodiscoides hominis. Fasciolopsiasis due to F. buski is the most prevalent infection. The clinical diagnosis is presumptive and is usually confirmed by the examination of faecal samples and/or following endoscopy examination. The diagnostic challenges are low sensiti vity of direct microscopy techniques and accurate species identification. Evaluation of multiple samples and application of sensitive techniques may reveal a higher positivity. The complications and extraintestinal manifestations following infection are also underestimated. In endemic areas, high worm load following repeated infections leads to complications, such as intestinal obstruction and perforation. Extraintestinal manifestations may involve spine, brain, kidneys, and the myocardium. If left untreated, the infection may cause significant morbidity and mortality. Praziquantel is the drug of choice and nitazoxanide therapy has also been reported effective for treatment. The reports indicating the implementation and effectiveness of any control strategies are lacking. The formulation and implementation of control strategies need to be based on a holistic approach, keeping in view multiple key factors, such as awareness of the infection and its complications, polyparasitism, population at risk, and zoonotic/aquatic transmission. A well-designed integrated program may simultaneously prevent multiple infections in addition to the intestinal trematode infections.
