ACL Reconstruction with Peroneus Longus Tendon Autograft Does Not Compromise Ankle Function: A Retrospective Study of 327 Patients With ≥ 2-Year Follow-Up.

Snail-borne trematodiases remain an underrecognized public health concern in Sri Lanka. From May to December 2024, this study assessed the diversity and prevalence of cercarial emergence in freshwater snails from the Maha Oya River and examined environmental and anthropogenic factors influencing infection patterns. A total of four snail species were collected monthly across six sites, with Pseudoplotia scabra being the most abundant (73.9%) followed by Melanoides tuberculata (19.7%). Cercarial emergence was observed only in P. scabra and M. tuberculata, with three morphotypes identified: pleurolophocercous, furcocercous, and gymnocephalous. Identifications of both snails and cercariae were based solely on morphology; no molecular confirmation was performed. The overall prevalence was 7.1%, highest in M. tuberculata, while no cercariae were detected in Gyraulus rotula or Radix luteola. Water quality measurements (e.g., dissolved oxygen, conductivity, total dissolved solids) and human activity records (e.g., solid waste dumping, washing clothes, fishing) were analyzed using redundancy analysis (RDA), showing that degraded water conditions and elevated anthropogenic activities were significantly associated with higher cercarial prevalence, and overall snail abundance was positively correlated with these factors. Although seasonal variation was limited, furcocercous cercariae (morphologically consistent with schistosomes) were present at sites with frequent human-water contact, highlighting potential transmission risks. These findings emphasize the links between environmental degradation, human behavior, and parasitic risk, underscoring the need for integrated strategies to manage snail-borne diseases and safeguard freshwater health in tropical ecosystems.