Bệnh sán lá gan lớn (SLGL) ở người là một bệnh nhiễm ký sinh trùng gây ra bởi loài F. hepatica hoặc F. gigantica. Người là các vật chủ tình cờ cho bệnh và vật chủ chính là cừu và một số gia súc khác như trâu, bò. Dù SLGL đang được quan tâm của cộng đồng và giới khoa học đi sâu vào các khía cạnh từ dịch tễ học, đến chẩn đoán, điều trị và đề xuất các biện pháp phòng bệnh, song vẫn còn nhiều vấn đề còn bỏ ngõ đang tiếp tục nghiên cứu như kháng thuốc do sán Fasciola sp., trên gia súc, biện pháp phòng chống theo mô hình chung chưa phổ cập rộng rãi, nguyên nhân bệnh SLGL lan rộng và gia tăng trong những năm gần đây chưa có câu trả lời chính xác, phải chăng do sự phát triển chăn nuôi gia súc nhập ngoại nhưng lại không được quản lý chặt chẽ; sự thay đổi về điều kiện khí hậu, môi sinh thuận lợi khiến mầm bệnh tăng lên; sự phát triển đột biến về loài SLGL trong quá trình lai tự nhiên giữa các loài thường gặp ở người; phương tiện chẩn đoán kỹ thuật về miễn dịch huyết thanh (ELISA và Western-blot) ngày càng được áp dụng rộng rãi tại các tuyến nên tăng khả năng phát hiện các trường hợp mắc bệnh?

Bệnh cạnh đó, trong quá trình nghiên cứu nhiều tác giả vẫn đưa ra một số vấn đề còn bỏ ngõ trong nghiên cứu về bệnh SLGL ở người cũng như gia súc như dịch tễ học huyết thanh (sero-epidemiology) tại một số tỉnh có số ca mắc cao chưa được điều tra toàn diện và quy mô, nhất là các địa phương có chăn thả gia súc phổ biến; phân vùng dịch tễ học bệnh SLGL cần điều chỉnh và bổ sung vì phiên bản trước đây liệu có còn phù hợp không khi có Hướng dẫn chẩn đoán ca bệnh của TCYTTG ra đời có những thay đổi về định nghĩa ca bệnh (WHO, 2007) so với phác đồ chẩn đoán và điều trị, định nghĩa ca bệnh khác nhau trong nghiên cứu và trong thực hành lâm sàng; đánh giá dịch tễ học bệnh SLGL đồng thời với bệnh SLGL tại một số vùng, nơi mà có sự hiện diện đồng thời đủ các vật chủ (cừu, trâu, bò, dê, người) là điểm thú vị nhưng còn hạn chế về số nghiên cứu; ngoài gía thể truyền bệnh trên các rau thủy sinh thì còn các giá thể nào khác giúp cho lan truyền bệnh quy mô rộng hơn như trước đây một số quốc gia vùng Trung Đông, châu Phi đã từng mô mô tả? Hướng nghiên cứu phối hợp y tế - thú y trong phòng chống SLGL cả gia súc và người (sentinel site) à nhân rộng mô hình vẫn còn đó. Vì tất cả nghiên cứu về SLGL ở người đều ghi nhận nữ giới mắc nhiều hơn nam giới gấp nhiều lần, song lý giải và chứng minh vẫn chưa có bằng chứng thuyết phục. Do vậy, cần phân tích về kháng nguyên bạch cầu người (HLA_Human Leucocyte Antigens) ở các nhóm nhiễm xem liệu có sự khác biệt ý nghĩa không? Một số bộ chẩn đoán huyết thanh miễn dịch hiện nay vẫn còn nhược điểm dương tính giả hoặc âm tính giả, do vậy cần xây dựng bộ chẩn đoán sán F. gigantica bằng phương pháp Outchterlony immunodiffusion test để phát hiện Ag/Ab đặc hiệu hơn; Nghiên cứu giải trình tự bộ gen trên cơ ở phân tích ở bộ gen nhân và hệ gen ty thể của sán F. gigantica ở người và so sánh hệ thống Genbank về các loài Fasciola sp. ở các quốc gia và lãnh thổ khác; liên quan giữa tổn thương áp xe nhu mô gan do F. gigantica trên hai nhóm gan bình thường và gan nhiễm mỡ về quá trình phục hồi thương tổn chưa được đánh giá; đánh giá tính giảm nhạy và kháng thuốc TCBZ do sán F. gigantica. Thử nghiệm can thiệp chống kháng bằng phác đồ TCBZ phối hợp với thuốc khác như một số ca bệnh đã trình bày?

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