Associations of Fluke (Spirorchiid) Infection and Buoyancy Disorder with Death in Stranded Sea Turtles Undergoing Rehabilitation in Taiwan

Sea turtles are increasingly regarded as indicators of coastal ecosystem health, as their clinical condition and disease profiles reflect prolonged exposure to environmental pressures in impacted marine habitats. Wildlife rehabilitation facilities play an important role in sea turtle conservation, although risk factors associated with mortality during rehabilitation are not well defined. This retrospective study evaluated clinical and infectious risk factors for death in 108 stranded sea turtles (including 70 green turtles, 19 olive ridley turtles, 16 hawksbill turtles, 2 loggerhead turtles, and 1 leatherback turtle) admitted to the rehabilitation facility at the National Museum of Marine Biology and Aquarium between 2018 and 2024. Data on buoyancy disorder, spirorchiid fluke infection, fibropapillomatosis and final disposition were analysed using univariate and multivariable logistic regression. Buoyancy disorder (adjusted OR = 9.96) and spirorchiid fluke infection (adjusted OR = 3.33) were associated with increased mortality, highlighting the need for careful monitoring and early detection of these conditions during rehabilitation. However, the retrospective design may inherently limit causal inference.