Abstract

BackgroundFascioliasis is a snail-borne zoonotic trematodiasis emerging due to climate changes, anthropogenic environment modifications, and livestock movements. Many areas where Fasciola hepatica is endemic in humans have been described in Latin America altitude areas. Highest prevalences and intensities were reported from four provinces of the northern Bolivian Altiplano, where preventive chemotherapy is ongoing. New strategies are now incorporated to decrease infection/re-infection risk, assessment of human infection sources to enable efficient prevention measures, and additionally a One Health initiative in a selected zone. Subsequent extension of these pilot interventions to the remaining Altiplano is key.MethodsTo verify reproducibility throughout, 133 specimens from 25 lymnaeid populations representative of the whole Altiplano, and 11 used for population dynamics studies, were analyzed by rDNA ITS2 and ITS1 and mtDNA cox1 and 16S sequencing to assess their classification, variability and geographical spread.ResultsLymnaeid populations proved to belong to a monomorphic group, Galba truncatula. Only a single cox1 mutation was found in a local population. Two cox1 haplotypes were new. Comparisons of transmission foci data from the 1990’s with those of 2018 demonstrated an endemic area expansion. Altitudinal, northward and southward expansions suggest movements of livestock transporting G. truncatula snails, with increasing temperatures transforming previously unsuitable habitats into suitable transmission areas. Transmission foci appear to be stable when compared to past field observations, except for those modified by human activities, including construction of new roads or control measures undertaken in relation to fascioliasis.ConclusionsFor a One Health initiative, the control of only one Fasciola species and snail vector species simplifies efforts because of the lower transmission complexity. Vector monomorphism suggests uniformity of vector population responses after control measure implementation. Hyperendemic area outer boundary instability suggests a climate change impact. All populations outside previously known boundaries were close to villages, human dwellings and/or schools, and should therefore be considered during disease control planning. The remarkable southward expansion implies that a fifth province, Aroma, should now be included within preventive chemotherapy programmes. This study highlights the need for lymnaeid molecular identification, transmission foci stability monitoring, and potential vector spread assessment.

Highlights

  • Fascioliasis is a snail-borne zoonotic trematodiasis emerging due to climate changes, anthropogenic environment modifications, and livestock movements

  • In the present study we describe the results of the 2018–2019 lymnaeid snail surveys made for two geographical purposes: (i) assessing presence/absence of lymnaeids in freshwater habitats located inside the whole endemic area to verify the stability of the patchy distribution established in the 1990s [34]; and (ii) analysis of freshwater habitats located in a wide perimeter outside the endemic boundaries established in the 1990s [34], to assess potential present and further spread of the disease occurred during the last 25 years

  • RDNA and mitochondrial DNA (mtDNA) marker sequences revealed that lymnaeids from all the localities surveyed belong to a single lymnaeid species, Galba truncatula

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Summary

Introduction

Fascioliasis is a snail-borne zoonotic trematodiasis emerging due to climate changes, anthropogenic environment modifications, and livestock movements. Increasing infection rates have been linked to the impact of climate change, both regarding animal fascioliasis [14] and more recently human fascioliasis [15], as it has been observed for other snailborne trematodiases [16] This new scenario has been considered of sufficient impact as to include fascioliasis within the group of food-borne trematodiases among the list of main neglected tropical diseases by the World Health Organization since the 1990s [17]. This scenario is characterized by a large heterogeneity and complexity in transmission patterns and epidemiological situations, characterized by multidisciplinary factors such as: environmental conditions; climate characteristics; lymnaeid species present; vector-specificity of the Fasciola species and their biogeography; livestock species present; local traditions of livestock management; sylvatic reservoir fauna; behaviour and social traditions and diet of the human communities; education and hygiene; among many others [8, 18]

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