Fascioliasis 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. To 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. Lymnaeid 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. For 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.

中文翻译：

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在玻利维亚高原人类最高筋膜炎高流行的“一个健康”倡议中发现的lymnaeid载体的遗传一致性，地理分布和人为栖息地修饰

筋膜病是一种蜗牛传播的人畜共患性皮肤病，是由于气候变化，人为环境变化和牲畜活动而引起的。在拉丁美洲的海拔地区，已经描述了许多人中Fasciola hepatica流行的地区。据报道，玻利维亚北部高原地区的四个省的发生率和强度最高，正在进行预防性化学治疗。现在采用了新的策略来降低感染/再感染的风险，评估人类感染源以采取有效的预防措施，以及在选定区域内实施“一个健康”计划。随后将这些试验性干预措施扩展到其余的高原地区是关键。为了验证整个过程的可重复性，代表了整个Altiplano的25个lymnaeid种群的133个标本，分别通过rDNA ITS2和ITS1以及mtDNA cox1和16S测序对用于种群动态研究的11种和11种进行了分析，以评估其分类，变异性和地理分布。淋巴菌群被证明属于一个单形群，即Galba truncatula。在本地人口中仅发现一个cox1突变。两种cox1单倍型是新的。1990年代与2018年的传播病灶数据的比较表明，流行区域扩大。垂直，向北和向南的扩张表明，牲畜运输的是迁徙的蜗牛，随着温度的升高，原来不合适的栖息地变成了合适的传播区域。与过去的实地观察相比，传播病灶似乎是稳定的，但人类活动导致的传播病灶除外，包括修建与筋膜病相关的新道路或采取的控制措施。对于“一个健康”计划，由于传播复杂性较低，因此仅控制一种Fasciola物种和蜗牛媒介物种可简化工作。向量单态性表明控制措施实施后向量种群响应的一致性。高流行区的外边界不稳定表明气候变化的影响。先前已知边界之外的所有人口都靠近村庄，人类住所和/或学校，因此应在疾病控制计划中予以考虑。显着的向南扩张意味着现在应该在预防性化学疗法计划中包括第五个省Aroma。这项研究强调了对淋巴结分子鉴定的需求，