Global warming induced spread of the highest human fascioliasis hyperendemic area.

Abstract

Background: Climate change is driving the occurrence of several infectious diseases. Within a One Health action to complement the ongoing preventive chemotherapy initiative against human fascioliasis in the Northern Bolivian Altiplano hyperendemic area, field surveys showed a geographical expansion of its lymnaeid snail vector. To assess whether climate change underlies this spread of the infection risk area, an in-depth analysis of the long-term evolution of climatic factors relevant for Fasciola hepatica development was imperative.

Methods: We used monthly climatic data covering at least a 30-year period and applied two climatic risk indices, the water-budget-based system and the wet-day index, both of verified usefulness for forecasting fascioliasis transmission in this endemic area. To reveal the long-term trends of the climatic factors and forecast indices, we applied procedures of seasonal-trend decomposition based on locally weighed regression and trend analysis on the basis of linear models. To further demonstrate the changes detected, we depicted selected variables in the form of anomalies.

Results: This study revealed a notorious climatic change affecting most of the hyperendemic area, with a strong impact on crucial aspects of the fascioliasis transmission. Trends in maximum and mean temperatures show significant increases throughout the endemic area, while trends in minimum temperatures are more variable. Precipitation annual trends are negative in most of the localities. Trends in climatic risk indices show negative trends at lower altitudes or when farther from the eastern Andean chain. However, monthly and yearly values of climatic risk indices indicate a permanent transmission feasibility in almost every location.

Conclusions: Warmer temperatures have enabled lymnaeids to colonize formerly unsuitable higher altitudes, outside the endemicity area verified in the 1990s. Further, drier conditions might lead to an overexploitation of permanent water collections where lymnaeids inhabit, favoring fascioliasis transmission. Therefore, the present preventive chemotherapy by annual mass treatments is in need to widen the area of implementation. This study emphasizes the convenience for continuous monitoring of nearby zones for quick reaction and appropriate action modification.