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Abstract
AbstractTransmission of schistosomiasis, a human parasitic disease, is intrinsically linked to inadequate water, sanitation, and hygiene (WASH) facilities and/or their use. The mainstay of control is population‐based chemotherapy. Globally, each year, 240 million people are estimated to require this preventative treatment. However, for long‐term, sustainable control of this disease, supplementary WASH improvements are required to prevent (re)infection of humans (provision of safe water) and transmission from humans to the environment (improved sanitation). While there is established methodology for monitoring transmission in human populations, presently methods for monitoring the impact of WASH interventions, in particular sanitation, on environmental transmission are lacking. Development of such becomes paramount as integrated control programs combine drug treatments with enhanced WASH facilities and behavior change interventions, with uptake likely correlated to a reduction in fecal matter, and schistosome eggs, in the environment but any impact on infection levels in humans taking longer to become apparent. This article reports and critiques the methods currently used to monitor schistosomiasis in freshwater and soil environments and explores how environmental DNA could be used to better understand and monitor environmental contamination in relation to sanitation. Stronger evidence is required to understand how different sanitation interventions serve to limit the environmental transmission of the parasite and their relative effectiveness in preventing disease.This article is categorized under: Engineering Water > Methods
Highlights
Human schistosomiasis is a chronic neglected tropical disease and transmission is intrinsically linked with inadequate water, sanitation, and hygiene (WASH) (Grimes et al, 2015)
Quantifying transmission risk of S. mansoni, by environmental DNA (eDNA) techniques to sample the aquatic environment, can provide valuable information on transmission risk related to water access and use (Sato et al, 2018; Sengupta et al, 2019)
Data on the soil environment may be more beneficial for the evaluation of sanitation interventions including their uptake and effectiveness. eDNA could provide timely information on the success of interventions in containing the fecal material and locate any leakage or general inadequate containment
Summary
Human schistosomiasis is a chronic neglected tropical disease and transmission is intrinsically linked with inadequate water, sanitation, and hygiene (WASH) (Grimes et al, 2015). Two species cause the majority of infection and disease on the African continent: Schistosoma mansoni, causing intestinal and hepatic schistosomiasis, and, Schistosoma haematobium which causes urogenital schistosomiasis These parasites require a mammalian and aquatic snail host to complete their lifecycle (Figure 1). The immature stage of the schistosome (schistosomula) develops in the human host and matures into adult parasitic worms which sexually reproduce Their eggs are released into the environment through their host's excreta, feces in the case of S. mansoni. Molecular approaches for the detection of Schistosoma mansoni: possible applications in the detection of snail infection, monitoring of transmission sites, and diagnosis of human infection
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