Schistosomiasis is among the most common parasitic diseases in the world, with over 142 million people infected in low- and middle-income countries. Measuring population-level transmission is centrally important in guiding schistosomiasis control programs. Traditionally, human Schistosoma mansoni infections have been detected using stool microscopy, which is logistically difficult at program scale and has low sensitivity when people have low infection burdens. We compared serological measures of transmission based on antibody response to S. mansoni soluble egg antigen (SEA) with stool-based measures of infection among 3,663 preschool-age children in an area endemic for S. mansoni in western Kenya. We estimated force of infection among children using the seroconversion rate and examined how it varied geographically and by age. At the community level, serological measures of transmission aligned with stool-based measures of infection (ρ = 0.94), and serological measures provided more resolution for between-community differences at lower levels of infection. Force of infection showed a clear gradient of transmission with distance from Lake Victoria, with 94% of infections and 93% of seropositive children in communities <1.5 km from the lake. Force of infection increased through age 3 y, by which time 65% (95% CI: 53%, 75%) of children were SEA positive in high-transmission communities—2 y before they would be reached by school-based deworming programs. Our results show that serologic surveillance platforms represent an important opportunity to guide and monitor schistosomiasis control programs, and that in high-transmission settings preschool-age children represent a key population missed by school-based deworming programs.

血吸虫病是世界上最常见的寄生虫病之一，在中低收入国家/地区感染了1.42亿人。在指导血吸虫病控制计划中，测量人群水平的传播至关重要。传统上，人类粪便曼氏血吸虫感染是使用粪便显微镜检测的，这在程序规模上在逻辑上是困难的，并且当人们的感染负担低时敏感性较低。我们比较了曼氏葡萄球菌流行地区中3,663名学龄前儿童中基于对曼氏葡萄球菌可溶性蛋抗原（SEA）抗体反应的传播的血清学测量与基于粪便的感染测量。在肯尼亚西部。我们使用血清转化率估算了儿童中的感染力，并研究了其在地理位置和年龄上的变化。在社区一级，传播的血清学措施与基于粪便的感染措施一致（ρ= 0.94），而血清学措施为较低感染水平下的社区间差异提供了更高的解决方案。感染力显示与维多利亚湖的距离呈明显的传播梯度，距离湖泊不到1.5公里的社区中94％的感染儿童和93％的血清反应阳性儿童。感染力在3岁之前有所增加，到那时，高传播社区中65％（95％CI：53％，75％）的儿童SEA呈阳性，这是在基于学校的驱虫计划之前2年。