Transmission 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.

中文翻译：

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监测血吸虫病和卫生干预措施—环境DNA的潜力

血吸虫病是一种人的寄生虫病，其传播与水，环境卫生和个人卫生（WASH）设施不足和/或使用不足有关。控制的主要手段是基于人群的化疗。在全球范围内，估计每年有2.4亿人需要这种预防性治疗。但是，为了对该疾病进行长期，可持续的控制，需要对WASH进行补充性改进，以防止（再）感染人类（提供安全水）和从人类传播到环境（改善卫生）。尽管已经建立了监测人口传播的方法，但目前缺乏监测WASH干预措施，特别是卫生设施对环境传播影响的方法。由于综合控制计划将药物治疗与增强的WASH设施和行为改变干预措施相结合，因此此类药物的开发变得至关重要。在环境中，吸收可能与粪便和血吸虫卵的减少有关，但对人类感染水平的任何影响都需要更长的时间。变得明显。本文报道并批评了当前用于监测淡水和土壤环境中血吸虫病的方法，并探讨了如何利用环境DNA更好地了解和监测与卫生有关的环境污染。需要更强有力的证据来了解不同的卫生干预措施如何限制寄生虫的环境传播及其在预防疾病中的相对有效性。