WHO's 2021–30 road map for neglected tropical diseases (NTDs) outlines disease-specific and cross-cutting targets for the control, elimination, and eradication of NTDs in affected countries. For schistosomiasis, the criterion for elimination as a public health problem (EPHP) is defined as less than 1% prevalence of heavy-intensity infections (ie, ≥50 Schistosoma haematobium eggs per 10 mL of urine or ≥400 Schistosoma mansoni eggs per g of stool). However, we believe the evidence supporting this definition of EPHP is inadequate and the shifting distribution of schistosomiasis morbidity towards more subtle, rather than severe, morbidity in the face of large-scale control programmes requires guidelines to be adapted. In this Viewpoint, we outline the need for more accurate measures to develop a robust evidence-based monitoring and evaluation framework for schistosomiasis. Such a framework is crucial for achieving the goal of widespread EPHP of schistosomiasis and to meet the WHO road map targets. We encourage use of overall prevalence of schistosome infection (instead of the prevalence of heavy-intensity infections), development of species-dependent and age-dependent morbidity markers, and construction of a standardised monitoring and evaluation protocol.

世卫组织 2021-30 年被忽视热带病 (NTD) 路线图概述了受影响国家控制、消除和根除 NTD 的特定疾病和跨领域目标。对于血吸虫病，作为公共卫生问题消除的标准 (EPHP) 被定义为重度感染的流行率低于 1%（即≥50 个埃及血吸虫每 10 mL 尿液中检出卵或每克粪便中≥400 个曼氏血吸虫卵）。然而，我们认为支持 EPHP 这一定义的证据是不充分的，面对大规模控制计划，血吸虫病发病率分布向更微妙而非严重的发病率转变，需要对指南进行调整。在这个观点中，我们概述了需要更准确的措施来开发一个强有力的基于证据的血吸虫病监测和评估框架。这样一个框架对于实现广泛传播血吸虫病 EPHP 的目标和实现 WHO 路线图目标至关重要。我们鼓励使用血吸虫感染的总体流行率（而不是高强度感染的流行率），开发依赖于物种和年龄的发病率标记，