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• W2894136508 abstract "The neglected tropical disease of schistosomiasis is caused by waterborne parasitic blood flukes of the genus Schistosoma, whose lifecycle involves an intermediate fresh-water snail host and a definitive human host. As recently highlighted, schistosomiasis still causes extensive morbidity in Southeast Asia, South America, parts of the Middle East, and, most notably, in Sub-Saharan Africa (McManus et al., 2018McManus D.P. Dunne D.W. Sacko M. Utzinger J. Vennervald B.J. Zhou X.-N. Schistosomiasis.Nat Rev Dis Primers. 2018; 4: 13Crossref PubMed Scopus (462) Google Scholar). Worryingly, an outbreak of urogenital schistosomiasis, imported by individuals infected most likely in Senegal, West Africa, was reported recently in Corsica, France, with more than 120 tourists or local people infected (Boissier et al., 2016Boissier J. Grech-Angelini S. Webster B.L. Allienne J.F. Huyse T. Mas-Coma S. et al.Outbreak of urogenital schistosomiasis in Corsica (France): an epidemiological case study.Lancet Infect Dis. 2016; 16: 971-979Abstract Full Text Full Text PDF PubMed Scopus (166) Google Scholar). It is now generally accepted that the elimination of schistosomiasis will only be achieved through a multifaceted intervention approach, including snail control, targeted health education, improved water, sanitation and hygiene facilities, drug treatment, tailored surveillance–response mechanisms, and accurate diagnostics, which will be key to eventual success (McManus et al., 2018McManus D.P. Dunne D.W. Sacko M. Utzinger J. Vennervald B.J. Zhou X.-N. Schistosomiasis.Nat Rev Dis Primers. 2018; 4: 13Crossref PubMed Scopus (462) Google Scholar). Currently the diagnosis of schistosomiasis primarily involves the detection of worm antigens in serum or eggs in excreta (McManus et al., 2018McManus D.P. Dunne D.W. Sacko M. Utzinger J. Vennervald B.J. Zhou X.-N. Schistosomiasis.Nat Rev Dis Primers. 2018; 4: 13Crossref PubMed Scopus (462) Google Scholar, Weerakoon et al., 2018Weerakoon K.G. Gordon C.A. McManus D.P. DNA diagnostics for schistosomiasis control.Trop Med Infect Dis. 2018; 3: 81Crossref Scopus (46) Google Scholar). In addition to the clinical diagnosis of schistosome infections, tools for detecting Schistosoma spp transmission in snail hosts and the environment will be critically important if the ultimate goal of schistosomiasis elimination is to be achieved. Xenomonitoring – the detection of infected snail hosts – is one pivotal indicator of schistosomiasis endemicity in a particular area, providing useful information on the potential for transmission (Rollinson et al., 2013Rollinson D. Knopp S. Levitz S. Stothard J.R. Tchuem Tchuenté L.-A. Garba A. et al.Time to set the agenda for schistosomiasis elimination.Acta Trop. 2013; 128: 423-440Crossref PubMed Scopus (389) Google Scholar). Furthermore, xenomonitoring is important in identifying infection risk areas to guide surveillance and necessary interventions, such as focused snail control using chemicals (e.g., niclosamide) released directly into water, and it represents a critical measure for achieving schistosomiasis elimination goals (Rollinson et al., 2013Rollinson D. Knopp S. Levitz S. Stothard J.R. Tchuem Tchuenté L.-A. Garba A. et al.Time to set the agenda for schistosomiasis elimination.Acta Trop. 2013; 128: 423-440Crossref PubMed Scopus (389) Google Scholar). The removal of infected snails results in lower numbers of infectious cercariae, thereby reducing the risk of infection. The importance of snail control in the successful elimination of schistosomiasis is exemplified by Japan, where elimination of Schistosoma japonicum was achieved before the roll-out of praziquantel, with the main control strategy involving the targeting of susceptible snail colonies through environmental modifications and the use of chemical molluscicides; the last new human case found in Japan was at Kofu in 1977 (Tanaka and Tsuji, 1997Tanaka H. Tsuji M. From discovery to eradication of schistosomiasis in Japan: 1847–1996.Int J Parasitol. 1997; 27: 1465-1480Crossref PubMed Scopus (98) Google Scholar). In addition to xenomonitoring, the other important surveillance measure to determine the existence of unsafe environmental contamination with schistosomes is the detection of miracidia and cercariae in water sources (Muhoho et al., 1997Muhoho N.D. Katsumata T. Kimura E. Migwi D.K. Mutua W.R. Kiliku F.M. et al.Cercarial density in the river of an endemic area of schistosomiasis haematobia in Kenya.Am J Trop Med Hyg. 1997; 57: 162-167Crossref PubMed Scopus (27) Google Scholar, Aoki et al., 2003Aoki Y. Sato K. Muhoho N.D. Noda S. Kimura E. Cercariometry for detection of transmission sites for schistosomiasis.Parasitol Int. 2003; 52: 403-408Crossref PubMed Scopus (27) Google Scholar). Evaluating the presence of these larvae is an important factor in detecting infection transmission sites. Testing for the presence of cercariae is helpful in determining their diurnal variation, seasonal patterns, and spatial distribution. However, commonly used conventional microscopic methods lack sensitivity and are highly labor-intensive (Muhoho et al., 1997Muhoho N.D. Katsumata T. Kimura E. Migwi D.K. Mutua W.R. Kiliku F.M. et al.Cercarial density in the river of an endemic area of schistosomiasis haematobia in Kenya.Am J Trop Med Hyg. 1997; 57: 162-167Crossref PubMed Scopus (27) Google Scholar, Aoki et al., 2003Aoki Y. Sato K. Muhoho N.D. Noda S. Kimura E. Cercariometry for detection of transmission sites for schistosomiasis.Parasitol Int. 2003; 52: 403-408Crossref PubMed Scopus (27) Google Scholar). Infection of sentinel mice has also been used to identify transmission sites and to assess the risk for schistosomiasis in China (Yang et al., 2013Yang K. Sun L. Liang Y. Wu F. Li W. Zhang J. et al.Schistosoma japonicum risk in Jiangsu province, People’s Republic of China: identification of a spatio-temporal risk pattern along the Yangtze River.Geospat Health. 2013; 8: 133-142Crossref PubMed Scopus (22) Google Scholar), but the procedure is time-consuming and impractical on a large scale. Furthermore, the near identical morphology of schistosome furcocercous cercariae makes identification to the species level practically challenging, if not impossible, and the fact that the cercariae of non-human and human schistosome species can co-exist in many endemic areas makes it important to be able to speciate these parasites precisely to confirm the presence and transmission of human schistosomiasis (Madsen and Hung, 2015Madsen H. Hung N.M. An overview of freshwater snails in Asia with main focus on Vietnam.Acta Trop. 2015; 140: 105-117Crossref Scopus (30) Google Scholar). As a result, PCR-based molecular diagnosis is now being considered increasingly as an option for this area of surveillance (Hamburger et al., 1998Hamburger J. Xu X. Ramzy R.M. Jourdane J. Ruppel A. Development and laboratory evaluations of polymerase chain reaction for monitoring Schistosoma mansoni infestation of water.Am J Trop Med Hyg. 1998; 59: 468-473Crossref PubMed Scopus (55) Google Scholar, Hung and Remais, 2008Hung Y.W. Remais J. Quantitative detection of Schistosoma japonicum cercariae in water by real-time PCR.PLoS Negl Trop Dis. 2008; 2e337Crossref PubMed Scopus (60) Google Scholar, Abath et al., 2006Abath F.G.C. Gomes A.L. Melo F.L. Barbosa C.S. Werkhauser R.P. 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.Mem Inst Oswaldo Cruz. 2006; 101: 145-148Crossref PubMed Scopus (32) Google Scholar). Although real-time PCR (qPCR) has been used successfully in the quantitative detection of schistosome cercariae in water samples (Hertel et al., 2004Hertel J. Kedves K. Hassan A.H.M. Haberl B. Haas W. Detection of Schistosoma mansoni cercariae in plankton samples by PCR.Acta Trop. 2004; 91: 43-46Crossref PubMed Scopus (18) Google Scholar, Worrel et al., 2011Worrel C. Xiao N. Vidal J.E. Chen L. Zhong B. Remais J. Field detection of Schistosoma japonicum cercariae in environmental water samples by quantitative PCR.Appl Environ Microbiol. 2011; 77: 2192-2195Crossref PubMed Scopus (29) Google Scholar), the paper by Sato et al. published in today’s issue of the International Journal of Infectious Diseases is timely in that it shows the potential for the first time of using environmental Schistosoma mansoni DNA to identify schistosomiasis transmission areas. Another important feature of this study is that the field validation of the environmental DNA (eDNA) qPCR method was undertaken in the district of Maevatanana in Madagascar, one of the poorest countries in the world, and where both hyper-endemic S. mansoni and Schistosoma haematobium persist despite efforts to reduce prevalence and reinfection rates and prevent the occurrence of severe disease complications (Ministère de la Santé Publique de Madagascar, 2016Ministère de la Santé Publique de Madagascar Cartographie des Maladies Tropicales negligees a Chimiotherapie preventive Schistosomiasis-geo Helminthiases-Filariose Lymphatique. Ministère de la Santé Publique de Madagascar, Antananarivo2016Google Scholar). Although not a new concept, the approach taken by Sato et al. was highly systematic and logical, involving (1) the design and development of an eDNA qPCR method targeting a specific fragment of the mitochondrial cox1 gene to detect S. mansoni, (2) testing of the eDNA detection capability in aquariums with experimentally infected snails, and (3) verification of the eDNA method for successfully detecting S. mansoni-contaminated water sources. A total of 21 water samples were collected from seven sites confirmed as water sources with human contact in two communes of Maevatanana District endemic for both S. mansoni and S. haematobium. Subsequently, one of 14 water samples tested proved positive by the qPCR assay (confirmed to be S. mansoni by sequencing of the targeted PCR amplicon), and the local intermediate host, Biomphalaria pfeifferi, was shown to be present only in this particular water source, indicating active transmission of S. mansoni there. The findings were reinforced by ultrasound examinations which confirmed active schistosomiasis cases in this locality. Interestingly, despite the fact that the authors reported ultrasound identification of S. haematobium patients in the study, no Bulinus spp. snails were found at any of the sampled sites and PCR tests on water samples were negative for S. haematobium eDNA. Urbanization, changes in land use, population movements, and climate change with associated elevated temperatures may increase the geographical distribution of schistosomiasis through the expansion of suitable environments for snails into higher altitudes and into further northern latitudes (McManus et al., 2018McManus D.P. Dunne D.W. Sacko M. Utzinger J. Vennervald B.J. Zhou X.-N. Schistosomiasis.Nat Rev Dis Primers. 2018; 4: 13Crossref PubMed Scopus (462) Google Scholar). These changes are happening rapidly and, as emphasized by Sato et al., the provision of safe water supplies and health education promoting behaviour change will be key elements in future schistosomiasis control, and ecological surveys will be required to identify water sources that may be contaminated with infectious schistosomes. Traditional methods that have been used in such surveillance include cercarial shedding with light exposure or microscopic detection of sporocysts and cercariae in crushed snails. These procedures have detection limitations, particularly in situations where there is a low parasite burden or where there is aborted development of sporocysts. Nevertheless, despite the labour-intensive nature of these methods, including the collection and handling of snails and the associated costs, they are still used widely in practice due to their technical simplicity, field applicability, and their ease of application. The eDNA detection test developed and verified (albeit in only one sampled site) by Sato et al. offers a promising and feasible option that could prove complementary to these more conventional methods as a surveillance tool for identifying schistosome-contaminated or safe water sources. This promising new detection technique now requires further extensive field verification in other areas and direct comparison with the traditional methods to determine its practical feasibility in resource-poor settings and to assess its cost-effectiveness. Furthermore, its application in environmental monitoring and surveillance could prove useful in the future to offset the potential risk of further schistosomiasis outbreaks in Europe akin to that reported in Corsica. Research in DPM’s laboratory is supported by the National Health and Medical Research Council of Australia. None. Usefulness of environmental DNA for detecting Schistosoma mansoni occurrence sites in MadagascarInternational Journal of Infectious DiseasesVol. 76PreviewSchistosomiasis is a waterborne blood fluke infection, and over 90% of affected people live in the countries of Sub-Saharan Africa, where there is poor access to clean water and sanitary facilities (Chitsulo et al., 2000; Adenowo et al., 2015). It is one of the leading causes of impaired health and socio-economic development in the world, and the control measures currently in use are based on large-scale preventive chemotherapy, as recommended by the World Health Organization (WHO) (WHO, 2012, 2013). Full-Text PDF Open Access" @default.
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• W2894136508 title "Testing of water samples for environmental DNA as a surveillance tool to assess the risk of schistosome infection in a locality" @default.
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