Xenomonitoring of Culex quinquefasciatus mosquitoes as a guide for detecting the presence or absence of lymphatic filariasis: a preliminary protocol for mosquito sampling

Housing Risk Factors of Four Tropical Neglected Diseases: A Brief Review of the Recent Literature

Alongside peace, education, food, income, a stable ecosystem, sustainable resources and social justice, shelter is a prerequisite for health. According to international human rights law, everyone is entitled to an adequate standard of living, which includes adequate housing. Adequate housing, including access to water and sanitation, plays a critical role in the prevention and management of neglected tropical diseases, which affect over 1 billion people worldwide. Inadequate housing conditions represent a risk factor for many of them, e.g., Chagas disease that affects 6–8 million people worldwide, visceral leishmaniasis that kills 20,000–30,000 people/year, lymphatic filariasis which threatens 859 million people worldwide or dengue that has increased 8–10 fold over the last two decades. Vector control strategies for the above-mentioned diseases have shown their effectiveness and should include systematic and repetitive in-house spraying and individual protection (e.g., impregnated nets), as well as better-quality construction material and techniques and better sanitation infrastructures and practices. Access to adequate housing is a basic human right. The violation of the right to adequate housing may affect the enjoyment of other human rights. Access to adequate housing can strengthen (and facilitate access to) other basic human rights, such as the rights to work, health, security, and education.

Presence of a cryptic Onchocerca species in black flies of northern California, USA

Background

Black flies (Diptera: Simuliidae) serve as arthropod vectors for various species of Onchocerca (Nematoda: Onchocercidae) that may be associated with disease in humans, domestic animals, and wildlife. The emergence of zoonotic Onchocerca lupi in North America and reports of cervid-associated zoonotic onchocerciasis by Onchocerca jakutensis highlight the need for increased entomological surveillance. In addition, there is mounting evidence that Onchocerca diversity in North America is far greater than previously thought, currently regarded as Onchocerca cervipedis species complex. This study reports new geographic records and black fly vector associations of an uncharacterized Onchocerca species.

Methods

To better understand the biodiversity and geographic distribution of Onchocerca, 485 female black flies (2015: 150, 2016: 335) were collected using CO₂-baited traps from February to October 2015–2016 in Lake County, northern California, USA. Individual flies were morphologically identified and pooled (≤ 10 individuals) by species, collection date, and trap location. Black fly pools were processed for DNA extraction, and subsequent PCR and sequencing targeting of the NADH dehydrogenase subunit 5 gene of filarioids.

Results

Among the pools of black flies, there were 158 individuals of Simulium tescorum (2015: 57, 2016: 101), 302 individuals of Simulium vittatum (sensu lato [s.l.]) (2015: 82, 2016: 220), 16 individuals of Simulium clarum “black” phenotype (2015: 5, 2016: 11), and 13 individuals of S. clarum “orange” phenotype (2015: 6, 2016: 7). PCR analysis revealed the percentage of filarioid-positive pools were 7.50% (n = 3) for S. tescorum, 3.75% (n = 3) for S. vittatum (s.l., likely S. tribulatum), 7.69% (n = 1) for S. clarum “black” phenotype, and no positives for S. clarum “orange” phenotype. Genetic distance and phylogenetic analyses suggest that the northern California Onchocerca isolates belong to the same species reported in black flies from southern California (average pairwise comparison: 0.32%), and seem closely related to Onchocerca isolates of white-tailed deer from upstate New York (average pairwise comparison: 2.31%).

Conclusion

A cryptic Onchocerca species was found in Lake County, California, and may be a part of a larger, continentally distributed species complex rather than a single described species of North America. In addition, there are at least three putative vectors of black flies (S. clarum, S. tescorum, S. vittatum) associated with this cryptic Onchocerca species. A comprehensive reassessment of North American Onchocerca biodiversity, host, and geographic range is necessary.

Graphical abstract

Systematic Review of Wolbachia Symbiont Detection in Mosquitoes: An Entangled Topic about Methodological Power and True Symbiosis

Wolbachia is an endosymbiotic bacterium that naturally infects several arthropods and nematode species. Wolbachia gained particular attention due to its impact on their host fitness and the capacity of specific Wolbachia strains in reducing pathogen vector and agricultural pest populations and pathogens transmission. Despite the success of mosquito/pathogen control programs using Wolbachia-infected mosquito release, little is known about the abundance and distribution of Wolbachia in most mosquito species, a crucial knowledge for planning and deployment of mosquito control programs and that can further improve our basic biology understanding of Wolbachia and host relationships. In this systematic review, Wolbachia was detected in only 30% of the mosquito species investigated. Fourteen percent of the species were considered positive by some studies and negative by others in different geographical regions, suggesting a variable infection rate and/or limitations of the Wolbachia detection methods employed. Eighty-three percent of the studies screened Wolbachia with only one technique. Our findings highlight that the assessment of Wolbachia using a single approach limited the inference of true Wolbachia infection in most of the studied species and that researchers should carefully choose complementary methodologies and consider different Wolbachia-mosquito population dynamics that may be a source of bias to ascertain the correct infectious status of the host species.

The use of molecular xenomonitoring for surveillance of mosquito-borne diseases

The scientific community recognizes that molecular xenomonitoring (MX) can allow infected mosquitoes to serve as a proxy for human infection in vector-borne disease surveillance, but developing reliable MX systems for programmatic use has been challenging. The primary aim of this article is to examine the available evidence to recommend how MX can best be used for various purposes. Although much of the literature published within the last 20 years focuses on using MX for lymphatic filariasis elimination, a growing body of evidence supports its use in early warning systems for emerging infectious diseases (EIDs). An MX system design must consider the goal and target (e.g. diseases targeted for elimination versus EIDs), mosquito and pathogen characteristics, and context (e.g. setting and health system). MX is currently used as a 'supplement' to human surveillance and will not be considered as a 'replacement' until the correlation between pathogen-infection rates in human and mosquito populations is better understood. Establishing such relationships may not be feasible in elimination scenarios, due to increasingly dwindling human infection prevalence after successful control, but may still be possible for EIDs and in integrated disease surveillance systems. This article is part of the theme issue 'Novel control strategies for mosquito-borne diseases'.

Optimisation and field validation of odour-baited traps for surveillance of Aedes aegypti adults in Paramaribo, Suriname

BACKGROUND

Emerging arboviral diseases like Zika, dengue and chikungunya that are transmitted by Aedes aegypti mosquitoes, are increasingly threatening human health. Blends of human-like synthetic chemical attractants can be used to attract host-seeking mosquitoes. The aim of this study was to test new combinations of traps and odour baits in the laboratory, followed by testing the best candidates in the field to improve Ae. aegypti monitoring and surveillance.

METHODS

First, the BG-Suna trap was evaluated for capturing laboratory-reared Ae. aegypti by testing normal and inverted positions in screen cage tests. Secondly, the attractiveness of the MB5 blend, CO₂, and their combination was tested. Thirdly, we tested the attractiveness of different trap types (BG-Suna, BG-Sentinel, MM-X and CDC light trap). Finally, we confirmed laboratory results in the field in Paramaribo, Suriname, using the MB5 and BG-Lure odour blends, CO₂ and the BG-Sentinel and BG-Bowl trap using a Latin Square design.

RESULTS

The MB5 blend in combination with CO₂ outperformed traps baited only with CO₂ or MB5 in screen cage tests (P < 0.0001). The BG-Sentinel trap performed equally well as the inverted BG-Suna and was taken to the field (P = 0.729). In the field, we captured Ae. aegypti, Cx. quinquefasciatus and Cx. nigripalpus. We confirmed the laboratory results and found that the combination of the MB5 blend and CO₂ almost doubled Ae. aegypti female captures (P = 0.004) and more than doubled Culex spp. female captures (P = 0.005) compared to using only CO₂. Interestingly, the MB5 blend outperformed the commercially available BG-Lure, in the BG-Sentinel (P < 0.001). The BG-Bowl also attracted Ae. aegypti when baited with the MB5 blend in similar numbers as the BG-Sentinel baited with the MB5 (P = 0.362).

CONCLUSIONS

Our study demonstrated that the BG-Sentinel trap baited with the MB5 blend and CO₂ outperforms the current golden standard (BG-Sentinel trap with BG-Lure) for monitoring Ae. aegypti females and males, in both laboratory and field experiments. The BG-Bowl baited with the MB5 blend is a good candidate for home use. Finally, the results show that CO₂ is an indispensable component of the attractive blend.

Resistance to insecticides and synergistic and antagonistic effects of essential oils on dimefluthrin toxicity in a field population of Culex quinquefasciatus Say

In this work, we firstly tested five spatial repellent pyrethroids, meperfluthrin, dimefluthrin, heptafluthrin, metofluthrin and transfluthrin, to determine the susceptibility of pyrethroids to field strains of Culex quinquefasciatus using adult topical bioassay. The results showed that though field strains exhibited the highest resistance to dimefluthrin among the selected five pyrethroids, it still can be considered low resistance in the scale of Cui et al. (2006; 2007). Then, the aim of this study was to optimise the synergistic efficacy of essential oils combined with dimefluthrin and explore the major contribution composition of eucalyptus oil, basil oil and cinnamon oil as natural synergist of dimefluthrin against the field populations of C. quinquefasciatus. GC-MS analysis showed 1,8-cineole, eugenol and trans-cinnamaldehyde were the main chemical components of eucalyptus oil, basil oil and cinnamon oil, respectively. The results of bioactivity showed that eucalyptus oil and 1,8-cineole have highly fumigant knock-down activity to the adults, showing KT₅₀ (the median knockdown time) of 5.76 and 4.27 min at the concentration of 24.2 µL/L; basil oil and eugenol, cinnamon oil and trans-cinnamaldehyde have highly fumigant toxicity to the adults, showing LD₅₀ of 1.00 and 0.79, 1.26 and 1.03 µL/L, respectively. Three effective main essential oil components were selected to prepare binary mixtures, which combined with dimefluthrin against the field population of Culex quinquefasciatus. 1,8-cineole+eugenol (9:1, w/w), 1,8-cineole+trans-cinnamaldehyde (1:1, w/w) and trans-cinnamaldehyde+eugenol (9:1, w/w) combined with dimefluthrin (10:1, w/w) were the most synergistic interaction, showed SR (synergistic ratio) values of 1.2471, 1.5709 and 1.1969; KT₅₀ of 11.68, 9.51 and 10.67 min respectively, by quadrate box method. In addition, to validate the stable synergistic interaction of 1,8-cineole+trans-cinnamaldehyde (1:1, w/w) combined with dimefluthrin (10:1, w/w), the SR values were about 1.3, and KT₅₀ values were 38.72-50.26 min by simulated house method. Overall, our results pointed out the promising potential of these essential oils to increase the efficacy of dimefluthrin. It might be expected that these essential oils could be developed to a useful botanical synergist of dimefluthrin for the control of the field populations of C. quinquefasciatus.

Development of an urban molecular xenomonitoring system for lymphatic filariasis in the Recife Metropolitan Region, Brazil

Introduction

Molecular xenomonitoring (MX)—pathogen detection in the mosquito rather than human—is a promising tool for lymphatic filariasis (LF) surveillance. In the Recife Metropolitan Region (RMR), the last LF focus in Brazil, Culex quinquefasciatus mosquitoes have been implicated in transmitting Wuchereria bancrofti parasites. This paper presents findings on the ideal mosquito collection method, mosquito dispersion, W. bancrofti infection in mosquitoes and W. bancrofti antigen in humans to aid MX development.

Methods

Experiments occurred within two densely populated urban areas of Olinda, RMR, in July and August 2015. U.S. Centers for Disease Control and Prevention (CDC) light traps were compared to battery-powered aspirators as collection methods, and mosquito dispersion was measured by mosquito mark release recapture (MMRR). Female Cx. quinquefasciatus were tested by PCR for W. bancrofti infection, and study area residents were screened by rapid tests for W. bancrofti antigen.

Results

Aspirators caught 2.6 times more total Cx. quinquefasciatus, including 38 times more blood-fed and 5 times more gravid stages, than CDC light traps. They also collected 123 times more Aedes aegypti. Of the 9,644 marked mosquitoes released, only ten (0.01%) were recaptured, nine of which were < 50m (34.8m median, 85.4m maximum) from the release point. Of 9,169 unmarked mosquitoes captured in the MMR, 38.3% were unfed, 48.8% blood-fed, 5.5% semi-gravid, and 7.3% gravid. PCR on 182 pools (1,556 mosquitoes) found no evidence of W. bancrofti infection in Cx. quinquefasciatus. Rapid tests on 110 of 111 eligible residents were all negative for W. bancrofti antigen.

Conclusions

Aspirators were more effective than CDC light traps at capturing Ae. aegypti and all but unfed stages of Cx. quinquefasciatus. Female Cx. quinquefasciatus traveled short (< 86m) distances in this urban area. Lack of evidence for W. bancrofti infection in mosquitoes and antigen in humans in these fine-scale studies does not indicate that LF transmission has ceased in the RMR. A MX surveillance system should consider vector-specific collection methods, mosquito dispersion, and spatial scale but also local context, environmental factors such as sanitation, and host factors such as infection prevalence and treatment history.

Lymphatic filariasis (LF) is a parasitic disease transmitted by mosquitoes, and can cause elephantiasis. It is the world’s leading cause of disability due to infectious diseases, affects over 120 million people globally, and is scheduled for global elimination via mass drug administration (MDA) and mosquito control. Molecular xenomonitoring (MX) is a process of screening mosquitoes—not humans—for parasites to estimate whether they are circulating in human populations. MX is especially useful during and following MDA, when new case detection becomes difficult, but is challenging to design and conduct in cities. Using two study sites in the Recife Metropolitan Region, Brazil, we investigated two crucial questions for urban MX development—“What is the best operationally feasible tool to catch adult mosquitoes?” and “How far do mosquitoes disperse in cities?”—in order to determine placement of future surveillance sites. We also screened a proportion of mosquitoes and all eligible residents from the study sites for LF infection. We determined that handheld battery powered aspirators were the best mosquito collection tool; that mosquitoes flew no more than about 85m; and—in this small sample of mosquitoes and very small sample of humans—there was no evidence of LF infection in mosquitoes or study area residents.

Biological nanopesticides: a greener approach towards the mosquito vector control

Mosquitoes, being a vector for some potentially dreadful diseases, pose a considerable threat to people all around the world. The control over the growth and propagation of mosquitoes comprises conventional pesticides, insect growth regulators and other microbial control agents. However, the usage of these common chemicals and conventional pesticides eventually has a negative impact on human health as well as the environment, which therefore becomes a major concern. The lacuna allows nanotechnology to come into action and exploit nanopesticides. Nanopesticides are majorly divided into two categories-synthetic and biological. Several nanoformulations serve as a promising nanopesticide viz. nanoparticles, e.g. biologically synthesised nanoparticles through plant extracts, nanoemulsions prepared using the essential oils like neem oil and citronella oil and nanoemulsion of conventional pesticides like pyrethroids. These green approaches of synthesising nanopesticides make use of non-toxic and biologically derived compounds and hence are eco-friendly with a better target specificity. Even though there are numerous evidences to show the effectiveness of these nanopesticides, very few efforts have been made to study the possible non-target effects on other organisms prevalent in the aquatic ecosystem. This study focuses on the role of these nanopesticides towards the vector control and its eco-safe property against the other non-target species.

Mosquito control with green nanopesticides: towards the One Health approach? A review of non-target effects

The rapid spread of highly aggressive arboviruses, parasites, and bacteria along with the development of resistance in the pathogens and parasites, as well as in their arthropod vectors, represents a huge challenge in modern parasitology and tropical medicine. Eco-friendly vector control programs are crucial to fight, besides malaria, the spread of dengue, West Nile, chikungunya, and Zika virus, as well as other arboviruses such as St. Louis encephalitis and Japanese encephalitis. However, research efforts on the control of mosquito vectors are experiencing a serious lack of eco-friendly and highly effective pesticides, as well as the limited success of most biocontrol tools currently applied. Most importantly, a cooperative interface between the two disciplines is still lacking. To face this challenge, we have reviewed a wide number of promising results in the field of green-fabricated pesticides tested against mosquito vectors, outlining several examples of synergy with classic biological control tools. The non-target effects of green-fabricated nanopesticides, including acute toxicity, genotoxicity, and impact on behavioral traits of mosquito predators, have been critically discussed. In the final section, we have identified several key challenges at the interface between "green" nanotechnology and classic biological control, which deserve further research attention.

The Current Status of Molecular Xenomonitoring for Lymphatic Filariasis and Onchocerciasis

The capacity of vector insect surveillance to provide estimates of pathogen prevalence and transmission potential has long been recognized within the global communities tasked with eliminating lymphatic filariasis (LF), the underlying cause of elephantiasis and hydrocele, and onchocerciasis (river blindness). Initially restricted to the practice of dissection, the potential of vector monitoring has grown due to the advent of molecular methods capable of increasing the sensitivity and throughput of testing. However, despite such advancement, operational research gaps remain. If insufficiently addressed, these gaps will reduce the utility of molecular xenomonitoring (MX) for onchocerciasis as elimination efforts expand into Africa. Similarly, such shortcomings will limit the programmatic usefulness of MX for LF, resulting in this technique's significant underutilization.

Toxicity of seaweed-synthesized silver nanoparticles against the filariasis vector Culex quinquefasciatus and its impact on predation efficiency of the cyclopoid crustacean Mesocyclops longisetus

Nearly 1.4 billion people in 73 countries worldwide are threatened by lymphatic filariasis, a parasitic infection that leads to a disease commonly known as elephantiasis. Filariasis is vectored by mosquitoes, with special reference to the genus Culex. The main control tool against mosquito larvae is represented by treatments with organophosphates and insect growth regulators, with negative effects on human health and the environment. Recently, green-synthesized nanoparticles have been proposed as highly effective larvicidals against mosquito vectors. In this research, we attempted a reply to the following question: do green-synthesized nanoparticles affect predation rates of copepods against mosquito larvae? We proposed a novel method of seaweed-mediated synthesis of silver nanoparticles using the frond extract of Caulerpa scalpelliformis. The toxicity of the seaweed extract and silver nanoparticles was assessed against the filarial vector Culex quinquefasciatus. Then, we evaluated the predatory efficiency of the cyclopoid crustacean Mesocyclops longisetus against larval instars of C. quinquefasciatus in a nanoparticle-contaminated water environment. Green-synthesized silver nanoparticles were characterized by UV-vis spectrum, Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and X-ray diffraction (XRD). In mosquitocidal assays, the LC₅₀ values of the C. scalpelliformis extract against C. quinquefasciatus were 31.38 ppm (I), 46.49 ppm (II), 75.79 ppm (III), 102.26 ppm (IV), and 138.89 ppm (pupa), while LC₅₀ of silver nanoparticles were 3.08 ppm, (I), 3.49 ppm (II), 4.64 ppm (III), 5.86 ppm (IV), and 7.33 ppm (pupa). The predatory efficiency of the copepod M. longisetus in the control treatment was 78 and 59% against I and II instar larvae of C. quinquefasciatus. In a nanoparticle-contaminated environment, predation efficiency was 84 and 63%, respectively. Predation was higher against first instar larvae over other instars. Overall, our study showed that seaweed-synthesized silver nanoparticles can be proposed in synergy with biological control agents against Culex larvae, since their use leads to little detrimental effects against aquatic predators, such as copepods.

Molecular xenomonitoring using mosquitoes to map lymphatic filariasis after mass drug administration in American Samoa

BACKGROUND

Mass drug administration (MDA) programs have dramatically reduced lymphatic filariasis (LF) incidence in many areas around the globe, including American Samoa. As infection rates decline and MDA programs end, efficient and sensitive methods for detecting infections are needed to monitor for recrudescence. Molecular methods, collectively termed 'molecular xenomonitoring,' can identify parasite DNA or RNA in human blood-feeding mosquitoes. We tested mosquitoes trapped throughout the inhabited islands of American Samoa to identify areas of possible continuing LF transmission after completion of MDA.

METHODOLOGY/PRINCIPLE FINDINGS

Mosquitoes were collected using BG Sentinel traps from most of the villages on American Samoa's largest island, Tutuila, and all major villages on the smaller islands of Aunu'u, Ofu, Olosega, and Ta'u. Real-time PCR was used to detect Wuchereria bancrofti DNA in pools of ≤ 20 mosquitoes, and PoolScreen software was used to infer territory-wide prevalences of W. bancrofti DNA in the mosquitoes. Wuchereria bancrofti DNA was found in mosquitoes from 16 out of the 27 village areas sampled on Tutuila and Aunu'u islands but none of the five villages on the Manu'a islands of Ofu, Olosega, and Ta'u. The overall 95% confidence interval estimate for W. bancrofti DNA prevalence in the LF vector Ae. polynesiensis was 0.20-0.39%, and parasite DNA was also detected in pools of Culex quinquefasciatus, Aedes aegypti, and Aedes (Finlaya) spp.

CONCLUSIONS/SIGNIFICANCE

Our results suggest low but widespread prevalence of LF on Tutuila and Aunu'u where 98% of the population resides, but not Ofu, Olosega, and Ta'u islands. Molecular xenomonitoring can help identify areas of possible LF transmission, but its use in the LF elimination program in American Samoa is limited by the need for more efficient mosquito collection methods and a better understanding of the relationship between prevalence of W. bancrofti DNA in mosquitoes and infection and transmission rates in humans.

A cohort study of lymphatic filariasis on socio economic conditions in Andhra Pradesh, India

Background

To assess the impact of socioeconomic variables on lymphatic filariasis in endemic villages of Karimnagar district, Andhra Pradesh, India.

Methods

A pilot scale study was conducted in 30 villages of Karimnagar district from 2004 to 2007. These villages were selected based on previous reports from department of health, Government of Andhra Pradesh, epidemiology, entomology and socioeconomic survey was conducted as per protocol. Collected data were analysed statistically by Chi square test, Principal Component Analysis, Odds ratio, Bivariate, multivariate logistic regression analysis.

Results

Total of 5,394 blood samples collected and screened for microfilaria, out of which 199 were found to be positive (3.7%). The socioeconomic data of these respondents/participants were correlated with MF prevalence. The socioeconomic variables like educational status (Odds Ratio (OR) = 2.6, 95% Confidence Interval (CI) = 1.1–6.5), house structure (hut OR = 1.9, 95% CI = 1.2–3.1; tiled OR = 1.3, 95% CI = 0.8–2) and participation in mass drug administration program (OR = 1.8, 95% CI = 1.3–2.6) were found to be highly associated with the occurrence of filarial disease. The socioeconomic index was categorized into low (3.6%; OR-1.1, 95% CI: 0.7–1.5) medium (4.9%; OR-1.5, 95% CI = 1–2.1) and high (3.3%) in relation to percentage of filarial parasite prevalence. A significant difference was observed among these three groups while comparing the number of cases of filaria with the type of socioeconomic conditions of the respondents (P = 0.067).

Conclusions

From this study it is inferred that age, education of family, type of house structure and awareness about the filarial disease directly influenced the disease prevalence. Beside annual mass drug administration program, such type of analysis should be undertaken by health officials to target a few socioeconomic factors to reduce the disease burden. Health education campaigns in the endemic villages and imparting of protection measures against mosquitoes using insecticide treated bed nets would substantially reduce the disease in these villages.

Comparison of engorged Culex quinquefasciatus collection and blood-feeding pattern among four mosquito collection methods in Puerto Barrios, Guatemala, 2007

Investigators have used a variety of techniques to sample resting, engorged mosquitoes for the purposes of studying mosquito blood-feeding behavior. However, evidence exists that mosquito blood-feeding patterns may vary according to collection method. Engorged mosquitoes were collected from rural and urban habitats after the 2007 dry (July) and wet (December) seasons in the Department of Izabal, Guatemala, with the use of Centers for Disease Control and Prevention (CDC) light traps, gravid traps, and aspiration from plastic pots and vegetation. We evaluated the utility of plastic pots as sampling tools for engorged Culex mosquitoes and compared Cx. quinquefasciatus blood host identities among collection methods. The array of vertebrate hosts supplying blood to Cx. quinquefasciatus did not differ significantly by method of collection. The density of engorged Cx. quinquefasciatus per trap-night was not significantly different between CDC light traps, gravid traps, and plastic pots; however, there was a significantly higher proportion of total mosquitoes that were engorged collected from pots than from either CDC light traps or gravid traps.

Transmission control for schistosomiasis - why it matters now

Current population-based schistosomiasis treatment programs are a first step to reducing the global burden of Schistosoma-related disease; however, they might not dramatically reduce parasite transmission in highly endemic areas. Consequently, the benefits of these programs remain in doubt because recurring low-level reinfection is likely to be associated with subtle but persistent morbidities such as anemia, undernutrition and diminished performance status. The real health benefits of transmission control need to be reconsidered and attention given to more aggressive and, ultimately, more affordable parasite elimination strategies. The next generation of schistosomiasis control can be optimized using new monitoring tools and effective transmission containment.