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Peer reviewedOpen accessSchistosomiasis

Detecting and identifying Schistosoma infections in snails and aquatic habitats: A systematic review

PLOS Neglected Tropical Diseases·

Bishoy Kamel, Martina R. Laidemitt, Lijun Lu, Caitlin Babbitt, Ola Liota Weinbaum, Gerald M. Mkoji, Eric S. Loker

DOI
10.1371/journal.pntd.0009175
PMID
33760814
PMCID
PMC8021170
OpenAlex
W3136559053
Study type
Systematic review
Publisher
Public Library of Science (PLoS)
Article type
journal-article
Integrity
current

Why this research matters now

Ability to detect schistosome infections in snails or water is essential for control and elimination programs to succeed. Field testing, standardization, sequence verification, and improvements in target selection are needed for long-term programmatic success.

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Structured evidence summary

Research question

The review evaluated techniques for diagnosing Schistosoma infections in snails and water at potential transmission sites to inform WHO guideline development for schistosomiasis control and elimination.

Study design

Systematic review following PRISMA methodology, searching multiple databases from 1970 to September 2020, with GRADE evidence assessment for retained techniques. The search included bibliography review and investigator contact, screening 949 articles and retaining 158 for data extraction.

Population and setting

The review focused on potential schistosomiasis transmission sites where snail intermediate hosts and water need to be monitored for Schistosoma infections.

Main findings

Twenty-five different diagnostic techniques were identified. GRADE analysis rated environmental DNA, qPCR, and LAMP as moderate quality evidence. qPCR-based protocols were found to be versatile, mature, sensitive, and specific, though requiring centralized facilities. Droplet digital PCR may offer complementary value when inhibitors are present or greater sensitivity is needed. LAMP and other isothermal techniques show promise for less expensive, distributed analysis but may face standardization challenges.

Public-health relevance

Ability to detect schistosome infections in snails or water is essential for control and elimination programs to succeed. Field testing, standardization, sequence verification, and improvements in target selection are needed for long-term programmatic success.

Important limitations

No single ideal diagnostic approach has been developed. The review notes that any diagnostic techniques used require regular verification through DNA sequencing to confirm species identity, and further improvements may be necessary to identify optimal target sequences for amplification. This summary is limited to the supplied abstract and metadata; the original paper is required for decision-grade interpretation of GRADE assessments, technique-specific performance metrics, and detailed advantages and disadvantages.

GIDS interpretation

This systematic review addresses diagnostic capacity for detecting schistosome infections in environmental samples. The classifier links indicate relevance to schistosomiasis surveillance under climate and environment, diagnostics, and transmission dynamics topics, making it discoverable for programs monitoring transmission risk at water contact sites.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicaddresses topicevaluates interventionhas pathogen typestudied population settinguses study design