Environmental monitoring for Ascaris egg remediation: a critical review

Ascariasis affects up to 1.2 billion people globally, with a significant burden in low-income regions. Despite high prevalence and substantial morbidity, existing monitoring and intervention strategies are insufficient due to sample extraction and quantification inaccuracies. This review underscores the need for enhanced environmental monitoring to improve Ascaris egg remediation and reduce disease incidence. We critically reviewed existing environmental monitoring practices and explored advanced technologies like lab-on-a-disk for rapid detection and quantification of Ascaris eggs. A meta-analysis and meta-regression of studies on Ascaris egg recovery revealed significant variability in recovery rates, with the best methods achieving less than 60% efficiency. Advanced imaging analyses and lab-on-a-disk technologies show promise for rapid detection and viability assessment. By identifying gaps in current methodologies, we recommend more effective environmental interventions. The review incorporated high-quality data adhering to PRISMA guidelines, ensuring comprehensive coverage of the latest methodologies. Integrating improved detection methods and environmental control strategies can significantly reduce ascariasis incidence, especially in endemic regions. Future efforts should focus on refining these technologies and validating their application in real-world settings for sustainable disease control.