A multicenter genomics study published in Science Advances identified genetic variants in the molecular target of praziquantel—TRPM pzQ—associated with reduced drug sensitivity in Schistosoma mansoni. The work analyzed whole-genome sequences from 570 parasites collected across Africa and the Caribbean. Researchers reported extensive long-distance parasite transmission and substantial genetic diversity between endemic regions, alongside four naturally occurring variants in the TRPM pzQ receptor linked to reduced praziquantel sensitivity. Analyses of parasite infrapopulations collected pre- and post-treatment also indicated instances consistent with treatment failure. Because mass drug administration with praziquantel is described as the cornerstone of schistosomiasis control and elimination, the findings function as an early warning signal for programs that have relied primarily on reactive surveillance. The study was led by researchers at the Wellcome Sanger Institute, the Royal Veterinary College, and the Medical College of Wisconsin, with Stephen Doyle, PhD, describing the value of scaling whole-genome sequencing for proactive monitoring.