Healthcare Workers’ Low Knowledge of Female Genital Schistosomiasis and Proposed Interventions to Prevent, Control, and Manage the Disease in Zanzibar

Abstract

Objectives: This study was conducted to explore healthcare workers’ knowledge of female genital schistosomiasis (FGS) and describe proposed interventions to raise awareness about FGS and strengthen healthcare facilities’ capacity to manage FGS cases.Methods: We conducted four cross-sectional focus group discussions and 16 key informant interviews with purposively selected healthcare workers in Zanzibar. Discussions and interviews were digitally recorded, transcribed, and analyzed using NVivo software.Results: Most participants had limited or no knowledge of FGS and lacked skills for managing it. They confused FGS with urogenital schistosomiasis and thought it was sexually transmitted. A few participants knew about FGS and associated it with Human Immunodeficiency Virus (HIV), ectopic pregnancy, cervical cancer, and infertility. To prevent and control FGS, participants proposed interventions targeting communities (including community-based health education) and the healthcare system (including training healthcare workers on FGS).Conclusion: Healthcare workers lacked knowledge of and skills for managing FGS. Besides, healthcare facilities had no diagnostic capacity to manage FGS. Along with on-going interventions to break S. haematobium transmission and eventually eliminate urogenital schistosomiasis in Zanzibar, we recommend training healthcare workers on FGS and equip healthcare facilities with medical equipment and supplies for managing FGS.

Knowledge, attitudes and practices toward female genital schistosomiasis among community women and healthcare professionals in Kimpese region, Democratic Republic of Congo

“…The same responses were given by 4% and 21% of the community women, respectively. Similar misconception of sexual transmission of FGS has been reported in studies conducted among local health workers in Zanzibar and Ghana [37,38]. These misconceptions could be linked to confusion, as reported in Ghana, Tanzania and Zanzibar, where the respondents could not clearly distinguish the transmission modes from those of other water-borne diseases and sexually transmitted infections (STI) [32,33,39].…”

Awareness and knowledge of female genital schistosomiasis in a population with high endemicity: a cross-sectional study in Madagascar

“…Additionally, a lack of knowledge of the FGS among HCWs can lead to incorrect diagnosis ( Mazigo et al, 2022b ) and treatment ( WHO, 2015 ). Raising awareness and knowledge about FGS, could help encourage women to seek timely medical care, prevent long term consequences, such as infertility or cancer associated with the disease ( Mazigo et al, 2022a ), and reduce antimicrobial resistance due to inappropriate use of antibiotics ( Nemungadi et al, 2022 ).…”

“…Female genital schistosomiasis (FGS) is the chronic manifestation of schistosomiasis induced by a persistent infection with S. haematobium through the deposition and calcification of eggs in the female genital tract ( Mazigo et al, 2022a ). The global burden of FGS is unknown most likely due to under-reporting ( Engels et al, 2020 ), but it is estimated that it affects 40 to 56 million women and girls worldwide ( Hotez et al, 2019a ).…”

“…FGS shares common clinical features with sexually transmitted diseases (STDs) such as pain, itching or vaginal discharge ( Mazigo et al, 2021 ) frequently leading to misdiagnosis, inappropriate treatment, social stigma, and further risk of under detection and underreporting. Limited awareness and treatment of FGS has been described both among HCWs and the general population in several endemic countries such as Ghana, Tanzania, and Cameroon ( Kukula et al, 2019 ; Masong et al, 2021 ; Mazigo et al, 2021 , 2022a ).…”

Knowledge and management of female genital schistosomiasis in sub-Saharan Africa: A scoping review protocol

“…34 Despite these efforts, studies have reported inadequate knowledge and skills to manage the disease by health professionals among community members. 24 , 35 , 36 , 37 Because of lack of awareness among affected communities and the insufficient expertise and understanding among medical professionals, FGS is an underreported, misdiagnosed and untreated medical condition. 35 , 38 , 39 The FGS menace cannot be adequately addressed without adequately equipping different cadres of healthcare workers with the knowledge and tools to diagnose and manage the disease.…”