The Association Between Female Genital Schistosomiasis and Other Infections of the Lower Genital Tract in Adolescent Girls and Young Women: A Cross-Sectional Study in South Africa

Abstract

Objectives/Purposes of the StudyThis study aimed to explore the relationship between female genital schistosomiasis (FGS), sexually transmitted infections, bacterial vaginosis, and yeast among young women living in Schistosoma haematobium-endemic areas.MethodsIn a cross-sectional study of young women, sexually active, aged 16 to 22 years in rural KwaZulu-Natal, South Africa, in 32 randomly selected rural schools in schistosomiasis-endemic areas, the authors performed gynecological and laboratory investigations, diagnosed FGS and other infections, and did face-to-face interviews.ResultsFemale genital schistosomiasis was the second most prevalent current genital infection (23%), significantly more common in those who had urinary schistosomiasis (35%), compared with those without (19%, p < .001). In the FGS-positive group, 35% had human papillomavirus compared with 24% in the FGS-negative group (p = .010). In the FGS-positive group, 37% were seropositive for herpes simplex virus infection, compared with 30% in the FGS-negative group (p = .079). There were significantly fewer chlamydia infections among women with FGS (20%, p = .018) compared with those who did not have FGS (28%).ConclusionsFemale genital schistosomiasis was the second most common genital infection after herpes simplex virus. Human papillomavirus infection was significantly associated with FGS, but Chlamydia was negatively associated with FGS. Women with FGS may have had more frequent contact with the health system for genital discharge. The results show the importance of the inclusion of FGS in the national management protocols for genital infections in areas endemic for S. haematobium and highlight a more comprehensive approach to diagnosis and genital disease management.

Screening for Resistant Bacteria, Antimicrobial Resistance Genes, Sexually Transmitted Infections and Schistosoma spp. in Tissue Samples from Predominantly Vaginally Delivered Placentae in Ivory Coast and Ghana

“…Sixth, considering the low number of samples available for the study, we abstained from planning in-depth assessments of associations of various detected pathogens. In spite of ongoing discussion on, e.g., associations of sexually transmitted infections and genital schistosomiasis [ 133 , 134 , 135 ], respective assessments were not performed for this reason. Indeed, only a single co-infection of Chlamydia trachomatis and Schistosoma haematobium complex was recorded, which does not allow any conclusions on this topic, considering the low overall case number.…”

Improved prevention of female genital schistosomiasis: piloting integration of services into the national health system in Côte d’Ivoire

“…Chronic infection leads to symptoms and complications including vaginal itching and discharge, post-coital bleeding, genital lesions, ectopic pregnancy, spontaneous abortion or infertility which are the consequence of schistosome eggs being deposited in the uterus, cervix, vagina, or vulva (2,4,5). The immunological reaction to the eggs has also been linked to prevalent human papillomavirus (HPV) and human immunodeficiency virus (HIV) (2, [6][7][8][9]. Those at-risk of FGS are vulnerable population groups as transmission of schistosomiasis is caused by skin contact with freshwater sources, previously contaminated due to the lack of appropriate sanitation.…”