The parasitology of female genital schistosomiasis

Orish, Verner N.; Morhe, Emmanuel; Azanu, Wisdom; Alhassan, Robert Kaba; Gyapong, Margaret

doi:10.1016/j.crpvbd.2022.100093

Cited by 20 publications

(31 citation statements)

References 73 publications

(174 reference statements)

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“…They probably might have linked the ‘genital’ in FGS to the occurrence of cervical cancer. The egg deposition in the vulva and vaginal tissue results in the sandy patches and rubbery papules which cause the vaginal wall to become brittle and is associated with contact bleeding [ 3 , 34 ], There is no classical ulceration associated with FGS.…”

Section: Discussionmentioning

confidence: 99%

Knowledge of female genital schistosomiasis and urinary schistosomiasis among final-year midwifery students in the Volta Region of Ghana

Azanu,

Osarfo,

Appiah

et al. 2024

PLoS ONE

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Background Female genital schistosomiasis (FGS) is a gynaecological complication of urinary schistosomiasis (US) with an estimated burden of 20–120 million cases in endemic areas. A neglected sexual and reproductive health disease in sub-Saharan Africa, FGS increases susceptibility to sexually transmitted infections including cervical cancer and infertility among other morbidities. However, there appears to be limited FGS knowledge among practicing and pre-service health providers with implications for control. We assessed FGS awareness among final-year midwifery students who would soon be delivering primary maternal and reproductive health care. Methods A cross-sectional study was conducted among 193 randomly selected final-year students from all three midwifery training institutions in the Volta region of Ghana in August/September, 2022. Data on participants’ demographics and knowledge of the transmission, signs and symptoms, complications, treatment and prevention of both FGS and US were collected using structured questionnaires. Summary statistics were presented as frequencies, proportions and percentages. Results Only 23.3% (44/189) of participants had heard about FGS compared to 64% (123/192) for US. Of the former, 42 (95%), 40 (91%) and 36 (81.8%) respectively identified genital itching/burning sensation, bloody vaginal discharge and pelvic pain/pain during intercourse as part of the symptoms of FGS. Less than a third (13/44) and about half (25/44) of those who indicated hearing about FGS knew it can be a risk for ectopic pregnancies and infertility respectively. Majority of these participants, 40 (91%), wrongly selected antibiotics as treatment for FGS while 9 indicated it is prevented by sleeping in insecticide-treated nets. Conclusion Awareness of FGS was limited among the study participants. The high prevalence of knowledge of some FGS symptoms related to the genitalia needs cautious interpretation. Health care training institutions must make deliberate efforts to highlight FGS in the training of midwives as the condition has diagnostic and management implications for some sexual and reproductive health conditions.

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Section: Discussionmentioning

confidence: 99%

Knowledge of female genital schistosomiasis and urinary schistosomiasis among final-year midwifery students in the Volta Region of Ghana

Azanu,

Osarfo,

Appiah

et al. 2024

PLoS ONE

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“…Common diagnostic methods, including urinalysis reagent strips and colposcopy, have limitations [42,43]. Reliable and de nitive diagnostic tools are essential for effective intervention and control [44].…”

Section: Diagnostic Challengesmentioning

confidence: 99%

Addressing Urogenital and Female Genital Schistosomiasis among Teenagers in Anambra State, Nigeria: A Cross-sectional Study

Aribodor,

Azugo,

Jacob

et al. 2023

Preprint

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Background Urogenital schistosomiasis (UgS) remains a persistent health challenge among adolescents in Anambra State, Nigeria, despite ongoing control efforts. Since 2013, mass praziquantel treatment programs have primarily targeted school-aged children (5-14 years), leaving teenagers susceptible to Schistosoma haematobium infection. Additionally, the extent of female genital schistosomiasis (FGS), a neglected gynaecological manifestation of UgS remains unclear. Methodology To address these gaps, our study conducted a comprehensive investigation in Anaocha Local Government Area between February and May 2023. Using stratified random sampling, we enrolled 470 teenagers (aged 10-19 years old). The study involved urinalysis tests for haematuria and microscopic detection of S. haematobium eggs via polycarbonate membrane filters. For females with heavy infections (≥ 50 eggs/10 ml urine), we performed colposcopy examinations of the cervicovaginal canal, complemented by acetic acid and Lugol's iodine staining for comprehensive sexual and reproductive health assessments. Data collection employed Kobo ToolBox software, following guidelines from the COUNTDOWN Consortium on FGS, ensuring gender-sensitive data collection. Our data underwent rigorous analysis using SPSS version 25, incorporating descriptive statistics, multinomial logistic regression, odds ratios, and significance testing. Results Unveiling our findings, we noted UgS prevalence of 14.5% with an average infection intensity of 5.25 eggs/10 ml urine. While females exhibited a slightly higher prevalence (16.1%), with 7.5% of females enduring heavy infection burdens, the gender difference was not statistically significant. However, males showed higher odds of infection (OR: 1.332; 95% CI: 0.791-2.244; p-value: 0.280). Colposcopy examinations showed FGS lesions as well as co-infection with Trichomonas vaginalis. Teenagers aged 10-14 had the highest prevalence, with significantly higher odds of infection (OR: 1720; 95% CI: 1.012-2.923; p-value: 0.045). Haematuria, though prevalent (24.6%), was not the sole indicator, as those without it faced significantly higher odds of infection (OR: 2.924; 95% CI: 1.731-4.941; p-value: 0.000). Dysuria and genital itching/burning were other UgS-associated symptoms identified. Remarkably, a 17-year-old girl with an FGS-positive diagnosis who reported severe itching was found to have Pthirus pubis (pubic louse) in her urine. This uncommon occurrence is likely due to close contact with an infected person or animal. Direct water contact was associated with higher infection odds (OR: 2.601; 95% CI: 1.007-6.716; p-value: 0.048). Co-infections with cercarial dermatitis further emphasized the risks, especially among individuals with extended water contact histories. Various risk factors were associated with UgS, including the purpose of waterbody visits, duration of freshwater exposure, awareness of UgS and FGS, deworming history, comfort in discussing genital health, and confidantes for such discussions. Conclusion The alarmingly high rates of UgS and FGS among teenagers in Anambra State call for integrated interventions, behaviour change campaigns, improved awareness, cost-effective diagnostics and treatments, and the training of healthcare workers in a people-centered approach. Our goal is to eliminate the neglect of marginalized populations and strive for disease elimination by 2030.

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“…Additionally, urine filtration, another diagnostic approach, can be expensive [ 42 ]. Furthermore, colposcopy, the method used to diagnose female genital schistosomiasis (FGS), faces difficulties due to the scarcity of equipment and its invasive nature [ 43 , 44 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing urogenital schistosomiasis and female genital schistosomiasis (FGS) among adolescents in Anaocha, Anambra State, Nigeria: implications for ongoing control efforts

Aribodor,

Azugo,

Jacob

et al. 2024

BMC Public Health

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Background Urogenital schistosomiasis (UgS) remains a persistent health challenge among adolescents in Anambra State, Nigeria, despite ongoing control efforts. Mass praziquantel treatment programs, initiated in 2013, primarily target primary school-aged children (5–14 years old), leaving adolescents (10–19 years old) enrolled in secondary schools vulnerable to urogenital schistosomiaisis. Additionally, the extent of female genital schistosomiasis (FGS), a neglected gynaecological manifestation of UgS remains unclear. Methodology To address these gaps, a cross-sectional study was conducted in Anaocha Local Government Area from February to May 2023. Four hundred and seventy consenting adolescents aged 10–19 years were enrolled. Urinalysis including urine filtration was employed to confirm haematuria and detect urogenital schistosomiasis (UGS) among the participants. For females with heavy infections (≥ 50 eggs/10 ml urine), a gynaecologist performed colposcopy examinations, complemented by acetic acid and Lugol’s iodine staining to assess for female genital schistosomiasis (FGS) lesions or other related reproductive health conditions. Socio-demographic data, including information on potential risk factors, were systematically collected using the Kobo ToolBox software, following gender-sensitive data collection guidelines. Data were analysed using SPSS version 25, incorporating descriptive statistics, multinomial logistic regression, odds ratios, and significance testing. Results Among the 470 adolescents (52.8% females, 47.2% males) examined, an overall UgS prevalence of 14.5% was observed, with an average of 5.25 eggs per 10 ml of urine. Females had a slightly higher prevalence (16.1%), and 7.5% had heavy infections. Although gender differences in infection rates were not statistically significant, males had slightly higher odds of infection (OR: 1.332; 95% CI: 0.791–2.244; p-value: 0.280). Adolescents aged 10–14 had the highest prevalence, with significantly increased odds of infection (OR: 1.720; 95% CI: 1.012–2.923; p-value: 0.045). Colposcopy examinations of females with heavy infections revealed FGS lesions and co-infections with Trichomonas vaginalis. Haematuria, though prevalent (24.6%), was not the sole indicator, as those without it faced significantly higher odds of infection (OR: 2.924; 95% CI: 1.731–4.941; p-value: 0.000). Dysuria and genital itching/burning sensation were other UgS and FGS associated symptoms. Direct water contact was associated with higher infection odds (OR: 2.601; 95% CI: 1.007–6.716; p-value: 0.048). Various risk factors were associated with UgS. Conclusion The study highlights the need for a comprehensive Urogenital Schistosomiasis (UGS) control strategy that includes secondary school adolescents, emphasizes risk factor management, promotes safe water practices, and raises awareness about UGS and Female Genital Schistosomiasis (FGS) among adolescents, thus improving control efforts and mitigating this health challenge in the region.

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The parasitology of female genital schistosomiasis

Cited by 20 publications

References 73 publications

Knowledge of female genital schistosomiasis and urinary schistosomiasis among final-year midwifery students in the Volta Region of Ghana

Knowledge of female genital schistosomiasis and urinary schistosomiasis among final-year midwifery students in the Volta Region of Ghana

Addressing Urogenital and Female Genital Schistosomiasis among Teenagers in Anambra State, Nigeria: A Cross-sectional Study

Assessing urogenital schistosomiasis and female genital schistosomiasis (FGS) among adolescents in Anaocha, Anambra State, Nigeria: implications for ongoing control efforts

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