Increasing awareness on genital manifestations of schistosomiasis

The genital manifestations of schistosomiasis seem to be less well known and less well managed  than the urinary, intestinal and  hepatosplenic. Schistosoma haematobium is the main species causing genital manifestations, however, cases have been described with other species of schistosomiasis. Genital schistosomiasis affects both female and male, however the clinical signs and complications are much more prevalent in women. It is estimated that  56 million women and girls in the African region may be affected by Female genital schistosomiasis  (FGS).

The most frequently observed signs and symptoms of (FGS) are abdominal and pelvic pain presenting in forms such as dyspareunia, dysmenorrhea, leucorrhoea, menstrual disorders, post-coital bleeding or simple contact bleeding (during an examination), cervicitis, endometritis and salpingitis. Male genital schistosomiasis (MGS)  can induce pathology of the seminal vesicles, prostate and other organs.

The disease may also provoke complications such as early abortion, ectopic pregnancy and infertility.

In 2015, WHO published a pocket atlas and clinical posters designed to increase awareness among health professionals about proper case management and prevention of female genital schistosomiasis. New publications suggest that the risk of HIV infection increases in women who are suffering from schistosomiasis. Preventive chemotherapy should therefore be expanded and sustained in areas in which HIV and schistosomiasis are co-endemic, and treatment of schistosomiasis should be included in interventions to prevent HIV.

WHO in collaboration with UNAIDS published an advocacy document No more neglect – Female genital schistosomiasis and HIV – Integrating sexual and reproductive health interventions to improve women’s lives in 2019 calling for integration of FGS and sexual and reproductive health interventions. The integration of FGS prevention and control with existing sexual and reproductive health and HIV services could contribute to improving the long-term health and well-being of women and girls in the African region.

More research is needed to improve diagnostic and treatment of genital manifestations of schistosomiasis.