Association of schistosomiasis and HIV infections: A systematic review and meta-analysis

Patel, Pragna; Rose, Charles E.; Kjetland, Eyrun Floerecke; Downs, Jennifer A.; Mbabazi, Pamela Sabina; Sabin, Keith; Chege, Wairimu; Watts, D. Heather; Secor, W. Evan

doi:10.1016/j.ijid.2020.10.088

Cited by 45 publications

(37 citation statements)

References 72 publications

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“…Urogenital schistosomiasis, caused by the blood fluke Schistosoma haematobium, is one of the most neglected tropical diseases (NTDs) worldwide, afflicting more than 100 million people, particularly in Africa and the Middle East [1,2]. This disease is transmitted to humans via aquatic snails (intermediate hosts) typically of the genus Bulinus [3] and is characterised by granulomata, fibrosis and calcification in the urinary bladder wall and other parts of the urogenital tract [4,5], with complications including increased susceptibility to HIV/AIDS [6] and squamous cell carcinoma of the urinary bladder [7,8].…”

Section: Introductionmentioning

confidence: 99%

Chromosome-level genome of Schistosoma haematobium underpins genome-wide explorations of molecular variation

et al. 2022

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Urogenital schistosomiasis is caused by the blood fluke Schistosoma haematobium and is one of the most neglected tropical diseases worldwide, afflicting > 100 million people. It is characterised by granulomata, fibrosis and calcification in urogenital tissues, and can lead to increased susceptibility to HIV/AIDS and squamous cell carcinoma of the bladder. To complement available treatment programs and break the transmission of disease, sound knowledge and understanding of the biology and ecology of S. haematobium is required. Hybridisation/introgression events and molecular variation among members of the S. haematobium-group might effect important biological and/or disease traits as well as the morbidity of disease and the effectiveness of control programs including mass drug administration. Here we report the first chromosome-contiguous genome for a well-defined laboratory line of this blood fluke. An exploration of this genome using transcriptomic data for all key developmental stages allowed us to refine gene models (including non-coding elements) and annotations, discover ‘new’ genes and transcription profiles for these stages, likely linked to development and/or pathogenesis. Molecular variation within S. haematobium among some geographical locations in Africa revealed unique genomic ‘signatures’ that matched species other than S. haematobium, indicating the occurrence of introgression events. The present reference genome (designated Shae.V3) and the findings from this study solidly underpin future functional genomic and molecular investigations of S. haematobium and accelerate systematic, large-scale population genomics investigations, with a focus on improved and sustained control of urogenital schistosomiasis.

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Section: Introductionmentioning

confidence: 99%

Chromosome-level genome of Schistosoma haematobium underpins genome-wide explorations of molecular variation

et al. 2022

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“…Indeed this gap in routine detection of FGS within current primary health care settings means most endemic communities are still unaware of the existence or diagnosis of this important gender-specific manifestation of urogenital schistosomiasis [24][25][26][27]. The need to readdress this unfortunate oversight is important as there is unequivocal evidence of the clear link between FGS, and raised acquisition of Human Immunodeficiency Virus (HIV) [28][29][30] and cervical cancer [22]. The Central Africa region is a known host for the Schistosoma haematobium blood flukes, with high endemicity in several countries like Gabon [31], Democratic Republic of Congo [32], Central African Republic and Cameroon [33].…”

Section: Introductionmentioning

confidence: 99%

Female Genital Schistosomiasis (FGS) in Cameroon: A formative epidemiological and socioeconomic investigation in eleven rural fishing communities

Masong

Wepnje

Marlene

et al. 2021

PLOS Glob Public Health

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Background Female Genital Schistosomiasis (FGS) is most often caused by presence of Schistosoma haematobium eggs lodged in the female reproductive tract which results in chronic fibrosis and scarring. In Cameroon, despite high community prevalences of urine-patent S. haematobium infections, FGS has yet to be studied in depth. To shed light on the clinical prevalence and socioeconomic effects of FGS, we undertook a formative community-based epidemiological and qualitative survey. Method A cross sectional multidisciplinary study of 304 girls and women from 11 remote rural fishing communities in Cameroon was undertaken using parasitological sampling, clinical colposcopy, and interviews. The lived experiences of those with FGS were documented using a process of ethnography with participant observation and in-depth interviews. Result Amongst 304 women and girls aged >5 years (Median age: 18; Interquartile range: 9.6–28), 198 females were eligible for FGS testing and 58 adult women were examined by clinical colposcopy. Of these, 34 were positive for FGS (proportion: 58.6%; 95% CI: 45.8–70.4), younger girls showing a higher FGS prevalence, and older women not shedding eggs showing a pattern for cervical lesions from earlier infection. In a subset of women with FGS selected purposively (12/58), in-depth interviews with participant observation revealed out-of-pocket expenditures of up to 500USD related health spending for repeated diagnosis and treatment of gynecological illnesses, and 9 hours daily lost reproductive labour. Psychosocial unrest, loss in social capital, and despair were linked with sub-fertility and persistent vaginal itch. Conclusion With our first formative evidence on prevalence, socioeconomic effects and experiences of FGS amongst women and girls in Cameroon, we have clarified to a new level of detail the deficit in provision of and access to peripheral health services in remote areas of Cameroon. Using this information, there is now strong evidence for national programs and services on women’s health and schistosomiasis to update and revise policies targeted on prevention and management of FGS. We therefore stress the need for regular provision of Praziquantel treatment to adolescent girls and women in S. haematobium endemic areas, alongside better access to tailored diagnostic services that can detect FGS and appropriately triage care at primary health level.

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“…A study looking across 43 sub-Saharan countries found that for every S. haematobium infection per 100 individuals, there was a relative increase of 2.9% in HIV prevalence suggesting an association between infection with S. haematobium and HIV (14). The local in ammatory response to the parasite eggs includes HIV target cells (CD4 + T lymphocytes and macrophages)( 22) and coupled with the friable epithelium and lesions which can cause bleeding during coitus creates a permissive setting for HIV transmission (23). Therefore, addressing schistosomiasis can improve women's overall reproductive health and decrease vulnerability to other important reproductive health threats such as HIV.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, addressing schistosomiasis can improve women's overall reproductive health and decrease vulnerability to other important reproductive health threats such as HIV. Recently, a WHO Technical Working Group on HIV and Schistosomiasis reviewed and summarized the evidence of the association between HIV and schistosomiasis and put forth concrete actions to control the HIV/schistosomiasis syndemic in adolescent girls and young women (AGYW) (3,23). In their systematic review(23) the authors, members of the working group, highlighted the need for training in health care workers as a critical gap to improve the condition of AGYW suffering from both diseases.…”

Section: Introductionmentioning

confidence: 99%

Addressing a Silent and Neglected Scourge in Sexual and Reproductive Health in Sub-Saharan Africa by Development of Training Competencies to Improve Prevention, Diagnosis, and Treatment of Female Genital Schistosomiasis (FGS) for Health Workers

Jacobson

Pantelias

Williamson

et al. 2021

Preprint

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Background Schistosomiasis is an acute and chronic disease caused by parasitic worms, that can take two main forms: intestinal or urogenital. If left untreated, the urogenital form can lead to female genital schistosomiasis (FGS) in women and girls; frequently resulting in severe reproductive health complications which are often misdiagnosed as sexually-transmitted infections (STIs) or can be confused with cervical cancer. Despite its impact on women’s reproductive health, FGS is typically overlooked in medical training and remains poorly recognized with low awareness both in affected communities and in health professionals. FGS has been described as the one of the most neglected sexual and reproductive health issues in sub-Saharan Africa(1–3). Increased knowledge and awareness of FGS is required to end this neglect, improve women’s reproductive health, and decrease the burden of this preventable and treatable neglected tropical disease. Methods We conducted interactive virtual workshops, in collaboration with the World Health Organization (WHO), engaging 64 participants with medical and public health backgrounds from around the world to establish standardized skills (or competencies) for prevention, diagnosis, and treatment of FGS at all levels of the health system. The competencies were drafted in small groups, peer-reviewed, and finalized by participants. Results This participatory process led to identification of 27 skills needed for FGS prevention, diagnosis, and management for two categories of health workers; those working in a clinical setting, and those working in a community setting. Among them, ten relate to the diagnosis of FGS including three that involve a pelvic exam and seven that do not. Six constitute the appropriate behaviors required to treat FGS in a clinical setting. Eleven address the community setting, with six relating to the identification of women at risk and five relating to prevention. Conclusion Defining the skills necessary for FGS management is a critical step to prepare for proper diagnosis and treatment of women and girls in sub-Saharan Africa by trained health professionals. The suggested competencies can now serve as the foundation to create educative tools and curricula to better train health care workers on the prevention, diagnosis, and management of FGS.

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Association of schistosomiasis and HIV infections: A systematic review and meta-analysis

Cited by 45 publications

References 72 publications

Chromosome-level genome of Schistosoma haematobium underpins genome-wide explorations of molecular variation

Chromosome-level genome of Schistosoma haematobium underpins genome-wide explorations of molecular variation

Female Genital Schistosomiasis (FGS) in Cameroon: A formative epidemiological and socioeconomic investigation in eleven rural fishing communities

Addressing a Silent and Neglected Scourge in Sexual and Reproductive Health in Sub-Saharan Africa by Development of Training Competencies to Improve Prevention, Diagnosis, and Treatment of Female Genital Schistosomiasis (FGS) for Health Workers

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