Case Report: Highlighting Male Genital Schistosomiasis (MGS) in Fishermen from the Southwestern Shoreline of Lake Malawi, Mangochi District

Abstract

Urogenital schistosomiasis causes morbidity within the genitalia but is underreported and infrequently examined in men. To draw attention to male genital schistosomiasis (MGS), a longitudinal cohort study was conducted among fishermen along the southwestern shoreline of Lake Malawi. A case series of five participants is presented inclusive of questionnaire interviews, parasitological examinations, ultrasonography, and provision of a standard dose (40 mg/kg) of praziquantel (PZQ) treatment at baseline, 1-, 3-, 6-, and 12-month follow-up time points. Eggs of Schistosoma haematobium were observed in urine or semen across all time points; parasitological diagnostics were bolstered by real-time PCR for Schistosoma DNA in semen and by portable ultrasonography to document putative MGS-associated morbidity. We highlight the importance of developing standard diagnostic tests for MGS and increasing the accessibility of PZQ treatment to men, especially those in at-risk endemic areas.

An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi

“…To respond to this outbreak of intestinal schistosomiasis, we propose that current MDA efforts should be intensified, adopting biannual treatment cycles in schools, which has been successfully implemented elsewhere [ 18 ], alongside expanded access to praziquantel for all community members with intestinal schistosomiasis, in need of regular treatment throughout the year [ 19 ]. From recent surveys of adult fishermen who have urogenital schistosomiasis, making specific reference to male genital schistosomiasis, co-infection with S. mansoni has been noted alongside re-infections within a calendar year [ 20 , 21 ]. To augment MDA and community-access to praziquantel, it is important to strengthen health education and outreach with suitable water, sanitation and hygiene (WASH) interventions [ 20 , 22 ], better appropriate to this lakeshore setting, noting that even focal application of molluscicides is inappropriate [ 17 ], given this lake’s global importance in biodiversity.…”

An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi

“…To respond to this outbreak of intestinal schistosomiasis, we propose that current MDA efforts should be intensi ed, adopting biannual treatment cycles in schools, which has been successfully implemented elsewhere [18], alongside expanded access to praziquantel for all community members with intestinal schistosomiasis, in need of regular treatment throughout the year [19]. From recent surveys of adult shermen who have urogenital schistosomiasis, making speci c reference to male genital schistosomiasis, co-infection with S. mansoni has been noted alongside re-infections within a calendar year [20,21]. To augment MDA and communityaccess to praziquantel, it is important to strengthen health education and outreach with suitable water, sanitation and hygiene (WASH) interventions [20,22], better appropriate to this lakeshore setting, noting that even focal application of molluscicides is inappropriate [17], given this lake's global importance in biodiversity.…”

“…From recent surveys of adult shermen who have urogenital schistosomiasis, making speci c reference to male genital schistosomiasis, co-infection with S. mansoni has been noted alongside re-infections within a calendar year [20,21]. To augment MDA and communityaccess to praziquantel, it is important to strengthen health education and outreach with suitable water, sanitation and hygiene (WASH) interventions [20,22], better appropriate to this lakeshore setting, noting that even focal application of molluscicides is inappropriate [17], given this lake's global importance in biodiversity.…”

An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi

“…To respond to this outbreak of intestinal schistosomiasis, we propose that current MDA efforts should be intensi ed, adopting biannual treatment cycles in schools, which has been successfully implemented elsewhere [18], alongside expanded access to praziquantel for all community members with intestinal schistosomiasis, in need of regular treatment throughout the year [19]. From recent surveys of adult shermen who have urogenital schistosomiasis, making speci c reference to male genital schistosomiasis, co-infection with S. mansoni has been noted alongside re-infections within a calendar year [20,21]. To augment MDA and communityaccess to praziquantel, it is important to strengthen health education and outreach with suitable WASH interventions [20,22], better appropriate to this lakeshore setting, noting that even focal application of molluscicides is inappropriate [17], given this lake's global importance in biodiversity.…”

“…From recent surveys of adult shermen who have urogenital schistosomiasis, making speci c reference to male genital schistosomiasis, co-infection with S. mansoni has been noted alongside re-infections within a calendar year [20,21]. To augment MDA and communityaccess to praziquantel, it is important to strengthen health education and outreach with suitable WASH interventions [20,22], better appropriate to this lakeshore setting, noting that even focal application of molluscicides is inappropriate [17], given this lake's global importance in biodiversity.…”