Classification of the lesions observed in female genital schistosomiasis

Kjetland, Eyrun Floerecke; Norseth, Hanne M.; Taylor, Myra; Lillebø, Kristine; Kleppa, Elisabeth; Holmen, Sigve; Andebirhan, Asmeret; Yohannes, Tsion H.; Gundersen, Svein Gunnar; Vennervald, Birgitte J.; Bagratee, Jayanthilall; Onsrud, Mathias; Leutscher, Peter

doi:10.1016/j.ijgo.2014.07.014

Cited by 37 publications

(45 citation statements)

References 4 publications

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“…In this population, Schistosoma PCR contributed to the diagnosis of rubbery papules, but it was not strong in the diagnosis of sandy patches and abnormal blood vessels, which may constitute inflammation around dead ova. At the point of care, clinical inspection must be the mainstay for diagnosis, and in research it should be combined with one of the laboratory tests [ 28 ]. Further studies are needed to explore the clinical algorithms that may lead to diagnosis at the point of care and diagnostic tools that can objectively identify the lesions.…”

Section: Discussionmentioning

confidence: 99%

Gynecological Manifestations, Histopathological Findings, and Schistosoma-Specific Polymerase Chain Reaction Results Among Women WithSchistosoma haematobiumInfection: A Cross-sectional Study in Madagascar

Randrianasolo¹,

Jourdan

Ravoniarimbinina

et al. 2015

J Infect Dis.

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Background. The pathophysiology of female genital schistosomiasis (FGS) is only partially understood. This study aims to describe the histopathological findings, polymerase chain reaction (PCR) results, and gynecological manifestations of FGS in women with different intensities of Schistosoma haematobium infection.Methods. Women aged 15–35 years living in an S. haematobium-endemic area in Madagascar underwent pelvic and colposcopic examinations. Small biopsy specimens were obtained from lesions and examined histopathologically. Schistosoma PCR was done on urine, biopsy, cervicovaginal lavage, and genital mucosal surface specimens.Results. Sandy patches and rubbery papules were found in 41 of 118 women (35%). Rubbery papules reflected an intense cellular immune reaction dominated by eosinophils, epithelial erosion, and viable ova. There was a significant decrease in the prevalence of rubbery papules with age, even after adjustment for urinary ova excretion. The sandy patches with grains showed moderate cellular immune reaction and ova (viable and/or calcified). They were most prevalent in cases with low-intensity urinary S. haematobium infection. Forty-two percent of women with Schistosoma-negative urine specimens had at least 1 genital specimen test positive for Schistosoma by PCR.Conclusions. The results indicate a diversity of lesions caused by S. haematobium and a dynamic evolution of the genital lesions. Schistosoma PCR may give an indication of the diagnosis.

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Section: Discussionmentioning

confidence: 99%

Gynecological Manifestations, Histopathological Findings, and Schistosoma-Specific Polymerase Chain Reaction Results Among Women WithSchistosoma haematobiumInfection: A Cross-sectional Study in Madagascar

Randrianasolo¹,

Jourdan

Ravoniarimbinina

et al. 2015

J Infect Dis.

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“…Complaints of genital schistosomiasis patients at first admission generally include itching, discharge, irregular hemorrhage, pelvic pain, dyspareunia, and unexplained infertility . The symptoms identified in the gynecological examination may be confused with premalignant or malignant lesions .…”

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confidence: 99%

“…The symptoms identified in the gynecological examination may be confused with premalignant or malignant lesions . The presence of grainy sandy patches, homogenous yellow sandy patches, or rubbery tubercles identified in gynecological examinations of women in endemic regions should raise the suspicion ofschistosomiasis …”

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confidence: 99%

“…The ova develop into the miracidia, Complaints of genital schistosomiasis patients at first admission generally include itching, discharge, irregular hemorrhage, pelvic pain, dyspareunia, and unexplained infertility. 3,[7][8][9] The symptoms identified in the gynecological examination may be confused with premalignant or malignant lesions. 7 The presence of grainy sandy patches, homogenous yellow sandy patches, or rubbery tubercles identified in gynecological examinations of women in endemic regions should raise the suspicion ofschistosomiasis.…”

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confidence: 99%

“…7 The presence of grainy sandy patches, homogenous yellow sandy patches, or rubbery tubercles identified in gynecological examinations of women in endemic regions should raise the suspicion ofschistosomiasis. 8 A definitive diagnosis can only be made with evidence of viable eggs in the urine, stool, or biopsy specimen. 2,4,6 A Pap smear is not routinely used for the diagnosis of schistosomiasis and has low diagnostic sensitivity.…”

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confidence: 99%

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Incidental detection of schistosome ova in a cervical smear and subsequent diagnosis of female genital schistosomiasis: an observation from Zimbabwe

Kiraz

Öztürk

Paksoy³

2020

Diagnostic Cytopathology

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A systematic review of handheld tools in lieu of colposcopy for cervical neoplasia and female genital schistosomiasis

Søfteland

Sebitloane

Taylor

et al. 2021

Intl J Gynecology & Obste

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Background Visualization of the lesions in the lower genital tract is the mainstay for diagnosis of the four lesions found in female genital schistosomiasis (FGS), but colposcopes are generally not available in low‐resource settings. Objective We sought to review handheld devices that could potentially be used for FGS diagnosis. Search strategy We searched Medline and Embase 2015–2019 for handheld devices used in cervical cancer screening and FGS diagnosis. Selection criteria We excluded studies that did not compare the device to standard‐of‐care colposcopes or histopathology. Main results and conclusion In 11 studies, four handheld colposcopes, two smartphones, and one compact digital camera were evaluated. Two handheld colposcopes were found to be potentially adequate for FGS diagnosis, namely Gynocular and Mobile ODT. The smartphones and digital camera did not have sufficient magnification to diagnose grainy sandy patches, one of the FGS lesion types. Customized software should be made to support the diagnosis of both FGS and cervical neoplasia. Real‐time postgraduate training and quality control should be considered in future studies of handheld colposcopes. For patients from schistosomiasis endemic areas, we recommend that handheld devices are used for FGS. Studies are needed to determine which of the two devices is most adequate for FGS diagnosis in schistosomiasis endemic areas.

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Classification of the lesions observed in female genital schistosomiasis

Cited by 37 publications

References 4 publications

Gynecological Manifestations, Histopathological Findings, and Schistosoma-Specific Polymerase Chain Reaction Results Among Women WithSchistosoma haematobiumInfection: A Cross-sectional Study in Madagascar

Gynecological Manifestations, Histopathological Findings, and Schistosoma-Specific Polymerase Chain Reaction Results Among Women WithSchistosoma haematobiumInfection: A Cross-sectional Study in Madagascar

Incidental detection of schistosome ova in a cervical smear and subsequent diagnosis of female genital schistosomiasis: an observation from Zimbabwe

A systematic review of handheld tools in lieu of colposcopy for cervical neoplasia and female genital schistosomiasis

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