Female genital schistosomiasis (FGS): from case reports to a call for concerted action against this neglected gynaecological disease

Abstract

In recent years, control of neglected tropical diseases has been increasingly gaining momentum and interventions against schistosomiasis are being progressively scaled-up through expansion of donated praziquantel and preventive chemotherapy campaigns. However, the public health importance of female genital schistosomiasis is not fully recognised nor its control is adequately addressed. Taking a clinical and anatomopathological perspective, we evaluated the available literature to highlight the importance of female genital schistosomiasis and its connections with two sexually transmitted infections of global importance, Human Immunodeficiency Virus (HIV) and Human Papilloma Virus. Outside the long list of clinical descriptive reports beginning in 1899, there is presently a shocking gap in epidemiological assessment and a significant underestimation of the burden of FGS remains. The scarcity of integrated approaches to address female genital schistosomiasis calls for more concerted action in its detection, treatment and prevention alongside other concomitant women's health issues, otherwise female genital schistosomiasis will remain a neglected gynaecological disease.

Female genital schistosomiasis (FGS) in Ogun State, Nigeria: a pilot survey on genital symptoms and clinical findings

“…Surveillance for FGS has been totally overlooked, whilst the disease has been firmly engrained in these communicates for decades, first formally reported in 1991 (Ofoezie et al 1991). More broadly, clinical surveillance of FGS in West Africa has not been undertaken largely due to lack of awareness and inexperience of health personnel at all cadres (Christinet et al 2016;Holmen et al 2016), inadequate resources for its detection within the primary care setting (WHO, 2015), as well as competing interests and priorities within NCPs that tackle more obvious issues associated with administration of preventive chemotherapy. The latter is an unfortunate polarity which on the one hand monitors and treats urinary signs and symptoms of schistosomiasis yet on the other totally neglects genital tract involvement.…”

“…For example, schistosome eggs lodged in the uterine and vaginal venous plexus cause female genital schistosomiasis (FGS) which is a major detriment to women's health in SSA (HellingGiese et al 1996a, b;Kjetland et al 2008;Christinet et al 2016). Although FGS was specifically recognized over 100 years ago, its pathology often mimics sexually transmitted diseases and is often incorrectly reported (Christinet et al 2016).…”

Incidental schistosomiasis in a case of carcinoma cervix

“…Several cases of cervical carcinoma associated with schistosomiasis have also been reported in the literature. 3 However there is now evidence indicating no association between cervical carcinoma and schistosomiasis. Hence, in view of no association between the two and also the absence of infection in genital tract in the index case, we conclude that it was an incidental detection in a case of carcinoma cervix.…”

Ectopic forms of schistosomiasis mansoni in the second macroregion of Alagoas: case series report and review of the literature

“…Originally described in 1851 in Egypt by Theodor Bilharz, schistosomiasis spread from Africa to other continents following migratory flows 1 . Today, according to the World Health Organization (WHO), schistosomiasis ranks second in the world in importance and socioeconomic repercussion, after malaria.…”

“…The extensive geographic distribution of schistosomiasis mansoni in Brazil, by itself, provides a dimension of the magnitude of this problem for public health 1 . It is estimated that 2.5 to 8 million Brazilians have the disease.…”