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

Abstract

S U M M A R YThe Nigerian national control programme (NCP) for schistosomiasis does not have a specific action plan for female genital schistosomiasis (FGS), mainly due to gaps in epidemiological and clinical surveillance. To address this, we conducted a pilot investigation for FGS in girls (>5 and ≤15 years) and adult women (≥16 years) in four rural communities near Abeokuta, Ogun State. Urine samples were collected from 317 participants [children (n = 187), adults (n = 130)] and examined for ova of Schistosoma haematobium by microscopy. A total of 149 participants (47·0%) had egg-patent urogenital schistosomiasis [children (64·7%), adults (21·6%)], reported blood in urine was common (44·5%) as well as sign-post symptoms of FGS. To verify FGS directly, 20 adult women each underwent a gynaecological investigation by colposcopy with observed lesions classified according to the WHO FGS pocket atlas. Fourteen (70·0%) women presented with FGS as grainy-sandy patches (n = 10), homogenous yellow sandy patches (n = 6), nabothian cysts and rubbery papules (n = 1). Our study confirms FGS in Ogun State and calls for further appraisals of this disease in other areas where urogenital schistosomiasis is endemic. The Nigerian NCP should be encouraged to develop an appropriate response to FGS not only to detect it, but also to prevent it.

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

“…This draws attention to the susceptibility of these young women and girls to infection with FGS [45], intensifying the need for more preventive and treatment focus of this group [51] and especially in childhood [25], with the recent advancement in developing of pediatric Praziquantel [52]. Related, menstrual irregularities (painful, irregular or seized menstruation found to be prevalent amongst 73.5% of FGS positive females), amongst post menarche girls with UGS, added to symptoms like vaginal itches and burning sensation in genitals, already asserted to infer FGS in young girls [15,53], was identified as signify possible presence of FGS amongst this group, especially in such resource limited settings. Culture and infection.…”

“…With regard to urogenital schistosomiasis, this disease can damage reproductive organs and tracts of both genders [10,11]. Over the past decade, there is heightening awareness of Female Genital Schistosomiasis (FGS), in terms of diagnostic research [12][13][14][15][16][17], knowledge sharing [18][19][20][21] and pragmatic policy guides and information [22,23], even though only a very small fraction of those with suspected FGS have been examined clinically [22].…”

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

“…Rubbery papules are firm, hard rubbery papulous lesions, which have only been seen in Madagascan women. These were observed by clinicians who have investigated women in five southern African countries, although one case was reported in Nigeria 9,22 . Abnormal blood vessels are circular, convoluted, corkscrew, reticular, and/ or branched, and of uneven‐caliber in those with FGS 14 .…”

Schistosomiasis outbreak during COVID-19 pandemic in Takum, Northeast Nigeria: Analysis of infection status and associated risk factors

“…Other complicated pathologies may include fibrosis of the bladder and ureter, kidney damage and in more advanced cases cancer of the bladder [4]. Urogenital schistosomiasis may become more complex in females in a condition known as female genital schistosomiasis (FGS), which may present with symptoms such as genital lesions, vaginal bleeding, pain during sexual intercourse and infertility [10][11][12]. The pathologies are worsened among children because of the developing immunity, with already established evidence on anemia, stunting, protein-energy malnutrition, school absenteeism and reduced cognition [13][14][15].…”