Schistosomiasis and Infertility in East Africa.

Case reports and pathology series suggest associations of female genital schistosomiasis () with infertility and ectopic pregnancy. Differential geographic distribution of infertility is not explained by analyses of known risk factors. In this cross-sectional multilevel semi-ecologic study, interpolated prevalence maps for and in East Africa were created using data from two open-access Neglected Tropical Diseases Databases. Prevalence was extracted to georeferenced survey sample points for Demographic and Health Surveys for Ethiopia, Kenya, Tanzania, and Uganda for 2000 and 2010. Exploratory spatial analyses showed that infertility was not spatially random and mapped the clustering of infertility and its co-location with schistosomiasis. Multilevel logistic regression analysis demonstrated that women living in high compared with absent locations had significantly higher odds of infertility (2000 odds ratio [OR] = 1.5 [confidence interval = 1.3, 1.8]; 2010 OR = 1.2 [1.1, 1.5]). Women in high compared with high locations had significantly higher odds of infertility (2000 OR 1.4 [1.1, 1.9]; 2010 OR 1.4 [1.1, 1.8]). Living in high compared with absent locations did not affect the odds of infertility. Infertility appears to be associated spatially with .