Urogenital schistosomiasis (UGS) and female genital schistosomiasis (FGS) in Cameroon: an observational assessment of key reproductive health determinants of girls and women in the Matta Health Area.

OBJECTIVES AND SETTING

Across sub-Saharan Africa, urogenital schistosomiasis (UGS), in particular female genital schistosomiasis (FGS), is a significant waterborne parasitic disease, with its direct burden on the sexual and reproductive health (SRH) of sufferers infrequently measured. UGS has an established control plan, which in most endemic regions as in Cameroon, still excludes FGS considerations. Highlighting existent associations between UGS and FGS could increase the management of FGS within UGS interventions. This study seeks to identify current associations among FGS and UGS with some reproductive health indicators, to provide formative information for better integrated control.

PARTICIPANTS

304 females aged 5-69 years were all examined for UGS by urine filtration and microscopy. Among these, 193 women and girls were eligible for clinical FGS assessment based on age (>13). After selective questioning for FGS symptoms, a subgroup of 67 women and girls consented for clinical examination for FGS using portable colposcopy, with observed sequelae classified according to the WHO FGS pocket atlas.

OUTCOME

Overall UGS and FGS prevalence was measured, with FGS-related/UGS-related reproductive health symptoms recorded. Associations between FGS and UGS were investigated by univariate and multivariate logistic regression analyses.

RESULTS

Overall UGS prevalence was 63.8% (194/304), where FGS prevalence (subgroup) was 50.7% (34/67). FGS manifestation increased significantly with increasing age, while a significant decrease with ascending age was observed for UGS. Lower abdominal pain (LAP) vaginal itches (VI) and coital pain (CP) were identified as the main significant shared symptoms of both FGS and UGS, while LAP with menstrual irregularity (MI) appeared a strong symptomatic indicator for FGS.

CONCLUSION

LAP, MI, CP and VI are the potential SRH indicators that could be exploited in future for targeting of praziquantel provision to FGS sufferers within primary care, complementary with existing praziquantel distribution for UGS sufferers in endemic areas.