Rafferty Hannah, Warrell Clare E, Polley Spencer, Bodhani Rashmita, Nabarro Laura E, Godbole Gauri, Bustinduy Amaya L, Kjetland Eyrun F, Hsieh Michael H, Chiodini Peter L
Hospital for Tropical Diseases, London, UK.
Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
Open Forum Infect Dis. 2025 Mar 24;12(5):ofaf180. doi: 10.1093/ofid/ofaf180. eCollection 2025 May.
Female genital schistosomiasis (FGS), the genital manifestation of infection in women, results in protean gynecological symptoms and longer-term complications. FGS affects an estimated 75% of women with , totaling 56 million women, mainly in Sub-Saharan Africa. With increasing migration, FGS will be encountered more frequently in nonendemic settings. Despite this, evaluation of FGS diagnosis and management and guidelines for these settings are lacking.
A retrospective case-notes review was undertaken of patients presenting to the Hospital for Tropical Diseases, London, from 1998 to 2018 with ova in terminal urine or on biopsy. Descriptive and outcome variables were collected. Specific FGS variables included documented gynecological symptoms and referrals to sexual health and gynecology specialists. Results informed a clinical pathway aiding diagnosis and management of FGS.
Overall, 186 patients with ova in terminal urine or biopsy were included, 62 (33.3%) of whom were women. Four women had documented gynecological symptoms (4/62, 6.5%). Two symptomatic women were referred to gynecology (2/4, 50%), and 2 were lost to follow-up (2/4, 50%). Gynecological symptoms were not documented for many women, despite proven infection.
Given that 75% of women with infection may have FGS, there is a gap in diagnosis in this nonendemic setting. We developed a clinical pathway to improve diagnosis and management of FGS, including inquiry about gynecological symptoms, followed by targeted referrals to gynecology, sexual health, and urological imaging. By formalizing a pathway, we aim to improve FGS care in this nonendemic setting.
女性生殖器血吸虫病（FGS）是女性感染血吸虫后的生殖器表现，可导致多种妇科症状和长期并发症。据估计，FGS影响了75%的感染血吸虫病的女性，总计5600万女性，主要分布在撒哈拉以南非洲。随着移民增加，在非流行地区将更频繁地遇到FGS。尽管如此，缺乏针对这些地区FGS诊断、管理及指南的评估。
对1998年至2018年在伦敦热带病医院就诊且终末尿液或活检中发现血吸虫卵的患者进行回顾性病例笔记审查。收集描述性和结果变量。特定的FGS变量包括记录的妇科症状以及转介至性健康和妇科专家处的情况。研究结果形成了有助于FGS诊断和管理的临床路径。
总体而言，纳入了186例终末尿液或活检中发现血吸虫卵的患者，其中62例（33.3%）为女性。4名女性有记录的妇科症状（4/62，6.5%）。2名有症状的女性被转介至妇科（2/4，50%），2名失访（2/4，50%）。尽管证实感染了血吸虫，但许多女性未记录妇科症状。
鉴于75%的感染血吸虫病的女性可能患有FGS，在这个非流行地区存在诊断差距。我们制定了一条临床路径以改善FGS的诊断和管理，包括询问妇科症状，随后针对性地转介至妇科、性健康和泌尿外科影像学检查。通过规范路径，我们旨在改善这个非流行地区的FGS护理。
