ABSTRACT
A cross-sectional study in an Schistosoma haematobium endemic area of rural Zimbabwe examined 483 resident women between the ages of 20 and 49 years who were interviewed about fertility. S. haematobium ova in genital tissue was found to be significantly associated with infertility.
Subject(s)
Genital Diseases, Female/epidemiology , Infertility, Female/epidemiology , Schistosomiasis haematobia/epidemiology , Adult , Animals , Female , Genital Diseases, Female/etiology , Humans , Infertility, Female/diagnosis , Infertility, Female/etiology , Middle Aged , Odds Ratio , Prognosis , Research Design , Residence Characteristics , Schistosoma haematobium/physiology , Schistosomiasis haematobia/complications , Young Adult , Zimbabwe/epidemiologyABSTRACT
OBJECTIVE: To examine the association between schistosomiasis and reproductive tract symptoms. METHOD: A cross-sectional study was conducted in a Schistosoma haematobium-endemic area of rural Zimbabwe. A total of 483 permanently resident adult women of Mupfure Ward aged 20-49 were interviewed and examined clinically, each providing three consecutive urine samples. Logistic regression analysis was used to control for sexually transmitted diseases (STDs). RESULTS: Women with genital sandy patches had significantly more genital itch (P = 0.009) and perceived their discharge as abnormal (P = 0.003). Eighty percent of the women who had genital itch, yellow discharge, and childhood or current waterbody contact had sandy patches. Fifty-two percent of the women with genital sandy patches did not have detectable S. haematobium ova in urine. Genital schistosomiasis was associated with stress incontinence and pollakisuria, but not with menstrual irregularities, current or previous ulcers, or tumours. CONCLUSION: Genital schistosomiasis may be a differential diagnosis to the STDs in women who have been exposed to fresh water in endemic areas. Because of the chronic nature of the disease in adults, we suggest to pay special attention to the prevention of morbidity.
Subject(s)
Endemic Diseases , Genital Diseases, Female/diagnosis , Schistosoma haematobium , Schistosomiasis/diagnosis , Adult , Animals , Cross-Sectional Studies , Diagnosis, Differential , Female , Genital Diseases, Female/parasitology , Humans , Middle Aged , Morbidity , Pruritus/parasitology , Rural Population , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/parasitology , Vagina/parasitology , Vaginal Discharge/parasitology , Young Adult , ZimbabweABSTRACT
Schistosoma haematobium infection may cause genital mucosal pathology in women with and without urinary schistosomiasis. This report seeks to explore the long-term effect of anti-schistosomal treatment on the clinical manifestations of S. haematobium infection in the lower genital tract. Prior treatment was reported by 248 (47%) of 527 women. Treatment received before the age of 20 years was significantly associated with the absence of sandy patches and contact bleeding, and this association was independent of current waterbody contact. Treatment in the past five years did not influence the prevalence of gynecologic schistosoma-induced lesions. The study indicates that early treatment may be more efficient for gynecologic morbidity control. Findings warrant an exploration into several chemotherapeutic agents administered at an early age, as well as in adults.
Subject(s)
Antigens, Helminth/urine , Genital Diseases, Female/parasitology , Schistosoma haematobium/isolation & purification , Schistosomiasis haematobia/drug therapy , Schistosomicides/therapeutic use , Adult , Animals , Antiplatyhelmintic Agents , Cross-Sectional Studies , Female , Genital Diseases, Female/epidemiology , Genital Diseases, Female/pathology , Humans , Schistosoma haematobium/classification , Schistosomiasis haematobia/epidemiology , Schistosomiasis haematobia/pathologyABSTRACT
Up to 75% of women with urinary schistosomiasis have Schistosoma haematobium ova in the genitals. This study aimed to describe the prevalence of gynecologic S. haematobium infection and to differentiate the disease from sexually transmitted infections (STIs). Gynecologic and laboratory investigations for S. haematobium and STIs were performed in 527 women between the ages of 20 and 49 in rural Zimbabwe. Genital homogenous yellow and/or grainy sandy patches, the commonest type of genital pathology, were identified in 243 (46%) women. Grainy sandy patches were significantly associated with S. haematobium ova only. Genital S. haematobium ova was also significantly associated with homogenous yellow sandy patches, mucosal bleeding, and abnormal blood vessels. The presence of ova was not a predictor for ulcers, papillomata, leukoplakia, polyps, or cell atypia. Mucosal sandy patches seem to be pathognomonic for S. haematobium infection in the female genitals. Coexistence of ova and other lesions may not be causal.