Female Genital Schistosomiasis (FGS) in Cameroon

A formative epidemiological and socioeconomic investigation in eleven rural fishing communities

Bibliographic Data

ID19593207
AuthorsMakia Christine Masong (0000-0002-2601-7068, Catholic University of Central Africa, corresponding author), Godlove Bunda Wepnje (0000-0001-8335-6624, University of Buea), Ntsinda Tchoffo Marlene (0000-0002-1871-4381, Catholic University of Central Africa), Victoria Gamba (0000-0003-1866-8941, University of Nairobi), Marie-Therese Mengue, Marie‐Thérèse Mengue (0000-0002-5867-7597, Catholic University of Central Africa), Estelle Kouokam (0000-0002-1177-1703, Catholic University of Central Africa), J Russell Stothard (0000-0002-9370-3420, Liverpool School of Tropical Medicine), Albert Legrand Same Ekobo (University Teaching Hospital of Yaounde)
EditorsHannah Tappis (0000-0002-4289-5418)
Year2021
Volume1
Issue10
Pagese0000007
Publication date2021-10-20
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000007
PMID36962084
OpenAlexW3206272231
LanguageEN
Citations received4
References cited42

Background Female Genital Schistosomiasis (FGS) is most often caused by presence of Schistosoma haematobium eggs lodged in the female reproductive tract which results in chronic fibrosis and scarring. In Cameroon, despite high community prevalences of urine-patent S. haematobium infections, FGS has yet to be studied in depth. To shed light on the clinical prevalence and socioeconomic effects of FGS, we undertook a formative community-based epidemiological and qualitative survey. Method A cross sectional multidisciplinary study of 304 girls and women from 11 remote rural fishing communities in Cameroon was undertaken using parasitological sampling, clinical colposcopy, and interviews. The lived experiences of those with FGS were documented using a process of ethnography with participant observation and in-depth interviews. Result Amongst 304 women and girls aged >5 years (Median age: 18; Interquartile range: 9.6–28), 198 females were eligible for FGS testing and 58 adult women were examined by clinical colposcopy. Of these, 34 were positive for FGS (proportion: 58.6%; 95% CI: 45.8–70.4), younger girls showing a higher FGS prevalence, and older women not shedding eggs showing a pattern for cervical lesions from earlier infection. In a subset of women with FGS selected purposively (12/58), in-depth interviews with participant observation revealed out-of-pocket expenditures of up to 500USD related health spending for repeated diagnosis and treatment of gynecological illnesses, and 9 hours daily lost reproductive labour. Psychosocial unrest, loss in social capital, and despair were linked with sub-fertility and persistent vaginal itch. Conclusion With our first formative evidence on prevalence, socioeconomic effects and experiences of FGS amongst women and girls in Cameroon, we have clarified to a new level of detail the deficit in provision of and access to peripheral health services in remote areas of Cameroon. Using this information, there is now strong evidence for national programs and services on women’s health and schistosomiasis to update and revise policies targeted on prevention and management of FGS. We therefore stress the need for regular provision of Praziquantel treatment to adolescent girls and women in S . haematobium endemic areas, alongside better access to tailored diagnostic services that can detect FGS and appropriately triage care at primary health level

Environmental health · Helminths · Latrine · Pathology · Population · Psychiatry · Psychosocial · Sanitation · Schistosoma haematobium · Schistosomiasis · Socioeconomic status · Demography · Medicine · Parasite Biology and Host Interactions · Parasites and Host Interactions · Research on Leishmaniasis Studies · Epidemiology · Immunology · Internal Medicine

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