The burden and risk factors of female genital schistosomiasis in two schistosomiasis-endemic states of Nigeria.

BACKGROUND

Female Genital Schistosomiasis (FGS) is a neglected gynaecological condition that arises from chronic complications of schistosomiasis infection. It is estimated to affect 56 million women and girls in sub-Saharan Africa. In Nigeria, the burden of FGS is largely unknown, and many cases of FGS are misdiagnosed due to poor levels of awareness among health workers.

METHODS

Using a cross-sectional study design, we investigated the prevalence of FGS and its associated risk factors among reproductive-aged women in 15 schistosomiasis hotspot communities in Ondo and Kebbi States of Nigeria. A questionnaire-based survey was conducted with community members to explore their sociodemographic characteristics and reported urogenital symptoms. Urine samples were collected to investigate presence of haematuria and Schistosoma haematobium eggs. Visual examination by colposcopy was also conducted among sexually active participants to determine their FGS status.

RESULTS

Five hundred and sixty-one (561) females were visually examined, with FGS prevalence estimated at 41.4% (95% C.I: 37.3 to 45.5). Age, marital status, educational attainment and state of residence were significantly associated (P < 0.05) with positive visual FGS diagnosis. Other factors such as surface water source, reported signs of blood in urine and presence of S. haematobium eggs in urine were associated risks for FGS.

CONCLUSION

FGS is a huge burden in schistosomiasis endemic areas of Nigeria. There is need for community-wide interventions to address and manage FGS, and integration of FGS into other sexual and reproductive health programmes.