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ORIGINAL RESEARCH article

Front. Trop. Dis
Sec. Neglected Tropical Diseases
Volume 5 - 2024 | doi: 10.3389/fitd.2024.1322667
This article is part of the Research Topic Female Genital Schistosomiasis: Research Needed to Raise Awareness and Deliver Action View all 12 articles

Assessment of Gynaecological Manifestations in Women with Female Genital Schistosomiasis with Reference to Cervicovaginal Schistosoma Biomarkers, Sexually Transmitted Infections and Bacterial Vaginosis

Provisionally accepted
Bodo S. Randrianasolo Bodo S. Randrianasolo 1Karoline Jøker Karoline Jøker 2Louise Arenholt Louise Arenholt 2,3,4Tiana O. Rabozakandraina Tiana O. Rabozakandraina 1Charles Emile Ramarokoto Charles Emile Ramarokoto 1Dorthe Brønnum Dorthe Brønnum 2Martin Jensen Martin Jensen 5Søren L. Christensen Søren L. Christensen 5Jorgen S. Jensen Jorgen S. Jensen 6Paul Corstjens Paul Corstjens 7Govert J. Dam Govert J. Dam 8Noriko Kobayashi Noriko Kobayashi 9Shinjiro Hamano Shinjiro Hamano 9Peter Leutscher Peter Leutscher 2,4*
  • 1 Association K’OLO VANONA, Antananarivo, Madagascar
  • 2 Centre for clinical research, North Denmark Regional Hospital, Hjoerring, Denmark
  • 3 Department of Obstetrics and Gynecology, North Denmark Regional Hospital, Hjoerring, Denmark
  • 4 Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  • 5 Research Data and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
  • 6 State Serum Institute (SSI), Copenhagen, Hovedstaden, Denmark
  • 7 Department of Cell and Chemical Biology, Leiden University Medical Center (LUMC), Leiden, Netherlands
  • 8 Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, Netherlands
  • 9 Department of Parasitology, The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan

The final, formatted version of the article will be published soon.

    Abstract Background: While a variety of different gynaecological manifestations are reported in women with female genital schistosomiasis (FGS), causality remains to be established. This study aimed to assess gynaecological manifestations in women with FGS in accordance with the status of Schistosoma biomarkers, in addition to sexually transmitted infections (STI) and bacterial vaginosis (BV). Methods: The study was conducted in a Schistosoma haematobium-endemic area in northern Madagascar in conjunction with a randomised controlled trial investigating the effect and safety of a praziquantel (PZQ) repeated-dosing regimen for women detected with FGS-associated cervical lesions. Urogenital complaints, pelvic exam abnormalities, and cervical lesion types were assessed in relation to cervicovaginal Schistosoma DNA, circulating anodic antigens (CAA) in serum, and urinary Sh egg count, in addition to STI and BV. Results: Among the included 116 women with a median of 26 years (range 15 to 35) cervicovaginal Schistosoma DNA was detected 18.1%, serum CAA in 76.9% and Sh eggs in urine in 74.1%. The distribution of Schistosoma DNA and CAA outcomes, specified as either positive (+) or negative (-), were as follows: +/+ (18.1 %), +/- (0 %), -/+ (58.6 %), -/- (23.3 %), respectively. Of the three Schistosoma biomarkers only Schistosoma DNA and the urogenital complaint of blood in the urine were significantly associated. None of the biomarkers were significantly associated with pelvic exam abnormalities or cervical lesions. Sixty women (52.6%) were diagnosed with STIs and/or BV. Positive status was not significantly associated with any of the gynaecological manifestations, except BV and homogeneous yellow sandy patches. Conclusion: It remains uncertain whether the applied panel of Schistosoma biomarkers of active infection adequately cover the full spectrum of FGS associated gynaecological manifestations, such as the chronic cervical lesions. The common co-existence of STI and BV as potential confounders to FGS further complicate the diagnostic assessment.

    Keywords: Schistosoma haematobium, female genital schistosomiasis, gynaecological manifestations, Schistosoma DNA, Circulating anodic antigens, sexually transmitted infections, bacterial vaginosis

    Received: 16 Oct 2023; Accepted: 15 Jul 2024.

    Copyright: © 2024 Randrianasolo, Jøker, Arenholt, Rabozakandraina, Ramarokoto, Brønnum, Jensen, Christensen, Jensen, Corstjens, Dam, Kobayashi, Hamano and Leutscher. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Peter Leutscher, Centre for clinical research, North Denmark Regional Hospital, Hjoerring, Denmark

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