S. haematobium as a common cause of genital morbidity in girls: a cross-sectional study of children in South Africa

PLoS Negl Trop Dis. 2013;7(3):e2104. doi: 10.1371/journal.pntd.0002104. Epub 2013 Mar 21.

Abstract

Background: Schistosoma (S.) haematobium infection is a common cause of genital morbidity in adult women. Ova in the genital mucosal lining may cause lesions, bleeding, pain, discharge, and the damaged surfaces may pose a risk for HIV. In a heterogeneous schistosomiasis endemic area in South Africa, we sought to investigate if young girls had genital symptoms and if this was associated with urinary S. haematobium.

Methodology: In a cross-sectional study of 18 randomly chosen primary schools, we included 1057 schoolgirls between the age of 10 and 12 years. We interviewed assenting girls, whose parents had consented to their participation and examined three urines from each of them for schistosome ova.

Principal findings: One third of the girls reported to have a history of genital symptoms. Prior schistosomal infection was reported by 22% (226/1020), this was associated with current genital symptoms (p<0.001). In regression analysis the genital symptoms were significantly associated both with urinary schistosomiasis (p<0.001) and water contact (p<0.001).

Conclusions: Even before sexually active age, a relatively large proportion of the participating girls had similar genital symptoms to those reported for adult genital schistosomiasis previously. Anti-schistosomal treatment should be considered at a young age in order to prevent chronic genital damage and secondary infections such as HIV, sexually transmitted diseases and other super-infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Prevalence
  • Reproductive Tract Infections / epidemiology*
  • Reproductive Tract Infections / parasitology
  • Reproductive Tract Infections / pathology
  • Schistosoma haematobium / isolation & purification*
  • Schistosomiasis haematobia / epidemiology*
  • Schistosomiasis haematobia / parasitology
  • Schistosomiasis haematobia / pathology
  • Schools
  • South Africa / epidemiology
  • Urine / parasitology

Grants and funding

The study was funded by Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo University Hospital Ullevaal (VIRUUS), Ship owner Tom Wilhelmsen Foundation (http://legatsiden.no), S.G. Sønneland Foundation (http://legatsiden.no) and General Travel Scholarships (http://legatsiden.no). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.