Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women
Abstract Background Female genital schistosomiasis (FGS) is a neglected tropical gynaecological disease that affects millions of women in sub-Saharan Africa (SSA). FGS is caused by Schistosoma haematobium, a parasitic carcinogen involved in the pathogenesis of squamous cell carcinoma of the bladder....
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| Format: | Article |
| Language: | English |
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BMC
2021-07-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-06380-5 |
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| author | H. Rafferty A. S. Sturt C. R. Phiri E. L. Webb M. Mudenda J. Mapani P. L. A. M. Corstjens G. J. van Dam A. Schaap H. Ayles R. J. Hayes L. van Lieshout I. Hansingo A. L. Bustinduy |
| author_facet | H. Rafferty A. S. Sturt C. R. Phiri E. L. Webb M. Mudenda J. Mapani P. L. A. M. Corstjens G. J. van Dam A. Schaap H. Ayles R. J. Hayes L. van Lieshout I. Hansingo A. L. Bustinduy |
| author_sort | H. Rafferty |
| collection | DOAJ |
| description | Abstract Background Female genital schistosomiasis (FGS) is a neglected tropical gynaecological disease that affects millions of women in sub-Saharan Africa (SSA). FGS is caused by Schistosoma haematobium, a parasitic carcinogen involved in the pathogenesis of squamous cell carcinoma of the bladder. Cervical cancer incidence and mortality are highest in SSA, where pre-cancerous cervical dysplasia is often detected on screening with visual inspection with acetic acid (VIA). There are no studies evaluating the association between VIA positivity and FGS diagnosed by genital PCR. Methods Women were recruited from the Bilharzia and HIV (BILHIV) study in Zambia a community-based study comparing genital self-sampling to provider obtained cervicovaginal-lavage for the diagnosis of FGS in women aged 18–31. FGS was defined as positive Schistosoma DNA from any genital PCR. Urogenital schistosomiasis diagnostics included urine circulating anodic antigen, urine microscopy and portable colposcopy. Participants were offered cervical cancer screening using VIA at Livingstone Central Hospital. Associations of PCR confirmed FGS and other diagnostics with VIA positivity were assessed using multivariable logistic regression. Results VIA results were available from 237 BILHIV participants. A positive Schistosoma PCR in any genital specimen was detected in 14 women (5.9%), 28.6% (4/14) of these women had positive VIA compared to 9.0% without PCR evidence of schistosome infection (20/223). Schistosoma PCR positivity in any genital specimen was strongly associated with VIA positivity (OR: 6.08, 95% CI: 1.58–23.37, P = 0.02). Conclusions This is the first study to find an association between FGS and positive VIA, a relationship that may be causal. Further longitudinal studies are needed. |
| first_indexed | 2024-12-19T16:18:20Z |
| format | Article |
| id | doaj.art-23fd6511cccd4c64b8fa5bc012a27c49 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-19T16:18:20Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-23fd6511cccd4c64b8fa5bc012a27c492022-12-21T20:14:34ZengBMCBMC Infectious Diseases1471-23342021-07-012111910.1186/s12879-021-06380-5Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian womenH. Rafferty0A. S. Sturt1C. R. Phiri2E. L. Webb3M. Mudenda4J. Mapani5P. L. A. M. Corstjens6G. J. van Dam7A. Schaap8H. Ayles9R. J. Hayes10L. van Lieshout11I. Hansingo12A. L. Bustinduy13Department of Clinical Research, London School of Hygiene and Tropical MedicineDepartment of Clinical Research, London School of Hygiene and Tropical MedicineZambartMRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical MedicineLivingstone Central HospitalLivingstone Central HospitalDepartment of Cell and Chemical Biology, Leiden University Medical CenterDepartment of Parasitology, Leiden University Medical CenterZambartDepartment of Clinical Research, London School of Hygiene and Tropical MedicineMRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical MedicineDepartment of Parasitology, Leiden University Medical CenterLivingstone Central HospitalDepartment of Clinical Research, London School of Hygiene and Tropical MedicineAbstract Background Female genital schistosomiasis (FGS) is a neglected tropical gynaecological disease that affects millions of women in sub-Saharan Africa (SSA). FGS is caused by Schistosoma haematobium, a parasitic carcinogen involved in the pathogenesis of squamous cell carcinoma of the bladder. Cervical cancer incidence and mortality are highest in SSA, where pre-cancerous cervical dysplasia is often detected on screening with visual inspection with acetic acid (VIA). There are no studies evaluating the association between VIA positivity and FGS diagnosed by genital PCR. Methods Women were recruited from the Bilharzia and HIV (BILHIV) study in Zambia a community-based study comparing genital self-sampling to provider obtained cervicovaginal-lavage for the diagnosis of FGS in women aged 18–31. FGS was defined as positive Schistosoma DNA from any genital PCR. Urogenital schistosomiasis diagnostics included urine circulating anodic antigen, urine microscopy and portable colposcopy. Participants were offered cervical cancer screening using VIA at Livingstone Central Hospital. Associations of PCR confirmed FGS and other diagnostics with VIA positivity were assessed using multivariable logistic regression. Results VIA results were available from 237 BILHIV participants. A positive Schistosoma PCR in any genital specimen was detected in 14 women (5.9%), 28.6% (4/14) of these women had positive VIA compared to 9.0% without PCR evidence of schistosome infection (20/223). Schistosoma PCR positivity in any genital specimen was strongly associated with VIA positivity (OR: 6.08, 95% CI: 1.58–23.37, P = 0.02). Conclusions This is the first study to find an association between FGS and positive VIA, a relationship that may be causal. Further longitudinal studies are needed.https://doi.org/10.1186/s12879-021-06380-5Female genital schistosomiasisCervical dysplasiaSchistosoma haematobiumPCRUrogenital schistosomiasis |
| spellingShingle | H. Rafferty A. S. Sturt C. R. Phiri E. L. Webb M. Mudenda J. Mapani P. L. A. M. Corstjens G. J. van Dam A. Schaap H. Ayles R. J. Hayes L. van Lieshout I. Hansingo A. L. Bustinduy Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women BMC Infectious Diseases Female genital schistosomiasis Cervical dysplasia Schistosoma haematobium PCR Urogenital schistosomiasis |
| title | Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women |
| title_full | Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women |
| title_fullStr | Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women |
| title_full_unstemmed | Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women |
| title_short | Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women |
| title_sort | association between cervical dysplasia and female genital schistosomiasis diagnosed by genital pcr in zambian women |
| topic | Female genital schistosomiasis Cervical dysplasia Schistosoma haematobium PCR Urogenital schistosomiasis |
| url | https://doi.org/10.1186/s12879-021-06380-5 |
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