Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approach
IntroductionFemale genital schistosomiasis is a common but neglected disease, which results in symptoms similar to sexually transmitted infections in Schistosoma haematobium-endemic areas of Africa and Middle East. In primary healthcare of low-income countries, healthcare professionals use syndromic...
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Frontiers Media S.A.
2024-04-01
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| Serija: | Frontiers in Tropical Diseases |
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| Online dostop: | https://www.frontiersin.org/articles/10.3389/fitd.2024.1379526/full |
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| author | Solrun Søfteland Solrun Søfteland Solrun Søfteland Motshedisi Sebitloane Hashini Nilushika Galappaththi-Arachchige Hashini Nilushika Galappaththi-Arachchige Elisabeth Kleppa Sigve Holmen Pavitra Pillay Patrica Doris Ndhlovu Myra Taylor Birgitte Jyding Vennervald Saloshni Naidoo Anne Cathrine Staff Anne Cathrine Staff Manala Makua Manala Makua Svein Gunnar Gundersen Eyrun Floerecke Kjetland Eyrun Floerecke Kjetland Eyrun Floerecke Kjetland |
| author_facet | Solrun Søfteland Solrun Søfteland Solrun Søfteland Motshedisi Sebitloane Hashini Nilushika Galappaththi-Arachchige Hashini Nilushika Galappaththi-Arachchige Elisabeth Kleppa Sigve Holmen Pavitra Pillay Patrica Doris Ndhlovu Myra Taylor Birgitte Jyding Vennervald Saloshni Naidoo Anne Cathrine Staff Anne Cathrine Staff Manala Makua Manala Makua Svein Gunnar Gundersen Eyrun Floerecke Kjetland Eyrun Floerecke Kjetland Eyrun Floerecke Kjetland |
| author_sort | Solrun Søfteland |
| collection | DOAJ |
| description | IntroductionFemale genital schistosomiasis is a common but neglected disease, which results in symptoms similar to sexually transmitted infections in Schistosoma haematobium-endemic areas of Africa and Middle East. In primary healthcare of low-income countries, healthcare professionals use syndromic management protocols for guidance when treating symptoms of genital infection, due to lack of laboratory resources. These protocols do not include treatment for female genital schistosomiasis, despite the overlap of symptoms. Women are at risk of not receiving the appropriate treatment. The aim of this study was to investigate challenges and missed opportunities when using syndromic management protocols for sexually transmitted infections in female genital schistosomiasis-endemic areas.MethodsThis is a secondary analysis of data from a large cross-sectional prevalence study conducted in 2011 in KwaZulu-Natal, South Africa. Young women in schistosomiasis-endemic areas were asked about genital symptoms and underwent laboratory testing and gynecological examinations to look for common genital infections including female genital schistosomiasis. We used the current South African syndromic management protocols as the basis and analyzed the associations between the reported genital symptoms and the differential diagnoses with logistic regression.ResultsBy use of the syndromic approach the conditions gonorrhea, trichomoniasis and herpes could be identified. The symptom “lower abdominal pain” was significantly associated with documented female genital schistosomiasis. However, the same association was not found with gonorrhea or chlamydia. We found no significant association between reported vaginal discharge syndrome and female genital schistosomiasis or between genital ulcer syndrome and female genital schistosomiasis.DiscussionFemale genital schistosomiasis frequently co-exists with, and mimics other genital infections in rural areas of Sub-Saharan Africa. The management protocols in schistosomiasis endemic countries should include advice on how to diagnose and manage this chronic, waterborne genital condition. There is an urgent need to upscale laboratory and diagnostic resources in low-and middle-income countries and specifically schistosomiasis-endemic areas, to diagnose these common genital infections more accurately and to treat affected women accordingly. |
| first_indexed | 2024-04-24T11:55:34Z |
| format | Article |
| id | doaj.art-85009541e3534fdfac572ffe6fd0e8ac |
| institution | Directory Open Access Journal |
| issn | 2673-7515 |
| language | English |
| last_indexed | 2024-04-24T11:55:34Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Tropical Diseases |
| spelling | doaj.art-85009541e3534fdfac572ffe6fd0e8ac2024-04-09T05:10:05ZengFrontiers Media S.A.Frontiers in Tropical Diseases2673-75152024-04-01510.3389/fitd.2024.13795261379526Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approachSolrun Søfteland0Solrun Søfteland1Solrun Søfteland2Motshedisi Sebitloane3Hashini Nilushika Galappaththi-Arachchige4Hashini Nilushika Galappaththi-Arachchige5Elisabeth Kleppa6Sigve Holmen7Pavitra Pillay8Patrica Doris Ndhlovu9Myra Taylor10Birgitte Jyding Vennervald11Saloshni Naidoo12Anne Cathrine Staff13Anne Cathrine Staff14Manala Makua15Manala Makua16Svein Gunnar Gundersen17Eyrun Floerecke Kjetland18Eyrun Floerecke Kjetland19Eyrun Floerecke Kjetland20Institute of Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Infectious Diseases Ullevaal, Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo, NorwayDepartment of Global Health, Oslo University Hospital, Oslo, NorwayDiscipline of Gynecology at Nelson Mandela School of Medicine, University KwaZulu-Natal, Durban, South AfricaInstitute of Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Infectious Diseases Ullevaal, Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo, NorwayDepartment of Infectious Diseases Ullevaal, Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo, NorwayHolmen Innovative Solutions AS, Hauge i Dalane, NorwayDepartment of Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South AfricaCentre for Bilharzia and Tropical Health Research (CBTHR), Shelly Beach, South AfricaDiscipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South AfricaSection for Parasitology and Aquatic Pathobiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkDiscipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South AfricaInstitute of Clinical Medicine, University of Oslo, Oslo, Norway0Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway1National Department of Health, Pretoria, South Africa2University of Pretoria, Pretoria, South Africa3Department of Global Development and Planning, University of Agder, Kristiansand, NorwayDepartment of Infectious Diseases Ullevaal, Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo, NorwayDepartment of Global Health, Oslo University Hospital, Oslo, NorwayDiscipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South AfricaIntroductionFemale genital schistosomiasis is a common but neglected disease, which results in symptoms similar to sexually transmitted infections in Schistosoma haematobium-endemic areas of Africa and Middle East. In primary healthcare of low-income countries, healthcare professionals use syndromic management protocols for guidance when treating symptoms of genital infection, due to lack of laboratory resources. These protocols do not include treatment for female genital schistosomiasis, despite the overlap of symptoms. Women are at risk of not receiving the appropriate treatment. The aim of this study was to investigate challenges and missed opportunities when using syndromic management protocols for sexually transmitted infections in female genital schistosomiasis-endemic areas.MethodsThis is a secondary analysis of data from a large cross-sectional prevalence study conducted in 2011 in KwaZulu-Natal, South Africa. Young women in schistosomiasis-endemic areas were asked about genital symptoms and underwent laboratory testing and gynecological examinations to look for common genital infections including female genital schistosomiasis. We used the current South African syndromic management protocols as the basis and analyzed the associations between the reported genital symptoms and the differential diagnoses with logistic regression.ResultsBy use of the syndromic approach the conditions gonorrhea, trichomoniasis and herpes could be identified. The symptom “lower abdominal pain” was significantly associated with documented female genital schistosomiasis. However, the same association was not found with gonorrhea or chlamydia. We found no significant association between reported vaginal discharge syndrome and female genital schistosomiasis or between genital ulcer syndrome and female genital schistosomiasis.DiscussionFemale genital schistosomiasis frequently co-exists with, and mimics other genital infections in rural areas of Sub-Saharan Africa. The management protocols in schistosomiasis endemic countries should include advice on how to diagnose and manage this chronic, waterborne genital condition. There is an urgent need to upscale laboratory and diagnostic resources in low-and middle-income countries and specifically schistosomiasis-endemic areas, to diagnose these common genital infections more accurately and to treat affected women accordingly.https://www.frontiersin.org/articles/10.3389/fitd.2024.1379526/fullfemale genital schistosomiasisgenital infectionssexually transmitted infectionssyndromic management protocolsschistosomiasispraziquantel |
| spellingShingle | Solrun Søfteland Solrun Søfteland Solrun Søfteland Motshedisi Sebitloane Hashini Nilushika Galappaththi-Arachchige Hashini Nilushika Galappaththi-Arachchige Elisabeth Kleppa Sigve Holmen Pavitra Pillay Patrica Doris Ndhlovu Myra Taylor Birgitte Jyding Vennervald Saloshni Naidoo Anne Cathrine Staff Anne Cathrine Staff Manala Makua Manala Makua Svein Gunnar Gundersen Eyrun Floerecke Kjetland Eyrun Floerecke Kjetland Eyrun Floerecke Kjetland Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approach Frontiers in Tropical Diseases female genital schistosomiasis genital infections sexually transmitted infections syndromic management protocols schistosomiasis praziquantel |
| title | Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approach |
| title_full | Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approach |
| title_fullStr | Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approach |
| title_full_unstemmed | Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approach |
| title_short | Diagnosis of female genital schistosomiasis and other genital infections in young South African women: challenges in the syndromic approach |
| title_sort | diagnosis of female genital schistosomiasis and other genital infections in young south african women challenges in the syndromic approach |
| topic | female genital schistosomiasis genital infections sexually transmitted infections syndromic management protocols schistosomiasis praziquantel |
| url | https://www.frontiersin.org/articles/10.3389/fitd.2024.1379526/full |
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