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Masong, Makia Christine, Wepnje, Godlove Bunda, Marlene, Ntsinda Tchoffo, Gamba, Victoria, Mengue, Marie-Therese, Kouokam, Estelle, Stothard, Russell 
ORCID: https://orcid.org/0000-0002-9370-3420 and Ekobo, Albert Legrand Same
(2021)
'Female Genital Schistosomiasis (FGS) in Cameroon: A formative epidemiological and socioeconomic investigation in eleven rural fishing communities'. PLOS Global Public Health, Vol 1, Issue 10, e0000007.
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Abstract
Background
Female Genital Schistosomiasis (FGS) is most often caused by presence of Schistosoma haematobium eggs lodged in the female reproductive tract which results in chronic fibrosis and scarring. In Cameroon, despite high community prevalences of urine-patent S. haematobium infections, FGS has yet to be studied in depth. To shed light on the clinical prevalence and socioeconomic effects of FGS, we undertook a formative community-based epidemiological and qualitative survey.
Method
A cross sectional multidisciplinary study of 304 girls and women from 11 remote rural fishing communities in Cameroon was undertaken using parasitological sampling, clinical colposcopy, and interviews. The lived experiences of those with FGS were documented using a process of ethnography with participant observation and in-depth interviews.
Result
Amongst 304 women and girls aged >5 years (Median age: 18; Interquartile range: 9.6–28), 198 females were eligible for FGS testing and 58 adult women were examined by clinical colposcopy. Of these, 34 were positive for FGS (proportion: 58.6%; 95% CI: 45.8–70.4), younger girls showing a higher FGS prevalence, and older women not shedding eggs showing a pattern for cervical lesions from earlier infection. In a subset of women with FGS selected purposively (12/58), in-depth interviews with participant observation revealed out-of-pocket expenditures of up to 500USD related health spending for repeated diagnosis and treatment of gynecological illnesses, and 9 hours daily lost reproductive labour. Psychosocial unrest, loss in social capital, and despair were linked with sub-fertility and persistent vaginal itch.
Conclusion
With our first formative evidence on prevalence, socioeconomic effects and experiences of FGS amongst women and girls in Cameroon, we have clarified to a new level of detail the deficit in provision of and access to peripheral health services in remote areas of Cameroon. Using this information, there is now strong evidence for national programs and services on women’s health and schistosomiasis to update and revise policies targeted on prevention and management of FGS. We therefore stress the need for regular provision of Praziquantel treatment to adolescent girls and women in S. haematobium endemic areas, alongside better access to tailored diagnostic services that can detect FGS and appropriately triage care at primary health level.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > WA 105 Epidemiology WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Tropical and Parasitic Diseases > WC 810 Schistosomiasis WJ Urogenital System > WJ 100 General works |
| Faculty: Department: | Biological Sciences > Department of Tropical Disease Biology |
| Digital Object Identifer (DOI): | https://doi.org/10.1371/journal.pgph.0000007 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | Stacy Murtagh |
| Date Deposited: | 21 Oct 2021 08:49 |
| Last Modified: | 21 Oct 2021 08:49 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/19232 |
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