Scientific publications
Chris Marco Mbianda Nana
Edmond François Tchago
Albert Bayibeki
Eto Darlhin Tertullien
André Tchoffo Kemlong
Clauvis Ngainang
Laeticia Sado Mbakam
Aubin Yves Balog
Frontiers in Tropical Diseases
Background Urogenital schistosomiasis (UGS), and in particular female genital schistosomiasis (FGS), is a waterborne disease caused by Schistosoma haematobium and it is endemic throughout Africa. In most endemic regions including Cameroon, control programs for urogenital schistosomiasis often do not adequately address FGS, partly due to limited knowledge regarding the frequency of lesions and associated symptoms. Identifying associations between cervical lesions, the presence of eggs, and urine colour could improve care management during routine clinical consultations. The aim of this study therefore was to determine the frequency of Schistosoma cervical lesions associated with observed signs, in order to provide information for improving control. Methods Following targeted questioning on FGS symptoms, 218 women aged between 17 and 73 Years were recruited after providing informed consent, at the Matta barrage health centre in west region of Cameroon and at the Loum District Hospital in the Littoral Region of Cameroon. Women who voluntary agreed to participate were examined for urogenital schistosomiasis by urine microscopy, and for clinical genital schistosomiasis through visual inspection with smartphones based imaging. Observed lesions were classified according to the WHO Pocket Atlas for Female Genital schistosomiasis. The overall prevalence of UGS and cervical FGS lesions, as well as their association with women’s severity, were recorded and analyzed using multivariate logistic regression models. Results The prevalence of UGS was 24.77% (54/218), while the prevalence of cervical FGS lesions was 30.28% (66/218), with a predominance of lesions with an “Neovascularization” (NVA) appearance (49.43%) and Grainy sandy patches (GS) appearance (36.78%). Also, 66.67% of participants with lesions had a low parasite density (<50 eggs/10ml) compared to 33.33% with a high parasite density (≥50 eggs/10ml). The prevalence of lesions with no Schistosoma eggs visible under the microscope was significantly higher in the endemic area of Matta Barrage than in Loum. Conclusion The presence of Schistosoma eggs in urine is a strong indicator of cervical lesions associated with FGS and has important implications for sexual and reproductive health. Control programs for this parasitic disease should take into account the epidemiological characteristic of each endemic region to improve effectiveness.
