From clinical research to public health action: addressing chronic female genital schistosomiasis in non-endemic countries.

Abstract

We analysed the early results of a screening and management protocol of imported female genital schistosomiasis (FGS) among migrant women from endemic countries. In total we screened 136 women, from which 39 had suspicion of FGS (serology-positive test and clinical signs and symptoms compatible). Median age was of 42.7 years [interquartile range (IQR 35-45)], median time living in the Europe (EU) was of 14 years (IQR 10-19) and all of them were coming from a West African country, mainly Senegal (17 out of 39; 43.6%). All of them had 1 or more clinical genitourinary findings [median 5 (IQR 2-6)], being the most prevalent pelvic pain, vaginal discharge and menstrual disorders. According to the protocol, colposcopy and cytology examination was performed in 11 participants, from whom 7 had findings compatible with FGS and 5 had low-grade cervical dysplasia with human papillomavirus (HPV)-negative results. After specific treatment with praziquantel (PZQ), we observed a high rate of resolution of clinical signs and symptoms, serology clearance at the 12th month of follow-up. Colposcopy lesions of 3 women assessed at the end of follow-up were fully resolved. Our findings and previous research support the implementation of management protocols of FGS in non-endemic countries, in spite of the knowledge gaps that still remain. Clinical trials need further assessment to determine the efficacy of PZQ, new diagnostic tools and the interaction between FGS, HPV and cervical cancer.