Mapping schistosoma haematobium for novel interventions against female genital schistosomiasis and associated HIV risk in kwazulu-natal, South Africa

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Mahala Livingston
  • Pavitra Pillay
  • Siphosenkosi Gift Zulu
  • Leiv Sandvik
  • Jane Dene Kvalsvig
  • Silindile Gagai
  • Hashini Nilushika Galappaththi-Arachchige
  • Elisabeth Kleppa
  • Patricia Ndhlovu
  • Vennervald, Birgitte J
  • Svein Gunnar Gundersen
  • Myra Taylor
  • Eyrun F. Kjetland

Women with female genital schistosomiasis (FGS) have been found to have genital symptoms and a threefold higher risk of HIV infection. Despite WHO recommendations, regular antischistosomal mass drug administration (MDA) has not yet been implemented in South Africa possibly because of the lack of updated epidemiological data. To provide data for future prevention efforts against FGS and HIV, this study explored Schistosoma haematobium prevalence in girls and young women and the effects of antischistosomal MDA, respectively. Urinary schistosomiasis and genital symptoms were investigated in 70 randomly selected secondary schools in three districts within KwaZulu-Natal and 18 primary schools. All study participants were treated for schistosomiasis, and schools with the highest urinary prevalence were followed up after 1 and 4 years of MDA. At baseline, urine analysis data showed that most schools were within the moderate-risk prevalence category where biennial antischistosomal MDA is recommended, as per WHO guidelines. Young women had high prevalence of genital symptoms (36%) after correcting for sexually transmitted infections. These symptoms may be caused by infection with schistosomes. However, FGS cannot be diagnosed by urine analysis alone. In KwaZulu-Natal rural schools, this study suggests that antischistosomal MDA with praziquantel could prevent genital symptoms in more than 200,000 young women. Furthermore, it is feasible that more than 5,000 HIV infections could be prevented in adolescent girls and young women by treatment and prevention of FGS.

TidsskriftAmerican Journal of Tropical Medicine and Hygiene
Udgave nummer6
Sider (fra-til)2055-2064
Antal sider10
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
Financial support: Financial support was provided by the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013/ERC Grant agreement no. PIRSES-GA-

Funding Information:
2010-269245); the South-Eastern Norway Regional Health Authority (network project no. 2011073); the University of Copenhagen with the support from the Bill & Melinda Gates Foundation (Grant # OPPGH5344); the Norwegian Research Council (ref 213702/H10); P. C. Flu Foundation, Oslo University Hospital Ullevaal, the Norwegian Centre for Imported and Tropical Diseases, Oslo, Norway; and the National Research Foundation, South Africa.

Publisher Copyright:
Copyright © 2021 by The American Society of Tropical Medicine and Hygiene

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