Urogenital schistosomiasis (UGS) and female genital schistosomiasis (FGS) in Cameroon: an observational assessment of key reproductive health determinants of girls and women in the Matta Health Area

Objectives and setting: Across sub-Saharan Africa, urogenital schistosomiasis (UGS), in particular female genital schistosomiasis (FGS), is a significant waterborne parasitic disease, with its direct burden on the sexual and reproductive health (SRH) of sufferers infrequently measured. UGS has an established control plan, which in most endemic regions as in Cameroon, still excludes FGS considerations. Highlighting existent associations between UGS and FGS could increase the management of FGS within UGS interventions. This study seeks to identify current associations among FGS and UGS with some reproductive health indicators, to provide formative information for better integrated control. Participants: 304 females aged 5–69 years were all examined for UGS by urine filtration and microscopy. Among these, 193 women and girls were eligible for clinical FGS assessment based on age (>13). After selective questioning for FGS symptoms, a subgroup of 67 women and girls consented for clinical examination for FGS using portable colposcopy, with observed sequelae classified according to the WHO FGS pocket atlas. Outcome: Overall UGS and FGS prevalence was measured, with FGS-related/UGS-related reproductive health symptoms recorded. Associations between FGS and UGS were investigated by univariate and multivariate logistic regression analyses. Results: Overall UGS prevalence was 63.8% (194/304), where FGS prevalence (subgroup) was 50.7% (34/67). FGS manifestation increased significantly with increasing age, while a significant decrease with ascending age was observed for UGS. Lower abdominal pain (LAP) vaginal itches (VI) and coital pain (CP) were identified as the main significant shared symptoms of both FGS and UGS, while LAP with menstrual irregularity (MI) appeared a strong symptomatic indicator for FGS. Conclusion: LAP, MI, CP and VI are the potential SRH indicators that could be exploited in future for targeting of praziquantel provision to FGS sufferers within primary care, complementary with existing praziquantel distribution for UGS sufferers in Schistosoma haematobium endemic areas

PREVALENCE AND RISK FACTORS OF TRICHOMONAS VAGINALIS INFECTION AMONG PREGNANT WOMEN RECEIVING ANTENATAL CARE IN ABEOKUTA, NIGERIA.

Background: Trichomoniasis is the most prevalent treatable sexually transmitted disease in the world. This study investigated the prevalence of trichomoniasis and associated risk factors among pregnant women attending ante-natal sessions in a tertiary health care facility in Abeokuta. Materials and Methods: High Vaginal Swabs (HVS) were collected and analyzed microscopically from 300 randomly selected ante-natal attendees. Questionnaires were concurrently administered to investigate associated risk factors about infection. Descriptive analysis was employed using SPSS (IBM, Amonk, NY, USA) version 20.0 and associations were ascertained using Pearson chi square. Significance level was set at p≤ 0.05 Results: An overall prevalence of 10.3% was recorded. Age group 40-44(14.8%) had the highest infection, while lowest infection was recorded among age group 25-29(9%). Majority of the infected patients were married 26(11%) and in their second trimester stage of pregnancy 11(11.1%). Type of toilet used and shared usage of toiletries show significant relationship with infections among patients with (P=0.024) and (P=0.000) respectively. Occupational related prevalence showed that traders were the most infected 12(18.5%). Conclusion: Our findings present higher prevalence of Trichomonas vaginalis among older women of reproductive age. Poor hygiene practices and knowledge about infection are major risk factors predisposing patients to infection. However, measures geared towards promoting prevention mechanism/s through safe hygiene practices should be emphasized through public enlightenment programs. Inclusion of Trichomonas vaginalis clinical testing during antenatal care services will also assist prompt diagnosis, management and control of infection

The new WHO guideline for control and elimination of human schistosomiasis: implications for the Schistosomiasis Elimination Programme in Nigeria.

With some 134,073,166 people living in endemic communities at risk of infection [1], Nigeria is the most endemic country in Africa and requires preventive chemotherapy (PC) for a total of 26.3 million persons [2]. The National Schistosomiasis Elimination Programme (NSCHEP), with the support of international partners, has been implementing PC in Nigeria since 2009 and most recently will need to revise its current strategy (Additional file 1). For example, the new World Health Organization (WHO) guideline has six key recommendations that will dramatically change the implementation of schistosomiasis elimination in endemic countries [3]. However, its impact and programmatic implications will vary from country to country, hence the need for a country-specific analysis. This article discusses these recommendations with specific reference to the challenges and opportunities in Nigeria. We summarise the key pointers in Additional file 1: Box 1 against the six recommendations of the WHO 2022 guideline

Development and testing of Schisto and Ladders™, an innovative health educational game for control of schistosomiasis in schoolchildren

Abstract Background Schistosomiasis remains a public health problem in many regions of the world, including Nigeria. Current control strategy involves mass drug administration with praziquantel to the endemic population. To complement and sustain on-going preventive chemotherapy, we developed a health educational game named Schisto and Ladders™ and tested its potential for the control of schistosomiasis among schoolchildren living in Imala-Odo, a highly endemic community near Abeokuta, Nigeria. Methods One hundred school children were randomly selected and divided into intervention and control groups through balloting. Their knowledge, attitudes and practices (KAP) concerning schistosomiasis transmission, control and prevention were assessed using structured questionnaires. Schisto and Ladders™ game were given to the intervention group and the popular Snake and Ladders™ game to the control group. Both games were played for 2 months under the supervision of their class teachers. A post-KAP assessment was carried out in both groups, including focus group discussions (FGDs) to investigate knowledge and the impact of the games. Results Knowledge about urinary schistosomiasis and its transmission significantly improved (P = 0.000) in the intervention group (68.0%) compared to the control group (8.0%). FGDs showed that the frequency of visits to dam water also significantly reduced (P = 0.048) in the intervention group (18.0%) compared to the control group (40.0%). There was a significant increase in knowledge regarding risk behaviours, prevention and control of schistosomiasis among the intervention group, but no new knowledge gained in the control group. Conclusions This study demonstrates the potential of the health education game Schisto and Ladders™ for teaching basic health education and promoting behavioural changes among schoolchildren in endemic communities