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Female genital schistosomiasis (FGS) is a disease manifestation of schistosomiasis caused by the Schistosoma haematobium, a waterborne parasite that affects both the urinary and genital tract of infected individuals. It develops over a long period of time (months to years) when girls and women do not have access to treatment. It has been described as one of the most neglected sexual and reproductive health diseases in sub-Saharan Africa, with an estimated 56 million women and girls currently living with FGS.
FGS occurs when the parasite eggs cause damage to the reproductive organs, which can result in gynaecological symptoms in women and adolescent girls, such as:
If left untreated, women living with FGS can experience a range of complications, including:
FGS causes open sores, inflammation and exposure to blood, giving easy access for any virus to enter the body. As a result, women and girls with FGS are up to three times more likely to acquire HIV.
FGS is not a sexually transmitted infection. FGS develops when someone has schistosomiasis, which is only caught through skin contact with contaminated freshwater sources. It cannot be passed from person to person directly.
FGS can be diagnosed by visual examination of the genitals and colposcopy, which is a procedure to take a closer look at someone’s vagina and cervix. Unfortunately the equipment required for this is expensive and requires lots of medical training, and this is not always available in the health facilities in all affected communities. Another challenge is that health professionals are often not familiar with FGS as it is typically not part of standard medical training. Therefore, it remains underreported, misdiagnosed and largely untreated.
This has serious consequences for women, who not only suffer physical symptoms but also mental health problems due to stigma surrounding infertility and because symptoms are often confused with those of sexually transmitted infections. The World Health Organization’s pocket atlas has been developed to aid healthcare professionals with diagnosis of the disease.
It is evident that there are many factors at play, but in order to prevent new cases and reduce the morbidity associated with FGS, appropriate training must be provided to healthcare professionals. Through early diagnosis and regular treatment of schistosomiasis, girls and women will be protected from developing FGS, which in turn can lead to improvements in their quality of life. Increased awareness of the disease and how to prevent it is critical so that communities understand the risks and impact of FGS on individuals, including the stigma that surrounds it.
Unlimit Health is working on various initiatives to tackle FGS, which you can find out more about below, and we have published a position paper.
Integrating preventive treatment for FGS into the national health system.
An innovative coalition of organisations galvanising joint action to tackle the neglected issue of FGS.
Unlimit Health’s position on FGS.
Improving adolescent girls’ and women’s health by reducing morbidity associated with FGS.
7 February 2024
In late January, the UK Parliament's International Development Committee released their report on UK aid impact on sexual and reproductive health. One of the report’s key recommendations was for the integration of and care for people affected by female genital schistosomiasis – a little known but painful and debilitating disease affecting millions of women - into broader sexual and reproductive health (SRH) programming.
Full story
3 March 2022
Female genital schistosomiasis (FGS) affects 56 million women and girls across Africa. The disease is entirely preventable but if infection occurs and appropriate treatment is not provided, it can lead to various complications such as bleeding during or after sexual intercourse, genital lesions, cancer, and infertility
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