What is female genital schistosomiasis?

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 has been described as one of the most neglected sexual and reproductive health diseases in sub-Saharan Africa, affecting an estimated 56 million women and girls.

Symptoms and complications of 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:

Vaginal discharge
Blood in urine
Abdominal and pelvic pain

If left untreated, women living with FGS can experience a range of complications, including:

Infertility
Abortion or ectopic pregnancy
Genital ulcers
Increased risk of HIV and human papillomavirus infections

SCI Foundation · Female Genital Schistosomiasis (FGS)- the most neglected gynaecological disease

Schistosomiasis and HIV

Farmer rinsing heads of salad in a water point located in her field in Grand-Zattry, Soubré District of Côte d’Ivoire. Credit: Unlimit Health/Aka Aboubakhr Thierry Kouamé

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.

Is FGS a sexually transmitted infection?

FGS is not a sexually transmitted infection. Although bloody urine is often the first sign of infection and is recognised in medical training, health professionals are often not familiar with FGS as it is typically not part of standard medical training.

How is FGS diagnosed

There is currently no recognised standard for diagnosing FGS. 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.

Raising awareness of FGS

Female researcher in Madagascar. Unlimit Health /The END Fund

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, women and adolescent girls can effectively manage their symptoms, which in turn can lead to improvements in their quality of life. Increased awareness of the disease is critical so that communities understand the risks and impact that FGS can have on individuals, including the stigma that surrounds it.