One of the most prevalent neglected tropical diseases in Sub-Saharan Africa is called schistosomiasis, bilharzia or “snail fever”.
Schistosomiasis is a parasitic disease that affects men, women and children living in tropical regions. Endemic in 78 countries, it is estimated that schistosomiasis disease affects more than 250 million people globally with approximately 90% of the disease burden found in Africa.
Disease transmission occurs through contact with freshwater bodies where aquatic snails breed and release the parasite that burrows through the skin on contact with water.
Regular daily activities (washing, bathing, gathering water, swimming) put adults and children at continuous risk of infection. Current strategies to control schistosomiasis focus on preventive chemotherapy using donated praziquantel.
In the case of one kind of Schistosomiasis (S. haematobium), the eggs are released into the genito-urinary tract where they embed in the tissue causing inflammation that results in a granulomatous response around the eggs causing what is called “female genital schistosomiasis (FGS)”.
FGS results in:
- abdominal and pelvic pain
- disorders of menstruation
- pain during intercourse
- vaginal bleeding after intercourse
- inflammation of reproductive organs
- genital lesions
- miscarriage
- ectopic pregnancy
- infertility
Increasing evidence shows that a woman with FGS has a threefold increased risk of HIV infection when she becomes sexually active.
Even though FGS is not commonly known, it remains one of the most important neglected areas in women’s and girl’s health globally. An estimated 56 million women and girls have FGS, nearly all in sub-Saharan Africa.
Community-level awareness of FGS and its associated sequelae for the reproductive system is lacking in places where the disease is endemic. Health care providers may not have received training about FGS and misdiagnosis and mistreatment occurs as FGS symptoms look like sexually transmitted infections.
This misdiagnosis leads to stigmatization amongst women and young girls who face judgment for “bad behaviour” and unnecessary treatment and clinical investigations which fail to reverse symptoms. Physiologically and socially, women and girls with FGS suffer a great deal.
