Imported female genital schistosomiasis: a neglected health issue across borders

TL;DR

Female genital schistosomiasis is a neglected tropical disease affecting millions of women, often undiagnosed in non-endemic countries due to lack of awareness and fragmented healthcare.

Contribution

Highlights the challenges in diagnosing imported FGS and emphasizes the need for improved awareness and integrated care pathways.

Findings

FGS is prevalent in women from or traveling to endemic regions and is associated with adverse pregnancy outcomes.

Imported FGS is often undiagnosed due to limited testing and lack of awareness among healthcare providers.

Structural inequities and stigma hinder diagnosis and management of FGS in non-endemic settings.

Abstract

Female genital schistosomiasis (FGS) is one of the most neglected tropical diseases in the world, affecting over 56 million women and girls in Africa alone. It is a sequala of Schistosoma haematobium infection and is characterised by lesions on the cervix and other reproductive structures. Schistosomiasis and FGS are prevalent in women living in, migrating from, or traveling to Schistosoma haematobium-endemic countries. FGS is associated with significant morbidity, including adverse pregnancy outcomes. Unfortunately, imported schistosomiasis and FGS often remain undiagnosed or are diagnosed only at late stages of disease progression, months to years after arrival in non-endemic settings. This is due to limited diagnostic and screening test availability for schistosomiasis and an absence of awareness and guidelines to diagnose imported FGS, especially among sexual and reproductive health providers. Fragmented care pathways between infectious disease, travel/tropical medicine, and reproductive health services further contribute to missed diagnoses, while structural and social inequities due to migration status and stigma lead to barriers in FGS diagnosis and management.