Authors

A Bustinduy¹;  ¹ London School of Hygiene and Tropical Medicine, UK

Discussion

Around 40 million women living in Sub-Saharan Africa (SSA) are affected by female genital schistosomiasis (FGS), a chronic gynaecological disease caused by Schistosoma haematobium (Sh). FGS clinical manifestations are varied and frequently confounded by those commonly associated with sexually transmitted infections, fostering stigma. Impact on fertility and normal sexual function is common, but awareness of the disease is largely absent in endemic communities, despite the increased prevalence of HIV and HPV, the precursor of cervical cancer (CC), seen in women with FGS. Conventional FGS diagnosis is challenging, as it relies on costly equipment and high-level specialised training seldom available in resource-limited countries. Visual diagnosis of FGS is notoriously non-specific. Molecular approaches for FGS diagnosis have gained traction in recent years but are still bottlenecked due to their cost and hurdles in procurement pipelines. Accurate estimation of disease burden is therefore hindered. This presentation will cover past and present efforts from different studies across countries to bring FGS out of neglect, with a focus on FGS diagnostic approaches. As a case study for community-based integrative diagnosis of FGS, the ongoing longitudinal Zipime Schista Study! will be presented. This study aims to offer multiple-pathogen screening through self-sampling (Sh, HPV) and offering self-testing for HIV and STIs. This strategy is coupled with isothermal diagnostic molecular assays that are field deployable and can provide a scalable cost-effective strategy.
*see Zipime Weka Schista Study: https://www.lshtm.ac.uk/research/centres-projects-groups/zipime-weka-schista