Authors

A Oluwole¹;  ¹ Sightsavers, UK

Discussion

Female Genital Schistosomiasis (FGS) is a neglected gynaecological condition resulting from schistosomiasis infection. Nigeria, the most endemic country for schistosomiasis, has over 30 million affected individuals across various communities. Despite this, the burden of FGS in Nigeria remains largely unknown, with only a few studies conducted in selected states (Ogun, Ondo, and Kebbi). Ongoing studies aim to determine FGS prevalence in other regions. Accurately assessing the national burden of FGS requires substantial funding and time due to the country’s size. Proactive measures are essential to address FGS in Nigeria, given its established prevalence in schistosomiasis-endemic areas. Three major challenges hinder the prompt diagnosis and management of FGS in Nigeria: 1. Poor Awareness: Health workers and professionals often miss or misdiagnose FGS as a sexually transmitted infection due to a lack of awareness. 2. Symptom Overlap and Stigma: FGS symptoms closely resemble other sexual and reproductive health issues, leading to stigma and reluctance to seek help. 3. Inadequate Diagnostic Facilities: Health facilities in endemic areas lack modern diagnostic equipment, such as colposcopy and molecular diagnostic techniques, necessary for differential diagnosis. To combat these challenges, we collaborated with the Ministry of Health to develop a training guide for health workers on the symptomatic diagnosis and management of FGS, including stigma reduction at the primary healthcare level. Additionally, the FGS Society of Nigeria, launched in 2021, aims to raise awareness among health workers and communities. We advocate for integrating FGS care into other sexual and reproductive health departments. We are also seeking funding for implementation research to scale up praziquantel treatment to all age groups, including girls and women of reproductive age, to reduce schistosomiasis transmission and the onset of FGS. In conclusion, developing point-of-care differential diagnostics for FGS that are easy to use in primary healthcare facilities is crucial. Scaling up praziquantel treatment in schistosomiasis-endemic communities, as recommended by WHO, is the most effective way to reduce new FGS cases and eventually eliminate the disease in these areas.