Sex-specific presentation, epidemiology, and control of schistosomiasis in women and adolescent girls

Abstract

Schistosomiasis presents a major public health problem for women and adolescent girls in endemic areas, particularly tropical and subtropical regions. Many sex-specific effects of schistosomiasis are due to Schistosoma haematobium, which primarily affects the genitourinary tract. Deposition of schistosome eggs in genital tissue causes female genital schistosomiasis (FGS), a chronic gynaecological condition that affects over 40 million women and girls. Women and girls living with FGS face intersecting challenges that compound its adverse effects. Disabling genital symptoms include pain, abnormal discharge, menstrual irregularities, and subfertility. These symptoms affect daily activities, impose financial burdens, and harm intimate relationships. Women and girls face stigma and isolation due to the similarity of FGS symptoms to sexually transmitted infections. Health systems in endemic areas are poorly equipped to consider, diagnose, and treat FGS, and women and girls are often excluded from schistosomiasis control strategies. Multifaceted approaches targeting schistosomiasis in women and girls are urgently needed.