{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:37:36Z","timestamp":1789648656026,"version":"4.0.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012102","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000}}],"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T00:00:00Z","timestamp":1715126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coalition for Operational Research on Neglected Tropical Diseases","award":["NTD-SC 158.3D"],"award-info":[{"award-number":["NTD-SC 158.3D"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Female genital schistosomiasis (FGS), caused by the parasite <jats:italic>Schistosoma haematobium (Sh)<\/jats:italic>, is prevalent in Sub-Saharan Africa. FGS is associated with sexual dysfunction and reproductive morbidity, and increased prevalence of HIV and cervical precancerous lesions. Lack of approved guidelines for FGS screening and diagnosis hinder accurate disease burden estimation. This study evaluated FGS burden in two <jats:italic>Sh<\/jats:italic>-endemic areas in Southern Malawi by visual and molecular diagnostic methods.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/Principal findings<\/jats:title>\n<jats:p>Women aged 15\u201365, sexually active, not menstruating, or pregnant, were enrolled from the MORBID study. A midwife completed a questionnaire, obtained cervicovaginal swab and lavage, and assessed FGS-associated genital lesions using hand-held colposcopy. \u2018<jats:italic>Visual-FGS\u2019<\/jats:italic> was defined as specific genital lesions. <jats:italic>\u2018Molecular-FGS<\/jats:italic>\u2019 was defined as <jats:italic>Sh<\/jats:italic> DNA detected by real-time PCR from swabs. Microscopy detected urinary <jats:italic>Sh<\/jats:italic> egg-patent infection.<\/jats:p>\n<jats:p>In total, 950 women completed the questionnaire (median age 27, [IQR] 20\u201338). Visual-and molecular-FGS prevalence were 26\u00b79% (260\/967) and 8\u00b72% (78\/942), respectively. 6\u00b75% of women with available genital and urinary samples (38\/584) had egg-patent <jats:italic>Sh<\/jats:italic> infection. There was a positive significant association between molecular- and visual-FGS (AOR = 2\u00b79, 95%CI 1\u00b77\u20135\u00b70). \u2018<jats:italic>Molecular-FGS\u2019<\/jats:italic> was associated with egg-patent <jats:italic>Sh<\/jats:italic> infection (AOR = 7\u00b75, 95% CI 3\u00b727\u201317\u00b72). Some villages had high \u2018<jats:italic>molecular-FGS\u2019<\/jats:italic> prevalence, despite &lt;10% prevalence of urinary <jats:italic>Sh<\/jats:italic> among school-age children.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/Significance<\/jats:title>\n<jats:p>Southern Malawi carries an under-recognized FGS burden. FGS was detectable in villages not eligible for schistosomiasis control strategies, potentially leaving girls and women untreated under current WHO guidelines. Validated field-deployable methods could be considered for new control strategies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012102","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T17:40:39Z","timestamp":1715190039000},"page":"e0012102","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["Female genital schistosomiasis burden and risk factors in two endemic areas in Malawi nested in the Morbidity Operational Research for Bilharziasis Implementation Decisions (MORBID) cross-sectional study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6650-6124","authenticated-orcid":true,"given":"Olimpia","family":"Lamberti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sekeleghe","family":"Kayuni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingase","family":"Kumwenda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bagrey","family":"Ngwira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veena","family":"Moktali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neerav","family":"Dhanani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Els","family":"Wessels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette","family":"Van Lieshout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona M.","family":"Fleming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themba","family":"Mzilahowa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6131-4159","authenticated-orcid":true,"given":"Amaya L.","family":"Bustinduy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,8]]},"reference":[{"key":"pntd.0012102.ref001","first-page":"1","volume-title":"Advances in Parasitology","author":"AL Bustinduy","year":"2022"},{"issue":"7","key":"pntd.0012102.ref002","doi-asserted-by":"crossref","first-page":"e0008337","DOI":"10.1371\/journal.pntd.0008337","article-title":"Genital self-sampling compared with cervicovaginal lavage for the diagnosis of female genital schistosomiasis in Zambian women: The BILHIV study","volume":"14","author":"AS Sturt","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"issue":"7","key":"pntd.0012102.ref003","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.ijpara.2016.02.006","article-title":"Female genital schistosomiasis (FGS): from case reports to a call for concerted action against this neglected gynaecological disease","volume":"46","author":"V Christinet","year":"2016","journal-title":"International Journal for Parasitology"},{"issue":"1","key":"pntd.0012102.ref004","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1186\/s12879-021-06380-5","article-title":"Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women","volume":"21","author":"H Rafferty","year":"2021","journal-title":"BMC Infect Dis"},{"key":"pntd.0012102.ref005","unstructured":"United Nations (2015). 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