{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:02:16Z","timestamp":1787806936252,"version":"build-2784847793"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012336","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000}}],"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"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":["grant number SGPV\/0310.320"],"award-info":[{"award-number":["grant number SGPV\/0310.320"]}]}],"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>The diagnosis of Female Genital Schistosomiasis (FGS) which is a clinical feature of urogenital schistosomiasis caused by <jats:italic>Schistosoma haematobium<\/jats:italic> is challenging, especially in primary healthcare facilities characterized by low resources which are dependent by the majority of the FGS endemic communities. To facilitate and improve diagnosis in these settings, a simple risk factors and symptoms tool has been developed to help healthcare workers at primary healthcare facilities identify and manage FGS cases. However, the sensitivity and specificity of the tool are not known. Therefore, the objective of this study was to assess the performance of risk factors and symptoms tools in diagnosing FGS in adolescent girls and women of reproductive age in selected villages of north-western Tanzania.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A community-based analytical cross-sectional study was conducted among 347 women aged 18\u201349 years in Maswa District, north-western Tanzania. A single urine sample was collected from each participant and screened for <jats:italic>S<\/jats:italic>. <jats:italic>haematobium<\/jats:italic> eggs using a urine filtration technique. Consenting participants (n = 177), underwent thorough speculum examination by trained gynaecologists using a digital portable colposcopy to capture images of the cervix and vagina. All the captured pictures were examined independently by two pairs (2 gynaecologists in each pair) of qualified obstetricians and gynaecologists. A descriptive analysis and logistic regression were used to demonstrate the prevalence, symptoms, and risk factors of FGS.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean age of 347 women enrolled in the study was 30 years (Standard Deviation (SD) \u00b17.7) and the prevalence of women with symptoms suggestive of FGS was 15.8% (95% CI; 10.8%- 22.0) by colposcope and 87% (95% CI; 83.0%-90.4%) using the risk factor and symptom checklist. The overall sensitivity, specificity, positive and negative predictive value of symptoms and risk factors checklist tool for diagnosing FGS schistosomiasis (\u22657 score points) using colposcope as a reference test were 85.7% (95%CI; 80.6%- 90.9%), 8.7% (95%CI; 4.6%-12.9%), 15.0% (95%CI; 9.7%-20.3%) and 76.5% (95%CI; 70.2%-82.7%). Multivariate analysis showed that female genital schistosomiasis using a risk factor and symptom checklist was associated with fetching water in contaminated fresh water (aOR:21.8, 95%CI;2.8\u2013171.2, P &lt;0.003), self-reported pelvic pain (aOR:5.3, 95%CI; 1.1\u201325.9, P&lt; 0.04) and having any urinary symptoms (aOR:12.2, 95%CI; 1.5\u201396.3, P&lt;0.018). Urine microscopy results were available for 345 participants, of these, 3.5% (12\/345) (95% CI; 1.8%-6.0%) were positive for <jats:italic>S<\/jats:italic>. <jats:italic>haematobium<\/jats:italic> infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Female genital schistosomiasis and urinary-related symptoms are common in the current study population. The risk factor and symptoms checklist for diagnosis of FGS achieved high sensitivity but low specificity for women who scored \u22657 points using colposcope as a reference diagnostic test. At present, the call to integrate FGS into the reproductive health services for women has received much attention, however, the diagnostic part of FGS remains a challenge, thus there is a need to continue evaluating this tool in different population and age structures in endemic areas.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012336","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T17:35:15Z","timestamp":1723484115000},"page":"e0012336","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["High sensitivity but low specificity of the risk factors and symptoms questionnaire in diagnosing female genital schistosomiasis among sexually active women with genital lesions in selected villages of Maswa District, North-Western Tanzania"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6122-6359","authenticated-orcid":true,"given":"Gladys","family":"Mbwanji","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Ndaboine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina Jumanne","family":"Yusuf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kabona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boniface","family":"Marwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humphrey 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United Republic of Tanzania President \u2018 S Office Regional Administration and Local Government Maswa District Council. 2017;30.20. National Beaural of Statistics: 2012 Population and Housing Census Population Distribution by Administrative areas Tanzania Ministry of Finance. The 2022 Population and Housing Census: Administrative Units Population Distribution Report; Tanzania, December 2022. Natl Popul House Census Tanzania Natl Bur Stat Dar es Salaam, Tanzania. 2022;"},{"issue":"1","key":"pntd.0012336.ref020","first-page":"1","article-title":"Precision and geographical prevalence mapping of schistosomiasis and soil-transmitted helminthiasis among school-aged children in selected districts of north-western Tanzania.","volume":"15","author":"HD Mazigo","year":"2022","journal-title":"Parasites and Vectors [Internet]."},{"key":"pntd.0012336.ref021","article-title":"The Colposcopic Atlas of Schistosomiasis in the Lower Female Genital Tract Based on Studies in Malawi, Zimbabwe, Madagascar and South Africa.","author":"HM Norseth","year":"2021"},{"issue":"6","key":"pntd.0012336.ref022","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1080\/00034983.1983.11811757","article-title":"Day-to-day variation and circadian rhythm of egg excretion in urinary schistosomiasis in the Sudan","volume":"77","author":"E Doehring","year":"1983","journal-title":"Ann Trop Med Parasitol"},{"key":"pntd.0012336.ref023","unstructured":"World Health Organization. Basic laboratory methods in medical parasitology. Geneva. 1991."},{"issue":"4","key":"pntd.0012336.ref024","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/S0377-1237(10)80024-3","article-title":"Visual Inspection using Acetic Acid for Cervical Cancer in Low Resource Settings.","volume":"66","author":"MS Mustafa","year":"2010","journal-title":"Med J Armed Forces India"},{"issue":"7194","key":"pntd.0012336.ref025","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1136\/bmj.318.7194.1322","article-title":"Reporting of precision of estimates for diagnostic accuracy: A review","volume":"318","author":"R Harper","year":"1999","journal-title":"Br Med J"},{"issue":"3","key":"pntd.0012336.ref026","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1086\/315345","article-title":"Female genital schistosomiasis of the lower genital tract: Prevalence and disease-associated morbidity in Northern Tanzania","volume":"181","author":"G Poggensee","year":"2000","journal-title":"J Infect Dis"},{"issue":"1","key":"pntd.0012336.ref027","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4314\/gmj.v45i1.68918","article-title":"Potential sources of transmission of hospital-acquired infections in the volta regional hospital in Ghana.","volume":"45","author":"DN Tagoe","year":"2011","journal-title":"Ghana Med J"},{"key":"pntd.0012336.ref028","first-page":"1","article-title":"Female genital schistosomiasis (FGS) in Ogun State, Nigeria: a pilot survey on genital symptoms and clinical findings.","volume":"3","author":"UF Ekpo","year":"2017","journal-title":"Parasitol Open."},{"issue":"5","key":"pntd.0012336.ref029","doi-asserted-by":"crossref","first-page":"649","DOI":"10.4269\/ajtmh.2000.62.649","article-title":"Simple anamnestic questions and recalled water-contact patterns for self-diagnosis of Schistosoma mansoni infection among schoolchildren in western C\u00c3\u00b4te d\u2019Ivoire.","volume":"62","author":"J Utzinger","year":"2000","journal-title":"Am J Trop Med Hyg"},{"issue":"9","key":"pntd.0012336.ref030","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/S1471-4922(02)02318-8","article-title":"Screening for schistosomiasis with questionnaires","volume":"18","author":"C Lengeler","year":"2002","journal-title":"Trends Parasitol"},{"key":"pntd.0012336.ref031","first-page":"13","article-title":"Association of urogenital symptoms with a history of water contact in young women in areas endemic for S","author":"HN Galappaththi-Arachchige","year":"2016","journal-title":"Haematobium. 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Int J Environ Res Public Health"},{"issue":"1","key":"pntd.0012336.ref032","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4269\/ajtmh.2008.79.79","article-title":"Prevention of gynecologic contact bleeding and genital sandy patches by childhood anti-schistosomal treatment","volume":"79","author":"EF Kjetland","year":"2008","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0012336.ref033","article-title":"WHO GUIDELINE on control and elimination of human schistosomiasis","author":"World Health Organization","year":"2022"},{"issue":"4","key":"pntd.0012336.ref034","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1046\/j.1365-3156.1998.00230.x","article-title":"Clinical findings in female genital schistosomiasis in Madagascar","volume":"3","author":"P Leutscher","year":"1998","journal-title":"Trop Med Int Heal"},{"issue":"6","key":"pntd.0012336.ref035","doi-asserted-by":"crossref","first-page":"2075.e7\u2013","DOI":"10.1016\/j.fertnstert.2009.05.043","article-title":"Genital schistosomiasis is a cause of female sterility and acute abdomen","volume":"93","author":"A Schanz","year":"2010","journal-title":"Fertil Steril"},{"key":"pntd.0012336.ref036","unstructured":"Female genital schistosomiasis: A pocket atlas for clinical health-care professionals. Who\/Htm\/Ntd\/20154 [Internet]. 2015;2015(September 1):49. Available from: http:\/\/apps.who.int\/iris\/bitstream\/10665\/180863\/1\/9789241509299_eng.pdf"},{"issue":"3","key":"pntd.0012336.ref037","doi-asserted-by":"crossref","first-page":"233","DOI":"10.4269\/ajtmh.2001.65.233","article-title":"Diagnosis of genital cervical schistosomiasis: Comparison of cytological, histopathological, and parasitological examination","volume":"65","author":"G Poggensee","year":"2001","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0012336.ref038","first-page":"59","article-title":"The transmission of Schistosoma haematobium in an area of Lake Province, Tanganyika","volume":"27","author":"G. 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