{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T23:23:36Z","timestamp":1772839416651,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Education in Poland","award":["667\/WIM\/2024"],"award-info":[{"award-number":["667\/WIM\/2024"]}]},{"name":"Military Institute of Medicine\u2014National Research Institute","award":["667\/WIM\/2024"],"award-info":[{"award-number":["667\/WIM\/2024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Madagascar is one of the lowest-income countries in Africa, and it has a poorly developed healthcare system. Malagasy women face limited access to sexual and reproductive health services, which is a serious risk factor facilitating the spread of sexually transmitted infections (STIs). The aim of the present study was to assess the prevalence of STIs (Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, and HIV-1\/HIV-2) and urogenital schistosomiasis, as well as to evaluate hematological parameters and nutritional status, in a group of women from northern Madagascar. Methods: The study was conducted in April 2024 at the Clinique M\u00e9dicale Beyzym in Manerinerina, Ambatoboeny District. Samples, which included overnight urine, venous blood, and vaginal swabs, were collected from 159 women aged 15\u201380 years. The urine samples were examined for the presence of Schistosoma haematobium eggs by light microscopy, the vaginal swabs were tested for the presence of Trichomonas vaginalis and Neisseria gonorrhoeae infections (by light microscopy), and venous blood samples were collected into VACUTAINER SEC collection tubes without anticoagulant and were tested for HIV-1\/HIV-2 and Treponema pallidum infections using test cassettes. Results: The prevalence of STIs in the study group was found to be 31.5%, while S. haematobium infections were found in 17.6% of the tested women. Cases of gonorrhea (20.1%), trichomoniasis (8.8%), syphilis (7.6%), and one case of HIV infection were identified. Conclusions: The study found a high prevalence of STIs and S. haematobium cases in Tsimihety women. In order to improve the quality of healthcare in Madagascar, it is necessary to improve accessibility to maternal, sexual, and reproductive health services.<\/jats:p>","DOI":"10.3390\/jcm14103479","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T05:11:57Z","timestamp":1747372317000},"page":"3479","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Health Status of Tsimihety Women: Sexually Transmitted Infections and Schistosomiasis, Northern Madagascar"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-2418","authenticated-orcid":false,"given":"Daniel","family":"Kasprowicz","sequence":"first","affiliation":[{"name":"Clinique Medicale Beyzym, Manerinerina, Ambatoboeny District, Manerinerina 403, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1932-9784","authenticated-orcid":false,"given":"Wanesa","family":"Wilczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Tropical Medicine, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-6279","authenticated-orcid":false,"given":"Krzysztof","family":"Korzeniewski","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Tropical Medicine, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"ref_1","unstructured":"Madagascar (2024, December 29). Overview. Available online: https:\/\/data.worldbank.org\/country\/madagascar."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Andrianantoandro, V.T., Pourette, D., Rakotomalala, O., Ramaroson, H.J.V., Ratovoson, R., and Rakotoarimanana, F.M.J. (2021). Factors influencing maternal healthcare seeking in a highland region of Madagascar: A mixed methods analysis. BMC Pregnancy Childbirth., 21.","DOI":"10.1186\/s12884-021-03930-2"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s13561-023-00462-7","article-title":"Do public health expenditures affect maternal and child health in Madagascar?","volume":"13","author":"Razakamanana","year":"2023","journal-title":"Health Econ. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1093\/jac\/dkac251","article-title":"Unmet needs and practical solutions in the management of invasive mould infections in Asia","volume":"77","author":"Chen","year":"2022","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_5","unstructured":"Institute National de la Statistique (INSTAT) (2024, December 18). Madagascar DHS, 2021\u2014Final Report (in French). Available online: https:\/\/dhsprogram.com\/publications\/publication-FR376-DHS-Final-Reports.cfm."},{"key":"ref_6","first-page":"292157","article-title":"Care seeking behaviour and barriers to accessing services for sexual health problems among women in rural areas of Tamilnadu state in India","volume":"2014","author":"Kulasekaran","year":"2014","journal-title":"J. Sex. Transm. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"451","DOI":"10.3109\/13625187.2015.1059414","article-title":"Barriers to preventing unintended pregnancies and sexually transmitted infections as experienced by women in Fort Dauphin, southeast Madagascar","volume":"20","author":"Robson","year":"2015","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_8","unstructured":"Madagascar, Comit\u00e9 National de Lutte Contre le SIDA (2024, December 20). Rapport D\u2019activit\u00e9 sur la Riposte au SIDA \u00e0 Madagascar, 2014. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/MDG_narrative_report_2014.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1377\/hlthaff.2016.1419","article-title":"In Madagascar, Use Of Health Care Services Increased When Fees Were Removed: Lessons For Universal Health Coverage","volume":"36","author":"Garchitorena","year":"2017","journal-title":"Health Aff."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e003647","DOI":"10.1136\/bmjgh-2020-003647","article-title":"District-level health system strengthening for universal health coverage: Evidence from a longitudinal cohort study in rural Madagascar, 2014-2018","volume":"5","author":"Garchitorena","year":"2020","journal-title":"BMJ Glob. Health"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Schuster, A., Randrianasolo, B.S., Rabozakandraina, O.O., Ramarokoto, C.E., Br\u00f8nnum, D., and Feldmeier, H. (2022). Knowledge, experiences, and practices of women affected by female genital schistosomiasis in rural Madagascar: A qualitative study on disease perception, health impairment and social impact. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010901"},{"key":"ref_12","first-page":"101","article-title":"Maternal health practices, beliefs and traditions in southeast Madagascar","volume":"18","author":"Morris","year":"2014","journal-title":"Afr. J. Reprod. Health"},{"key":"ref_13","unstructured":"Institut Pasteur de Madagascar (2024, December 20). Manuel de Pr\u00e9l\u00e8vement des \u00c9chantillons Primaires, 2023. Available online: https:\/\/www.pasteur.mg\/wp-content\/uploads\/2023\/11\/CBC_MP_001_Manuel_de_pre-levement_des_echantillons_primaires_V14.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20302","DOI":"10.7448\/IAS.18.6.20302","article-title":"Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV","volume":"18","author":"Avni","year":"2015","journal-title":"J. Int. AIDS Soc."},{"key":"ref_15","unstructured":"World Health Organization (WHO) (2024, December 20). Report on Global Sexually Transmitted Infection Surveillance. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/sexually-transmitted-infections-(stis)."},{"key":"ref_16","unstructured":"World Health Organization (WHO) (2024, December 20). Global Health Sector Strategy on Sexually Transmitted Infections 2016\u20132021: Toward ending STIs, 2016. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-RHR-16.09."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.ijgo.2010.04.001","article-title":"Addressing critical gaps in achieving universal access to sexual and reproductive health (SRH): The case for improving adolescent SRH, preventing unsafe abortion, and enhancing linkages between SRH and HIV interventions","volume":"110","author":"Mbizvo","year":"2010","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/OLQ.0000000000000607","article-title":"Help and care seeking for sexually transmitted infections among youth in low- and middle-income countries","volume":"44","author":"Leichliter","year":"2017","journal-title":"Sex. Transm. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.11604\/pamj.2022.42.111.30871","article-title":"Prevalence and trends of sexually transmitted infections among pregnant women in Mizan Tepi University Teaching Hospital, Southwest Ethiopia: A cross-sectional study","volume":"42","author":"Asres","year":"2022","journal-title":"Pan Afr. Med. J."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Semwogerere, M., Dear, N., Tunnage, J., Dear, N., Tunnage, J., Reed, D., Kibuuka, H., Kiweewa, F., Iroezindu, M., and Bahemana, E. (2021). Factors associated with sexually transmitted infections among care-seeking adults in the African Cohort Study. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10762-4"},{"key":"ref_21","first-page":"1","article-title":"Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies","volume":"15","author":"Torrone","year":"2018","journal-title":"PLoS Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Shewarega, E.S., Fentie, E.A., Asmamaw, D.B., Negash, W.D., Fetene, S.M., Teklu, R.E., Aragaw, F.M., Alemu, T.G., Eshetu, H.B., and Belay, D.G. (2022). Sexually transmitted infections related care-seeking behavior and associated factors among reproductive age women in East Africa: A multilevel analysis of demographic and health surveys. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14120-w"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"585","DOI":"10.4314\/ahs.v21i2.13","article-title":"Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia","volume":"21","author":"Isara","year":"2021","journal-title":"Afr. Health Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1097\/01.olq.0000152820.17242.17","article-title":"Sexually transmitted infections in rural Madagascar at an early stage of the HIV epidemic: A 6-month community-based follow-up study","volume":"32","author":"Leutscher","year":"2005","journal-title":"Sex. Transm. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1046\/j.1365-3156.2001.00690.x","article-title":"Sexually transmitted infections and associated socio-demographic and behavioural factors in women seeking primary care suggest Madagascar\u2019s vulnerability to rapid HIV spread","volume":"6","author":"Behets","year":"2001","journal-title":"Trop. Med. Int. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1258\/09564620260216308","article-title":"Laboratory diagnosis of sexually transmitted infections in women with genital discharge in Madagascar: Implications for primary care","volume":"13","author":"Behets","year":"2002","journal-title":"Int. J. STD AIDS."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/tmi.12007","article-title":"Serological survey of HIV and syphilis in pregnant women in Madagascar","volume":"18","author":"Frickmann","year":"2013","journal-title":"Trop. Med. Int. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1046\/j.1365-3156.2003.00986.x","article-title":"The absence of HIV seropositivity contrasts with a high prevalence of markers of sexually transmitted infections among registered female sex workers in Toliary, Madagascar","volume":"8","author":"Xueref","year":"2003","journal-title":"Trop. Med. Int. Health"},{"key":"ref_29","unstructured":"Banque Mondiale (2024, December 19). Programme Global de Lutte Contre le VIH\/SIDA. VIH\/SIDA\u2014Obtenir des R\u00e9sultats, 2008. Available online: http:\/\/siteresources.worldbank.org\/INTHIVAIDS\/Resources\/375798-1132695455908\/M&EGRMadagascarFR.pdf."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Fortas, C., Harimanana, A.N., Rasoanandrianina, S.B., Rasoanaivo, T.F., Razanadranaivo, H.L., Mangahasimbola, R.T., Rasolon, D.T., Rafetrarivony, L.F., Rasolofomanana, T.T., and Rabarisoa, L. (2025). Sexually transmitted infections and bacterial vaginosis in women of child-bearing age in Antananarivo, Madagascar: Prevalence and risk factors from a cross-sectional study. BMC Infect. Dis., 25.","DOI":"10.1186\/s12879-025-10578-2"},{"key":"ref_31","first-page":"1178633717752686","article-title":"High Burden of Human Papillomavirus Infection in Madagascar: Comparison With Other Sexually Transmitted Infections","volume":"11","author":"Bigoni","year":"2018","journal-title":"Infect. Dis. Res. Treat."},{"key":"ref_32","unstructured":"Centers for Disease Control and Prevention (2024, December 19). Sexually Transmitted Infections in Developing Countries. Available online: http:\/\/web.worldbank.org\/archive\/website01213\/WEB\/IMAGES\/AAGSTIFI.PDF."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1182\/blood.V91.1.301","article-title":"Epidemiology of anemia in human immunodeficiency virus (HIV)-infected persons: Results from the multistate adult and adolescent spectrum of HIV disease surveillance project","volume":"91","author":"Sullivan","year":"1998","journal-title":"Blood"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Adapen, C., R\u00e9ot, L., and Menu, E. (2022). Role of the human vaginal microbiota in the regulation of inflammation and sexually transmitted infection acquisition: Contribution of the non-human primate model to a better understanding?. Front. Reprod. Health, 4.","DOI":"10.3389\/frph.2022.992176"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1086\/591127","article-title":"Coexistence of urogenital schistosomiasis and sexually transmitted infection in women and men living in an area where Schistosoma haematobium is endemic","volume":"47","author":"Leutscher","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40249-023-01094-z","article-title":"Prevalence and risk distribution of schistosomiasis among adults in Madagascar: A cross-sectional study","volume":"12","author":"Gruninger","year":"2023","journal-title":"Infect. Dis. Poverty"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.actatropica.2012.04.013","article-title":"Time to set the agenda for schistosomiasis elimination","volume":"128","author":"Rollinson","year":"2013","journal-title":"Acta Trop."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1056\/NEJMp1914709","article-title":"Female genital schistosomiasis","volume":"381","author":"Hotez","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.ijid.2020.10.088","article-title":"Association of schistosomiasis and HIV infections: A systematic review and meta-analysis","volume":"102","author":"Patel","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s40249-023-01139-3","article-title":"Female genital schistosomiasis, human papilloma virus infection, and cervical cancer in rural Madagascar: A cross sectional study","volume":"12","author":"Kutz","year":"2023","journal-title":"Infect. Dis. Poverty"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Mazigo, H.D., Samson, A., Lambert, V.J., Kosia, A.L., Ngoma, D.D., Murphy, R., and Matungwa, D.J. (2021). \u201cWe know about schistosomiasis but we know nothing about FGS\u201d: A qualitative assessment of knowledge gaps about female genital schistosomiasis among communities living in Schistosoma haematobium endemic districts of Zanzibar and northwestern Tanzania. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009789"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Rausche, P., Rakotoarivelo, R.A., Rakotozandrindrainy, R., Rakotomalala, R.S., Ratefiarisoa, S., Rasamoelina, T., Kutz, J.-M., Jaeger, A., Hoeppner, Y., and Lorenz, E. (2023). Awareness and knowledge of female genital schistosomiasis in a population with high endemicity: A cross-sectional study in Madagascar. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1278974"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Angora, E.K., Boissier, J., Menan, H., Rey, O., Tuo, K., Tour\u00e9, A.O., Coulibaly, J.T., M\u00e9it\u00e9, A., Raso, G., and N\u2019Goran, E.K. (2019). Prevalence and Risk Factors for Schistosomiasis among Schoolchildren in two Settings of C\u00f4te d\u2019Ivoire. Trop. Med. Infect. Dis., 4.","DOI":"10.3390\/tropicalmed4030110"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1093\/infdis\/jiaa746","article-title":"Schistosoma Transmission in a Dynamic Seasonal Environment and its Impact on the Effectiveness of Disease Control","volume":"225","author":"Huang","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_45","first-page":"134","article-title":"Healthcare Access in Rural Madagascar: A Study of Barriers in the Tsimihety Region","volume":"35","author":"Rakotomamonjy","year":"2020","journal-title":"Health Policy Plan."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/10\/3479\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:33:38Z","timestamp":1760031218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/10\/3479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,16]]},"references-count":45,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14103479"],"URL":"https:\/\/doi.org\/10.3390\/jcm14103479","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,16]]}}}