Abstract

BackgroundSchistosomiasis is an acute and chronic disease caused by parasitic worms, that can take two main forms: intestinal or urogenital. If left untreated, the urogenital form can lead to female genital schistosomiasis (FGS) in women and girls; frequently resulting in severe reproductive health complications which are often misdiagnosed as sexually-transmitted infections (STIs) or can be confused with cervical cancer. Despite its impact on women’s reproductive health, FGS is typically overlooked in medical training and remains poorly recognized with low awareness both in affected communities and in health professionals. FGS has been described as the one of the most neglected sexual and reproductive health issues in sub-Saharan Africa (Swai in BMC Infect Dis 6:134, 2006; Kukula in PLoS Negl Trop Dis 13:e0007207; Joint United Nations Programme on HIV/AIDS (UNAIDS) 2019). Increased knowledge and awareness of FGS is required to end this neglect, improve women’s reproductive health, and decrease the burden of this preventable and treatable neglected tropical disease.MethodsWe conducted interactive virtual workshops, in collaboration with the World Health Organization (WHO), engaging 64 participants with medical and public health backgrounds from around the world to establish standardized skills (or competencies) for prevention, diagnosis, and treatment of FGS at all levels of the health system. The competencies were drafted in small groups, peer-reviewed, and finalized by participants.ResultsThis participatory process led to identification of 27 skills needed for FGS prevention, diagnosis, and management for two categories of health workers; those working in a clinical setting, and those working in a community setting. Among them, ten relate to the diagnosis of FGS including three that involve a pelvic exam and seven that do not. Six constitute the appropriate behaviors required to treat FGS in a clinical setting. Eleven address the community setting, with six relating to the identification of women at risk and five relating to prevention.ConclusionDefining the skills necessary for FGS management is a critical step to prepare for proper diagnosis and treatment of women and girls in sub-Saharan Africa by trained health professionals. The suggested competencies can now serve as the foundation to create educative tools and curricula to better train health care workers on the prevention, diagnosis, and management of FGS.

Highlights

  • La bilharziose ou schistosomiase est une maladie aiguë et chronique causée par des parasites, qui peut prendre deux formes principales: intestinale ou urogénitale

  • Se não for tratada, a forma urogenital pode resultar em mulheres e meninas à esquistossomose genital feminina (EGF); frequentemente resultando em graves complicações na saúde reprodutiva que são por vezes mal diagnosticadas como doenças sexualmente transmissíveis (DSTs) ou podem ser confundidas com câncer cervical

  • As a result of this process, the final output of the workshop included 27 competencies across two categories of health workers: those working in a clinical setting, and those working in a community setting (Fig. 6)

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Summary

Introduction

La bilharziose ou schistosomiase est une maladie aiguë et chronique causée par des parasites, qui peut prendre deux formes principales: intestinale ou urogénitale. La BGF a été décrite comme l’un des problèmes de santé sexuelle et reproductive les plus négligés en Afrique subsaharienne (Swai in BMC Infect Dis 6:134, 2006; Kukula in PLoS Negl Trop Dis 13:e0007207; Joint United Nations Programme on HIV/AIDS (UNAIDS) 2019). The urogenital form can lead to female genital schistosomiasis (FGS) in women and girls; frequently resulting in severe reproductive health complications which are often misdiagnosed as sexually-transmitted infections (STIs) or can be confused with cervical cancer. FGS has been described as the one of the most neglected sexual and reproductive health issues in sub-Saharan Africa (Swai in BMC Infect Dis 6:134, 2006; Kukula in PLoS Negl Trop Dis 13:e0007207; Joint United Nations Programme on HIV/AIDS (UNAIDS) 2019). The first step towards this goal is to clearly define a standardized set of learning outcomes; the competencies or behaviors required to adequately prevent, diagnose, and manage an FGS case

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