Abstract
Schistosoma haematobium causes female genital schistosomiasis (FGS), which is a poverty-related disease in sub-Saharan Africa. Furthermore, it is co-endemic with human immunodeficiency virus (HIV), and biopsies from genital lesions may expose the individual to increased risk of HIV infection. However, microscopy of urine and hematuria are nonspecific and insensitive predictors of FGS and gynecological investigation requires extensive training. Safe and affordable diagnostic methods are needed. We explore a novel method of diagnosing FGS using computer color analysis of colposcopic images. In a cross-sectional study on young women in an endemic area, we found strong associations between the output from the computer color analysis and both clinical diagnosis (odds ratio [OR] = 5.97, P < 0.001) and urine microscopy for schistosomiasis (OR = 3.52, P = 0.004). Finally, using latent class statistics, we estimate that the computer color analysis yields a sensitivity of 80.5% and a specificity of 66.2% for the diagnosis of FGS.
Highlights
Gynecological disease due to Schistosoma haematobium, female genital schistosomiasis (FGS), is endemic throughout Africa with a major burden of disease in sub-Saharan Africa.[1,2,3] It is related to poverty through poor sanitation and dependency on unprotected water sources such as rivers, dams, and lakes.[4]
The relationship between FGS and human immunodeficiency virus (HIV) has been explored in two independent cross-sectional studies including almost 1,000 women, showing that women with urogenital schistosomiasis have a higher prevalence of HIV.[7,8]
Sandy patches appearing as grains were described in 112 (14%) participants and sandy patches appearing as homogenous, yellow areas were described in 128 (16%)
Summary
Gynecological disease due to Schistosoma haematobium, female genital schistosomiasis (FGS), is endemic throughout Africa with a major burden of disease in sub-Saharan Africa.[1,2,3] It is related to poverty through poor sanitation and dependency on unprotected water sources such as rivers, dams, and lakes.[4]. FGS may create lesions and inflammation in the female genital tract, causing bleeding, pelvic discomfort, dyspareunia, and infertility.[3,5] there is growing concern that it may increase the risk of acquiring human immunodeficiency virus (HIV).[6,7,8,9,10] The relationship between FGS and HIV has been explored in two independent cross-sectional studies including (in total) almost 1,000 women, showing that women with urogenital schistosomiasis have a higher prevalence of HIV (increased odds ratio [OR] of 2.9–4.0).[7,8]
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