Female genital schistosomiasis (FGS) impacts the health and well-being of 56 million women and girls in Africa. Schistosomiasis, or bilharzia, is caused by parasitic worms that live in lakes, rivers and ponds where people bathe, wash clothes and collect water.

The worms burrow into the skin and can cause inflammation, open sores and bleeding on the cervix and vagina, increasing women’s and girls’ risk of other serious health issues, including HIV.

HIV is more easily transmitted if there is an entry point for it into the body, such as inflammation or open sores. This means that women and girls with FGS have a three-times higher risk of acquiring HIV and two-times higher risk for human papilloma virus (HPV), which is a cause of cervical cancer. FGS can also lead to infertility, miscarriage and stillbirth.

The impact of misdiagnosed FGS

In many healthcare settings where providers are not trained in diagnosing FGS, adolescent girls and young women who experience FGS symptoms such as pelvic pain or vaginal discharge are often misdiagnosed with a sexually transmitted infection (STI).

This kind of misdiagnosis of FGS as an STI not only means the condition is left untreated, but it can also lead to girls and women with FGS being stigmatised by healthcare workers because of their assumed sexual activity. This stigma is replicated in families and communities, where women with FGS symptoms often experience violence from intimate partners who suspect they’ve had sex outside the relationship.

What’s the solution?

FGS is treatable and preventable. A short course of medication (praziquantel) kills the worms, and transmission can be reduced through improved access to safe water, adequate sanitation and good hygiene.

However, neither the neglected tropical diseases (NTD) or sexual and reproductive health and rights (SRHR) sectors are currently systematically addressing the prevention, diagnosis and treatment of FGS in comprehensive way. Changing this has the potential to increase women’s and girls’ protection from a number of other serious health issues, including cervical cancer and HIV.

The FGS Integration Group (FIG) is a coalition of organisations working in the SRHR, HIV, HPV/cervical cancer, NTD and water, sanitation and hygiene (WASH) sectors. Its aim is to mobilise resources for operational research, programming and advocacy for sustainable integration of FGS into public and community health programmes, placing the needs of women and girls at risk of FGS at the centre.

FIG is co-led by Frontline AIDS and Bridges to Development, with core members LVCT Health, SCI Foundation. AvertSightsavers and the Global Schistosomiasis Alliance.

Want to know more?

If you’d like to know more about FIG and how you can support its work, please contact Fran Purcell at fpurcell@frontlineaids.org.

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