Objective: It is known that Schistosoma haematobium infection causes gynaecological lesions in women. We sought to explore genital symptoms in schoolgirls in an endemic area, and to determine the association between symptoms and risk factors for female genital schistosomiasis (FGS) infection; present urinary schistosomiasis infection and having high-risk water contact.
Design and methods: A cross-sectional study with questionnaire and three urine specimens that were investigated for schistosome ova. The participants were 620 schoolgirls between the age of 9 and 13 years old, in rural Ugu district Kwa-Zulu Natal.
Results: Half of the study population reported to have experienced genital symptoms. Having had high-risk water contact was associated with genital symptoms (chi-square; P <0,001). Bloody discharge, malodorous discharge and genital sores were associated with high-risk water contact (chi-square; p = 0,001, p < 0,001 and p = 0,003 respectively). Bloody discharge was also highly associated with urinary schistosomiasis (chi-square; p < 0,001). However, there were no significant associations between urinary schistosomiasis and the other genital symptoms. Prior schistosomiasis infection was reported by 31 % (189/602), and this was associated with current genital symptoms (chi-square; p < 0,001). Seventeen percent of the girls (105/620) reported to have received treatment previously, and treatment had no significant effect on the association between genital symptoms and urinary schistosomiasis or high risk waterbody contact.
Conclusion: Young girls in an S. haematobium endemic area have genital symptoms, some of which are significantly associated with high-risk water contact, urinary schistosomiasis and prior schistosomiasis infection. One should consider anti-schistosomal treatment at young age in S. haematobium endemic areas to prevent genital damage.