1. FEMALE GENITAL SCHISTOSOMIASIS (FGS) IN ABEOKUTA, NIGERIA
STAC36 - March 2014
FEMALE GENITAL SCHISTOSOMIASIS (FGS) IN ABEOKUTA, NIGERIA
1U F Ekpo, 1O M Odeyemi, 1HO Mogaji, 1A S Oluwole, 2H O Abdussalam 1Federal University of Agriculture, Abeokuta, Nigeria; 2Federal Medical Centre, Abeokuta, Nigeria;  
Contact Address:
Spatial Parasitology and Health GIS unit,
Department of Pure and Applied Zoology,
Federal University of Agriculture, Abeokuta, Nigeria.
54th BSP Spring Meeting 2016, Imperial College London
54th BSP Spring Meeting 2016, Imperial College London.

2. SCHISTOSOMIASIS Water borne trematode parasitic disease.
Over 200 million people affected worldwide (WHO, 2010).
85% of them are resident in sub- Saharan Africa (WHO, 2010).
Nigeria is the leading country in Sub-Saharan Africa for schistosomiasis with over 29 million affected people (Hotez et al., 2012)
Water borne trematode parasitic disease.
Parasite belongs to the genus Schistosoma.
Currently six species have been reported to infect man (WHO, 2014)
Figure 1: Life cycle of Schistosoma
54th BSP Spring Meeting 2016, Imperial College London

3. FEMALE GENITAL SCHISTOSOMIASIS (FGS)
FGS is a disease condition where migrating eggs laid by Adult Schistoma haematobium (urogenital schistosomiasis) are trapped in genital organs such as fallopian tube, ureter, cervix, and vagina (Mbabazi, 2011; Hotez, et. al., 2009: Kjetland, et.al., 2012)
According to WHO (WHO, 2009 ), over 44 million women living in sub-Saharan Africa (SSA) are currently affected by FGS
: areas where eggs are trapped
FGS is an emerging public health problem for female living in urogenital schistosomiasis endemic areas.
54th BSP Spring Meeting 2016, Imperial College London

4. Female Genital Schistosomiasis – Signs & SYMPTOMS
FGS Clinical Signs and Symptoms.
Chronic female genital-tract inflammation
Vaginal itching and discharge (Kjetland, 2008)
Post-coital bleeding (Poggensee, 2000)
Genito-pelvic discomfort (Leutscher, 2008)
Infertility (Kjetland, 2006)
Menstrual disorders (Nour, 2010)
Anaemia (Nour, 2010)
Preterm Labour (Nour, 2010).
Female participate mostly in water contact activities where they are exposed to infection

5. RATIONALE FOR THE STUDY
FGS have been studied in South Africa (Hergertun, et. al., 2013), Tanzania (Downs, et.al., 2011), Madagascar and Ghana (Owusu-Bempah, et. al., 2013), and Zimbabwe (Kjetland, 2008).
Despite the fact that Nigeria is the most endemic country for schistosomiasis in sub-Saharan Africa, there are no epidemiological and clinical evidences for FGS in Nigeria.
This study was conducted in Abeokuta. Abeokuta is located in Ogun State, South Western Nigeria. The area is endemic for urogenital Schistosomiasis (Ofoezie et al, 1991; Ekpo et al, 2008; Ekpo et. al. 2010)
54th BSP Spring Meeting 2016, Imperial College London

6. Methods Study procedures Interviewing of study participants (n=317)
Enrollment of Study Participants (n=317)
Interviewing of study participants (n=317)
Collection of Urine samples (n=317)
Laboratory analysis (Dipstick and Microscopy)
Gynecological examination (n=20)
Study design – cross sectional
Study sites - Four urogenital schistosomiasis endemic communities of Imala Odo, Apojola, Abule titun and Ibaro.
Inclusion Criteria
Young girls (5-14 years )
Child bearing female (15-49yrs)
Exclusion Criteria
Girls below 5 years of Age
Women above 49 years
54th BSP Spring Meeting 2016, Imperial College London
54th BSP Spring Meeting 2016, Imperial College London.

7. Results
Overview of the study participants
Age group (years)
Ibaro
NE (%)
Imala-Odo
Abule-titun NE (%)
Apojola
Total
5-15
36 (56.2)
88 (67.1)
33 (47.8)
30 (56.6)
187
16-25
11 (17.2)
22 (16.7)
17 (24.6)
12 (22.6) 62
26-49
17 (26.6)
21 (16.0)
19 (27.5)
11 (20.8) 68
Total (%)
64 (100)
131 (100)
69 (100)
53 (100)
317
A total of 317 females were examined, with majority of them within the age range 5-15 years
54th BSP Spring Meeting 2016, Imperial College London
54th BSP Spring Meeting 2016, Imperial College London.

8. PREVALENCE OF HAEMATURIA AND URINOGENITAL SCHISTOSOMIASIS
Ibaro
NE(%)
Imala-odo NE(%)
Abule-titun NE(%)
Apojola NE(%)
Total
Positive (%)
29 (45.3)
78 (59.5)
11 (15.9)
32 (60.4)
150 (47.3)
Haematuria
Negative (%)
35 (54.7)
53 (40.5)
58 (84.1)
21 (39.6)
167 (52.7) 64
131 69 53
317
77 (58.8)
149 (47.0)
S. haematobium infection
54 (41.2)
168 (53.0)
A total of 149 (47.0%) of the 317 females examined were infected with S. haematobium
54th BSP Spring Meeting 2016, Imperial College London
54th BSP Spring Meeting 2016, Imperial College London.

9. PREVALENCE BY AGE GROUP
No. examined
Prevalence
Intensity
P-value
5-15
187
121 (64.7)
± ᵇ
Age group
16-25 62
18 (29.0)
± ᵃ
26-49 68
10 (14.7)
± ᵃ
Total
317
149 (47.0)
± ᵃ
0.000
Prevalence 121 (64.7%) and intensity of infection (0.0446±0.5628) were significantly (p <0.05) higher in young girls (aged 5-15 years) than their older counterparts
54th BSP Spring Meeting 2016, Imperial College London

10. GYNAECOLOGICAL RESULTS
Only 20 female participants consented to this procedure…
Age group (years)
Positive (%)
Negative (%)
Total
16-25
5 (71.4)
2 (28.6)
7 (35.0)
26-49
9 (69.2)
4 (30.8)
13 (65.0)
14 (70.0)
6 (30.0)
20 (100)
“Of the 20 participants, 14 (70.0%) had FGS”
FGS diagnosis: Present of sandy patches which can either be single or clustered grains or appearing as homogenous yellow areas, rubbery papules, nabothian cysts and aceto-negative lesion.
54th BSP Spring Meeting 2016, Imperial College London

11. GYNEACOLOGICAL RESULT CONT’D
Morbidity
Number examined
Frequency (%)
Yellow sandy patches 20
8 (40.0)
Grainy sandy patches
14 (70.0)
Nabothian cysts and Rubbery papules
1 (5.0)
Gynaecological morbidity observed were 70.0% with grainy-sandy patches, 40.0% with yellow sandy patches, 5.0% with nabothian cysts and rubbery papules in their vaginal and cervical wall respectively
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12. FGS presentations B C A A: Yellow patches around cervix
STAC36 - March 2014 B C A
A: Yellow patches around cervix
B: Sandy Patches around cervix
C: Inflammation of cervix
54th BSP Spring Meeting 2016, Imperial College London
54th BSP Spring Meeting 2016, Imperial College London.

13. IMPLICATIONS Implication of our findings
This study has confirmed presence of FGS in Ogun State, Nigeria. There is the need to assess its impacts and implications for reproductive health of young girls and women of child bearing age living in urogenital schistosomiasis endemic communities in Nigeria.
Measures are needed for early diagnosis and treatment to prevent reproductive health complication of young girls and women of child bearing age.
Way forward
Creation of awareness about FGS in Nigeria.
Assessment of its burden in young girls and women.
Advocate for support and funding for studies on FGS in Nigeria.
54th BSP Spring Meeting 2016, Imperial College London

14. 54th BSP Spring Meeting 2016, Imperial College London
STAC36 - March 2014
Acknowledgments:
Prof Russel Stothard (LSTM) for his support in this investigation
Federal Medical Centre, Abeokuta for gynaecological examination support.
Contact Address:
Spatial Parasitology and Health GIS unit,
Department of Pure and Applied Zoology,
Federal University of Agriculture, Abeokuta, Nigeria.
54th BSP Spring Meeting 2016, Imperial College London
54th BSP Spring Meeting 2016, Imperial College London.