title: Female genital schistosomiasis--a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe.
abstract: OBJECTIVE
  To examine the association between schistosomiasis and reproductive tract symptoms.
  
  
  METHODS
  A cross-sectional study was conducted in a Schistosoma haematobium-endemic area of rural Zimbabwe. A total of 483 permanently resident adult women of Mupfure Ward aged 20-49 were interviewed and examined clinically, each providing three consecutive urine samples. Logistic regression analysis was used to control for sexually transmitted diseases (STDs).
  
  
  RESULTS
  Women with genital sandy patches had significantly more genital itch (P = 0.009) and perceived their discharge as abnormal (P = 0.003). Eighty percent of the women who had genital itch, yellow discharge, and childhood or current waterbody contact had sandy patches. Fifty-two percent of the women with genital sandy patches did not have detectable S. haematobium ova in urine. Genital schistosomiasis was associated with stress incontinence and pollakisuria, but not with menstrual irregularities, current or previous ulcers, or tumours.
  
  
  CONCLUSIONS
  Genital schistosomiasis may be a differential diagnosis to the STDs in women who have been exposed to fresh water in endemic areas. Because of the chronic nature of the disease in adults, we suggest to pay special attention to the prevention of morbidity.
authors.affiliation: Centre for Imported and Tropical Diseases, Ullevaal University Hospital, Oslo, Norway. e.f.kjetland@medisin.uio.no
authors.forename: Eyrun Floerecke
authors.initials: EF
authors.lastname: Kjetland
authors.forename: Edith Nyaradzai
authors.initials: EN
authors.lastname: Kurewa
authors.forename: Patricia D
authors.initials: PD
authors.lastname: Ndhlovu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Midzi
authors.forename: Lovemore
authors.initials: L
authors.lastname: Gwanzura
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mason
authors.forename: Exnevia
authors.initials: E
authors.lastname: Gomo
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Takafira
authors.initials: T
authors.lastname: Mduluza
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
authors.forename: Svein Gunnar
authors.initials: SG
authors.lastname: Gundersen
mesh_terms: D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D019353:Endemic Diseases; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000469:parasitology; D006801:Humans; D008875:Middle Aged; D009017:Morbidity; D011537:Pruritus / Q000469:parasitology; D012424:Rural Population; D012548:Schistosoma haematobium; D012552:Schistosomiasis / Q000175:diagnosis*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000469:parasitology; D014621:Vagina / Q000469:parasitology; D019522:Vaginal Discharge / Q000469:parasitology; D055815:Young Adult; D015030:Zimbabwe