title: S. haematobium as a common cause of genital morbidity in girls: a cross-sectional study of children in South Africa.
abstract: BACKGROUND
  Schistosoma (S.) haematobium infection is a common cause of genital morbidity in adult women. Ova in the genital mucosal lining may cause lesions, bleeding, pain, discharge, and the damaged surfaces may pose a risk for HIV. In a heterogeneous schistosomiasis endemic area in South Africa, we sought to investigate if young girls had genital symptoms and if this was associated with urinary S. haematobium.
  
  
  METHODS
  In a cross-sectional study of 18 randomly chosen primary schools, we included 1057 schoolgirls between the age of 10 and 12 years. We interviewed assenting girls, whose parents had consented to their participation and examined three urines from each of them for schistosome ova.
  
  
  RESULTS
  One third of the girls reported to have a history of genital symptoms. Prior schistosomal infection was reported by 22% (226/1020), this was associated with current genital symptoms (p<0.001). In regression analysis the genital symptoms were significantly associated both with urinary schistosomiasis (p<0.001) and water contact (p<0.001).
  
  
  CONCLUSIONS
  Even before sexually active age, a relatively large proportion of the participating girls had similar genital symptoms to those reported for adult genital schistosomiasis previously. Anti-schistosomal treatment should be considered at a young age in order to prevent chronic genital damage and secondary infections such as HIV, sexually transmitted diseases and other super-infections.
authors.affiliation: Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Oslo, Norway.
authors.forename: Ingrid Elise Amlie
authors.initials: IE
authors.lastname: Hegertun
authors.forename: Kristin Marie
authors.initials: KM
authors.lastname: Sulheim Gundersen
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kleppa
authors.forename: Siphosenkosi Gift
authors.initials: SG
authors.lastname: Zulu
authors.forename: Svein Gunnar
authors.initials: SG
authors.lastname: Gundersen
authors.forename: Myra
authors.initials: M
authors.lastname: Taylor
authors.forename: Jane D
authors.initials: JD
authors.lastname: Kvalsvig
authors.forename: Eyrun Floerecke
authors.initials: EF
authors.lastname: Kjetland
mesh_terms: D000818:Animals; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015995:Prevalence; D060737:Reproductive Tract Infections / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology; D012548:Schistosoma haematobium / Q000302:isolation & purification*; D012553:Schistosomiasis haematobia / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology; D012574:Schools; D013019:South Africa / Q000453:epidemiology; D014556:Urine / Q000469:parasitology
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