title: Knowledge and awareness of genital involvement and reproductive health consequences of urogenital schistosomiasis in endemic communities in Ghana: a cross-sectional study.
abstract: BACKGROUND
  The World Health Organization, in the year 2009, renamed Schistosomiasis haematobium disease, urinary schistosomiasis, as urogenital schistosomiasis. This study, sought to determine whether urogenital schistosomiasis endemic community members were aware of the broadened scope of the disease and associated certain reproductive health related signs and symptoms to S. haematobium infection.
  
  
  METHODS
  This is a cross-sectional study in which 2,585 respondents aged 15-49 years from 30 riparian communities along the lower arm of the Volta lake were interviewed using a structured questionnaire; 24 focus group discussions were also conducted. Descriptive statistics were used to determine the frequency of responses for each question posed and Chi squared tests used to determine the associations between demographic variables and variables of interest. Binary logistic regression was used to predict the probability of a reported symptom as an indicator of urogenital schistosomiasis. Thematic analysis was used to examine narratives.
  
  
  RESULTS
  Ninety four percent of male respondents and 88.7 % of female respondents acknowledged schistosomiasis as a water-borne disease. Only 207 out of 1,096 subjects (18.9 %) responding to questionnaire agreed to the knowledge that urogenital schistosomiasis can have reproductive health implications. A significant difference in variation in this knowledge was found between males (14.5 %) and females (7.2 %) (p = 0.001). The study also found that, although knowledge on HIV was high, only 12.3 % of respondents knew that urogenital schistosomiasis could facilitate the acquisition of HIV. Women who reported to have ever suffered schistosomiasis were 1.3 and 1.5 times more likely to report vaginal discharge and vaginal itch. Sexual dysfunction (11.1 %) and urethral discharge (10.6 %) were the most frequently reported symptoms among males.
  
  
  CONCLUSIONS
  The study finds very limited knowledge on the reproductive health consequences of the disease among endemic communities. It is recommended that health education on urogenital schistosomiasis should also include issues on symptoms of the disease, reproductive health consequences and HIV transmission.
authors.affiliation: Institute of Environment and Sanitation Studies, University of Ghana, P.O Box 209, Legon, Accra, Ghana. dzidzoy@staff.ug.edu.gh.
authors.forename: Dzidzo R
authors.initials: DR
authors.lastname: Yirenya-Tawiah
authors.affiliation: School of Public Health, University of Ghana, Legon, Accra, Ghana.
authors.forename: Mercy M
authors.initials: MM
authors.lastname: Ackumey
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
authors.forename: Kwabena M
authors.initials: KM
authors.lastname: Bosompem
keywords: Awareness; Genital; Ghana; Knowledge; Reproductive health; Schistosomiasis; Symptoms; Urogenital