title: Association of Urogenital Symptoms with History of Water Contact in Young Women in Areas Endemic for S. haematobium. A Cross-Sectional Study in Rural South Africa.
abstract: Female genital schistosomiasis is a neglected tropical disease caused bySchistosoma haematobium. Infected females may suffer from symptoms mimicking sexually transmitted infections. We explored if self-reported history of unsafe water contact could be used as a simple predictor of genital schistosomiasis. In a cross-sectional study in rural South Africa, 883 sexually active women aged 16-22 years were included. Questions were asked about urogenital symptoms and water contact history. Urine samples were tested forS. haematobiumova. A score based on self-reported water contact was calculated and the association with symptoms was explored while adjusting for other genital infections using multivariable logistic regression analyses.S. haematobiumova were detected in the urine of 30.5% of subjects. Having ova in the urine was associated with the water contact score (p< 0.001). Symptoms that were associated with water contact included burning sensation in the genitals (p= 0.005), spot bleeding (p= 0.012), abnormal discharge smell (p= 0.018), bloody discharge (p= 0.020), genital ulcer (p= 0.038), red urine (p< 0.001), stress incontinence (p= 0.001) and lower abdominal pain (p= 0.028). InS. haematobiumendemic areas, self-reported water contact was strongly associated with urogenital symptoms. In low-resource settings, a simple history including risk of water contact behaviour can serve as an indicator of urogenital schistosomiasis.
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Postboks 4956 Nydalen, Oslo 0450, Norway. hashiniga@gmail.com.|Institute of Clinical Medicine, University of Oslo, Oslo 0312, Norway. hashiniga@gmail.com.
authors.forename: Hashini Nilushika
authors.initials: HN
authors.lastname: Galappaththi-Arachchige
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Postboks 4956 Nydalen, Oslo 0450, Norway. ingrid.hegertun@gmail.com.
authors.forename: Ingrid Elise
authors.initials: IE
authors.lastname: Amlie Hegertun
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Postboks 4956 Nydalen, Oslo 0450, Norway. sigve.holmen@gmail.com.|Institute of Clinical Medicine, University of Oslo, Oslo 0312, Norway. sigve.holmen@gmail.com.
authors.forename: Sigve
authors.initials: S
authors.lastname: Holmen
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo 0312, Norway. UXERQU@ous-hf.no.|Department of Gynaecology, Women and Children's Division, Ullevaal University Hospital, Oslo 0450, Norway. UXERQU@ous-hf.no.
authors.forename: Erik
authors.initials: E
authors.lastname: Qvigstad
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Postboks 4956 Nydalen, Oslo 0450, Norway. elisabethkleppa@gmail.com.|Institute of Clinical Medicine, University of Oslo, Oslo 0312, Norway. elisabethkleppa@gmail.com.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kleppa
authors.affiliation: Discipline of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4001, South Africa. sebitloanem@ukzn.ac.za.
authors.forename: Motshedisi
authors.initials: M
authors.lastname: Sebitloane
authors.affiliation: Imperial College London, Claybrook Center, London W68LN, UK. p.ndhlovu@imperial.ac.uk.
authors.forename: Patricia Doris
authors.initials: PD
authors.lastname: Ndhlovu
authors.affiliation: Section for Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark. bjv@sund.ku.dk.
authors.forename: Birgitte Jyding
authors.initials: BJ
authors.lastname: Vennervald
authors.affiliation: Research Unit, Sorlandet Hospital, Kristiansand 4615, Norway. svein.g.gundersen@sshf.no.|Department of Global Development and Planning, University of Agder, Kristiansand 4630, Norway. svein.g.gundersen@sshf.no.
authors.forename: Svein Gunnar
authors.initials: SG
authors.lastname: Gundersen
authors.affiliation: Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa. taylor@ukzn.ac.za.
authors.forename: Myra
authors.initials: M
authors.lastname: Taylor
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Postboks 4956 Nydalen, Oslo 0450, Norway. e.f.kjetland@medisin.uio.no.|Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa. e.f.kjetland@medisin.uio.no.
authors.forename: Eyrun Floerecke
authors.initials: EF
authors.lastname: Kjetland
mesh_terms: D000293:Adolescent; D000818:Animals; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D012423:Rural Health; D012548:Schistosoma haematobium / Q000302:isolation & purification; D012553:Schistosomiasis haematobia / Q000175:diagnosis* / Q000635:transmission; D057566:Self Report; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D013019:South Africa; D014867:Water / Q000469:parasitology*; D060753:Water Quality; D000069578:Waterborne Diseases / Q000175:diagnosis* / Q000635:transmission; D055815:Young Adult
chemical_list: D014867:Water
keywords: Schistosoma haematobium; female genital schistosomiasis; sexually transmitted infections; urogenital symptoms; water contact