TY - JOUR

T1 - Gynecological manifestations, histopathological findings, and schistosoma-specific polymerase chain reaction results among women with Schistosoma haematobium infection

T2 - a cross-sectional study in Madagascar

AU - Randrianasolo, Bodo Sahondra

AU - Jourdan, Peter Mark

AU - Ravoniarimbinina, Pascaline

AU - Ramarokoto, Charles Emile

AU - Rakotomanana, Fanjasoa

AU - Ravaoalimalala, Vololomboahangy Elisabeth

AU - Gundersen, Svein Gunnar

AU - Feldmeier, Hermann

AU - Vennervald, Birgitte J

AU - van Lieshout, Lisette

AU - Roald, Borghild

AU - Leutscher, Peter

AU - Kjetland, Eyrun Floerecke

N1 - © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

PY - 2015/7/15

Y1 - 2015/7/15

N2 - BACKGROUND: The pathophysiology of female genital schistosomiasis (FGS) is only partially understood. This study aims to describe the histopathological findings, polymerase chain reaction (PCR) results, and gynecological manifestations of FGS in women with different intensities of Schistosoma haematobium infection.METHODS: Women aged 15-35 years living in an S. haematobium-endemic area in Madagascar underwent pelvic and colposcopic examinations. Small biopsy specimens were obtained from lesions and examined histopathologically. Schistosoma PCR was done on urine, biopsy, cervicovaginal lavage, and genital mucosal surface specimens.RESULTS: Sandy patches and rubbery papules were found in 41 of 118 women (35%). Rubbery papules reflected an intense cellular immune reaction dominated by eosinophils, epithelial erosion, and viable ova. There was a significant decrease in the prevalence of rubbery papules with age, even after adjustment for urinary ova excretion. The sandy patches with grains showed moderate cellular immune reaction and ova (viable and/or calcified). They were most prevalent in cases with low-intensity urinary S. haematobium infection. Forty-two percent of women with Schistosoma-negative urine specimens had at least 1 genital specimen test positive for Schistosoma by PCR.CONCLUSIONS: The results indicate a diversity of lesions caused by S. haematobium and a dynamic evolution of the genital lesions. Schistosoma PCR may give an indication of the diagnosis.

AB - BACKGROUND: The pathophysiology of female genital schistosomiasis (FGS) is only partially understood. This study aims to describe the histopathological findings, polymerase chain reaction (PCR) results, and gynecological manifestations of FGS in women with different intensities of Schistosoma haematobium infection.METHODS: Women aged 15-35 years living in an S. haematobium-endemic area in Madagascar underwent pelvic and colposcopic examinations. Small biopsy specimens were obtained from lesions and examined histopathologically. Schistosoma PCR was done on urine, biopsy, cervicovaginal lavage, and genital mucosal surface specimens.RESULTS: Sandy patches and rubbery papules were found in 41 of 118 women (35%). Rubbery papules reflected an intense cellular immune reaction dominated by eosinophils, epithelial erosion, and viable ova. There was a significant decrease in the prevalence of rubbery papules with age, even after adjustment for urinary ova excretion. The sandy patches with grains showed moderate cellular immune reaction and ova (viable and/or calcified). They were most prevalent in cases with low-intensity urinary S. haematobium infection. Forty-two percent of women with Schistosoma-negative urine specimens had at least 1 genital specimen test positive for Schistosoma by PCR.CONCLUSIONS: The results indicate a diversity of lesions caused by S. haematobium and a dynamic evolution of the genital lesions. Schistosoma PCR may give an indication of the diagnosis.

KW - Adolescent

KW - Adult

KW - Animals

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Madagascar

KW - Molecular Diagnostic Techniques

KW - Polymerase Chain Reaction

KW - Schistosoma haematobium

KW - Schistosomiasis haematobia

KW - Uterine Diseases

KW - Young Adult

U2 - 10.1093/infdis/jiv035

DO - 10.1093/infdis/jiv035

M3 - Journal article

C2 - 25725656

VL - 212

SP - 275

EP - 284

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 2

ER -