Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women.
Adolescent
Adult
Animals
Colposcopy
/ methods
Diagnostic Tests, Routine
/ methods
Early Detection of Cancer
/ methods
Female
Genitalia, Female
/ parasitology
Humans
Incidence
Microscopy
/ methods
Polymerase Chain Reaction
Schistosoma haematobium
/ genetics
Schistosomiasis haematobia
/ diagnosis
Specimen Handling
Urinalysis
/ methods
Uterine Cervical Dysplasia
/ diagnosis
Uterine Cervical Neoplasms
/ diagnosis
Young Adult
Zambia
/ epidemiology
Cervical dysplasia
Female genital schistosomiasis
PCR
Schistosoma haematobium
Urogenital schistosomiasis
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
17 Jul 2021
17 Jul 2021
Historique:
received:
26
02
2021
accepted:
27
05
2021
entrez:
18
7
2021
pubmed:
19
7
2021
medline:
31
7
2021
Statut:
epublish
Résumé
Female genital schistosomiasis (FGS) is a neglected tropical gynaecological disease that affects millions of women in sub-Saharan Africa (SSA). FGS is caused by Schistosoma haematobium, a parasitic carcinogen involved in the pathogenesis of squamous cell carcinoma of the bladder. Cervical cancer incidence and mortality are highest in SSA, where pre-cancerous cervical dysplasia is often detected on screening with visual inspection with acetic acid (VIA). There are no studies evaluating the association between VIA positivity and FGS diagnosed by genital PCR. Women were recruited from the Bilharzia and HIV (BILHIV) study in Zambia a community-based study comparing genital self-sampling to provider obtained cervicovaginal-lavage for the diagnosis of FGS in women aged 18-31. FGS was defined as positive Schistosoma DNA from any genital PCR. Urogenital schistosomiasis diagnostics included urine circulating anodic antigen, urine microscopy and portable colposcopy. Participants were offered cervical cancer screening using VIA at Livingstone Central Hospital. Associations of PCR confirmed FGS and other diagnostics with VIA positivity were assessed using multivariable logistic regression. VIA results were available from 237 BILHIV participants. A positive Schistosoma PCR in any genital specimen was detected in 14 women (5.9%), 28.6% (4/14) of these women had positive VIA compared to 9.0% without PCR evidence of schistosome infection (20/223). Schistosoma PCR positivity in any genital specimen was strongly associated with VIA positivity (OR: 6.08, 95% CI: 1.58-23.37, P = 0.02). This is the first study to find an association between FGS and positive VIA, a relationship that may be causal. Further longitudinal studies are needed.
Sections du résumé
BACKGROUND
BACKGROUND
Female genital schistosomiasis (FGS) is a neglected tropical gynaecological disease that affects millions of women in sub-Saharan Africa (SSA). FGS is caused by Schistosoma haematobium, a parasitic carcinogen involved in the pathogenesis of squamous cell carcinoma of the bladder. Cervical cancer incidence and mortality are highest in SSA, where pre-cancerous cervical dysplasia is often detected on screening with visual inspection with acetic acid (VIA). There are no studies evaluating the association between VIA positivity and FGS diagnosed by genital PCR.
METHODS
METHODS
Women were recruited from the Bilharzia and HIV (BILHIV) study in Zambia a community-based study comparing genital self-sampling to provider obtained cervicovaginal-lavage for the diagnosis of FGS in women aged 18-31. FGS was defined as positive Schistosoma DNA from any genital PCR. Urogenital schistosomiasis diagnostics included urine circulating anodic antigen, urine microscopy and portable colposcopy. Participants were offered cervical cancer screening using VIA at Livingstone Central Hospital. Associations of PCR confirmed FGS and other diagnostics with VIA positivity were assessed using multivariable logistic regression.
RESULTS
RESULTS
VIA results were available from 237 BILHIV participants. A positive Schistosoma PCR in any genital specimen was detected in 14 women (5.9%), 28.6% (4/14) of these women had positive VIA compared to 9.0% without PCR evidence of schistosome infection (20/223). Schistosoma PCR positivity in any genital specimen was strongly associated with VIA positivity (OR: 6.08, 95% CI: 1.58-23.37, P = 0.02).
CONCLUSIONS
CONCLUSIONS
This is the first study to find an association between FGS and positive VIA, a relationship that may be causal. Further longitudinal studies are needed.
Identifiants
pubmed: 34273957
doi: 10.1186/s12879-021-06380-5
pii: 10.1186/s12879-021-06380-5
pmc: PMC8286581
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
691Subventions
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Informations de copyright
© 2021. The Author(s).
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