TY - STAND
KW - Female genital schistosomiasis (FGS)
KW - Cervical cancer
KW - PCR
AU - Rafferty H
AU - Sturt A
AU - Phiri CR
AU - Webb E
AU - Mudenda M
AU - Mapani J
AU - Corstjens P
AU - Dam GV
AU - Schaap A
AU - Ayles H
AU - Hayes R
AU - Lieshout LV
AU - Hansingo I
AU - Bustinduy AL
AB - <jats:title>Abstract</jats:title>
        <jats:p><jats:bold>Background: </jats:bold>Female genital schistosomiasis (FGS) is a neglected tropical gynaecological disease that affects millions of women in sub-Saharan Africa (SSA). FGS is caused by <jats:italic>Schistosoma (S.) haematobium</jats:italic>, 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). No studies have evaluated the association between VIA positivity and FGS diagnosed by genital PCR. <jats:bold>Methods: </jats:bold>Women were recruited from the BILHIV study in Zambia, which compared genital self-sampling to provider obtained cervicovaginal-lavage for the diagnosis of FGS in women aged 18-31. FGS was defined as positive <jats:italic>Schistosoma</jats:italic> 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.<jats:bold>Results: </jats:bold>VIA results were available from 237 BILHIV participants. A positive <jats:italic>Schistosoma </jats:italic>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% (20/223) without PCR evidence of schistosome infection. <jats:italic>Schistosoma</jats:italic> PCR positivity in any genital specimen was strongly associated with VIA positivity (OR: 6.08, 95% CI: 1.58-23.37, <jats:italic>P</jats:italic>=0.02). <jats:bold>Conclusions: </jats:bold>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.</jats:p>
DO - 10.21203/rs.3.rs-279255/v1
LA - eng
N2 - <jats:title>Abstract</jats:title>
        <jats:p><jats:bold>Background: </jats:bold>Female genital schistosomiasis (FGS) is a neglected tropical gynaecological disease that affects millions of women in sub-Saharan Africa (SSA). FGS is caused by <jats:italic>Schistosoma (S.) haematobium</jats:italic>, 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). No studies have evaluated the association between VIA positivity and FGS diagnosed by genital PCR. <jats:bold>Methods: </jats:bold>Women were recruited from the BILHIV study in Zambia, which compared genital self-sampling to provider obtained cervicovaginal-lavage for the diagnosis of FGS in women aged 18-31. FGS was defined as positive <jats:italic>Schistosoma</jats:italic> 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.<jats:bold>Results: </jats:bold>VIA results were available from 237 BILHIV participants. A positive <jats:italic>Schistosoma </jats:italic>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% (20/223) without PCR evidence of schistosome infection. <jats:italic>Schistosoma</jats:italic> PCR positivity in any genital specimen was strongly associated with VIA positivity (OR: 6.08, 95% CI: 1.58-23.37, <jats:italic>P</jats:italic>=0.02). <jats:bold>Conclusions: </jats:bold>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.</jats:p>
PB - Research Square
PY - 2021
TI - Association Between Cervical Dysplasia and Female Genital Schistosomiasis Diagnosed by Genital PCR in Zambian Women
UR - https://www.researchsquare.com/article/rs-279255/v1.pdf
ER -