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Int. J. Environ. Res. Public Health 2016, 13(11), 1135; doi:10.3390/ijerph13111135

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

1
Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Postboks 4956 Nydalen, Oslo 0450, Norway
2
Institute of Clinical Medicine, University of Oslo, Oslo 0312, Norway
3
Department of Gynaecology, Women and Children’s Division, Ullevaal University Hospital, Oslo 0450, Norway
4
Discipline of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4001, South Africa
5
Imperial College London, Claybrook Center, London W68LN, UK
6
Section for Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
7
Research Unit, Sorlandet Hospital, Kristiansand 4615, Norway
8
Department of Global Development and Planning, University of Agder, Kristiansand 4630, Norway
9
Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 3 October 2016 / Revised: 24 October 2016 / Accepted: 7 November 2016 / Published: 14 November 2016
(This article belongs to the Section Global Health)
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Abstract

Female genital schistosomiasis is a neglected tropical disease caused by Schistosoma 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 for S. haematobium ova. 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. haematobium ova 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). In S. haematobium endemic 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. View Full-Text
Keywords: Schistosoma haematobium; female genital schistosomiasis; water contact; urogenital symptoms; sexually transmitted infections Schistosoma haematobium; female genital schistosomiasis; water contact; urogenital symptoms; sexually transmitted infections
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MDPI and ACS Style

Galappaththi-Arachchige, H.N.; Amlie Hegertun, I.E.; Holmen, S.; Qvigstad, E.; Kleppa, E.; Sebitloane, M.; Ndhlovu, P.D.; Vennervald, B.J.; Gundersen, S.G.; Taylor, M.; Kjetland, E.F. 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. Int. J. Environ. Res. Public Health 2016, 13, 1135.

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