Gynecological manifestations, histopathological findings, and schistosoma-specific polymerase chain reaction results among women with Schistosoma haematobium infection: a cross-sectional study in Madagascar.
Bottom Line: Sandy patches and rubbery papules were found in 41 of 118 women (35%).There was a significant decrease in the prevalence of rubbery papules with age, even after adjustment for urinary ova excretion.The results indicate a diversity of lesions caused by S. haematobium and a dynamic evolution of the genital lesions.
Affiliation: Helminthiasis Unit.Show MeSH
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Mentions: FGS was diagnosed in 41 women (35%) on the basis of finding 48 lesions (Table 1). These were rubbery papules (Figure 2A), sandy patches appearing as single or clustered grains (Figure 2B), and sandy patches appearing as homogenous yellow sandy areas (Figure 2C). Rubbery papules and contact bleeding were only found in women with eggs excreted in urine, with frequencies of 15 of 79 (19%) and 16 of 79 (20%), respectively. Rubbery papules decreased in prevalence as the intensity of schistosomiasis decreased (Table 1). Sandy patches with grains, however, were most prevalent in the low-intensity group. Twenty-nine women (25%) were found to have abnormal mucosal blood vessels (Figure 2D). One woman had a malignant-looking lesion, which was confluent with rubbery papules (not shown). There was no overall association between the intensity of urinary S. haematobium infection (as measured by egg excretion in urine) and colposcopic findings (data not shown). There was a significant decrease in the prevalence of rubbery papules with increasing age, even after adjustment for urinary ova excretion (adjusted OR, 0.85; 95% CI, .74–.99; P = .037). Similarly, the prevalence of sandy patches presenting as grains increased with increasing age, although this was not significant (adjusted OR, 1.07; 95% CI, .98–1.17; P = .13). The prevalence of homogenous sandy patches was not associated with age (P = .82).Table 1.