RESULTS: Women aged 15-65, sexually active, not menstruating, or pregnant, were enrolled from the MORBID study. A midwife completed a questionnaire, obtained cervicovaginal swab and lavage, and assessed FGS-associated genital lesions using hand-held colposcopy. \'Visual-FGS\' was defined as specific genital lesions. \'Molecular-FGS\' was defined as Sh DNA detected by real-time PCR from swabs. Microscopy detected urinary Sh egg-patent infection. In total, 950 women completed the questionnaire (median age 27, [IQR] 20-38). Visual-and molecular-FGS prevalence were 26·9% (260/967) and 8·2% (78/942), respectively. 6·5% of women with available genital and urinary samples (38/584) had egg-patent Sh infection. There was a positive significant association between molecular- and visual-FGS (AOR = 2·9, 95%CI 1·7-5·0). \'Molecular-FGS\' was associated with egg-patent Sh infection (AOR = 7·5, 95% CI 3·27-17·2). Some villages had high \'molecular-FGS\' prevalence, despite <10% prevalence of urinary Sh among school-age children.
CONCLUSIONS: Southern Malawi carries an under-recognized FGS burden. FGS was detectable in villages not eligible for schistosomiasis control strategies, potentially leaving girls and women untreated under current WHO guidelines. Validated field-deployable methods could be considered for new control strategies.
结果:15-65岁女性,性活跃,不是来月经,或怀孕,从MORBID研究中招募。一名助产士填写了一份问卷,获得宫颈阴道拭子和灌洗,并使用手持式阴道镜评估FGS相关生殖器病变。“Visual-FGS”定义为特定的生殖器病变。“分子FGS”定义为通过实时PCR从拭子中检测到的ShDNA。显微镜检查检测到尿Sh卵专利感染。总的来说,950名妇女完成了问卷(平均年龄27岁,[IQR]20-38)。视觉和分子FGS患病率分别为26·9%(260/967)和8·2%(78/942),分别。6·5%的生殖器和尿液样本的女性(38/584)患有卵孔Sh感染。分子-和视觉-FGS之间存在正相关(AOR=2·9,95CI1·7-5·0)。“分子FGS”与卵专利Sh感染相关(AOR=7·5,95%CI3·27-17·2)。一些村庄的分子FGS患病率很高,尽管学龄儿童的尿Sh患病率<10%。
结论:马拉维南部的FGS负担不足。在不符合血吸虫病控制策略条件的村庄可以检测到FGS,根据世卫组织现行准则,可能会导致女孩和妇女得不到治疗。对于新的控制策略,可以考虑经过验证的现场可部署方法。