A simple change to existing health services could help tackle one of the most overlooked threats to girls’ reproductive health in sub-Saharan Africa, according to a new study published in The Lancet Microbe.
Researchers say integrating screening and treatment for female genital schistosomiasis (FGS) into routine adolescent, maternal and reproductive health services could improve early diagnosis, reduce long-term complications and reach millions of women and girls who currently go untreated.
FGS is a neglected tropical disease caused by Schistosoma haematobium, a parasitic worm transmitted through contact with infested freshwater. When parasite eggs become trapped in genital tissues, they can cause chronic inflammation, lesions and scarring, increasing the risk of HIV acquisition, persistent human papillomavirus (HPV) infection and cervical cancer.
Despite affecting an estimated 40–56 million women and girls, FGS is rarely included in routine sexual and reproductive health services. Because its symptoms often resemble those of sexually transmitted infections, many patients are misdiagnosed or receive treatment only after complications have developed.
Rather than calling for entirely new programmes, the researchers argue that existing health services provide an opportunity to close this gap.
One recommendation is to integrate FGS screening into established HPV, cervical cancer and HIV services. The study suggests that a single genital sample could be used to test for both FGS and HPV, reducing the need for separate appointments and making better use of existing healthcare infrastructure.
The researchers also recommend equipping frontline health workers to recognise the signs of FGS during routine consultations with adolescent girls and women, particularly in communities where schistosomiasis is endemic.
New diagnostic technologies, including molecular testing and artificial intelligence-assisted imaging, could further improve detection, while expanding the use of praziquantel through school-based deworming programmes and linking treatment with HPV vaccination and water, sanitation and hygiene initiatives could strengthen prevention efforts.
Some of these approaches are already being explored. The World Health Organization Regional Office for Africa, through its Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), has established a Technical Advisory Group on urogenital schistosomiasis to support countries with risk mapping, technical guidance and policy development.
Researchers say integrating FGS into existing services could allow countries to address a neglected disease without creating entirely new health programmes. By building on systems that already reach girls and women, they argue that countries can improve access to diagnosis and treatment while making more efficient use of limited health resources.
The study also notes that challenges remain. Limited awareness, inadequate diagnostic capacity and competing health priorities continue to hinder progress in many endemic countries. Researchers say further implementation, investment and evaluation will be needed to determine how integrated approaches perform at scale.
For countries seeking practical ways to strengthen girls’ health services, the study presents integration not as a complete solution, but as an evidence-informed response that can be built into existing systems.
Source: The Lancet Microbe.
