Integration of prevention and control measures for female genital schistosomiasis, HIV and cervical cancer

• Published in: Bulletin of the World Health Organization 2020-09, Vol.98 (9), p.615-624
• Main Authors: Engels, Dirk, Hotez, Peter J, Ducker, Camilla, Gyapong, Margaret, Bustinduy, Amaya L, Secor, William E, Harrison, Wendy, Theobald, Sally, Thomson, Rachael, Gamba, Victoria, Masong, Makia C, Lammie, Patrick, Govender, Kreeneshni, Mbabazi, Pamela S, Malecela, Mwelecele N
• Format: Article
• Language: English
• Subjects: Antiretroviral agents; Antiretroviral therapy; Attention; Bleeding; Cancer; Cancer vaccines; Cervical cancer; Cervix; Chronic infection; Chronic pain; Disease; Disease transmission; Empowerment; Exposure; Females; Girls; Health care policy; Health policy; HIV; Human immunodeficiency virus; Human papillomavirus; Human rights; Infections; Infertility; Integration; Intervention; Life course; Medical treatment; Operations research; Organizational research; Pain; Policy & Practice; Policy making; Praziquantel; Prevention; Prevention programs; Prophylaxis; Public health; Reproductive health; Reproductive rights; Risk analysis; Risk factors; Schistosoma haematobium; Schistosomiasis; Sexually transmitted diseases; Social justice; STD; Stigma; Storms (meteorology); Vaccines; Viruses; Women; Womens health; Womens rights
• ISSN: 0042-9686; 1564-0604
• DOI: 10.2471/blt.20.252270

Female genital schistosomiasis as a result of chronic infection with (commonly known as bilharzia) continues to be largely ignored by national and global health policy-makers. International attention for large-scale action against the disease focuses on whether it is a risk factor for the transmission of human immunodeficiency virus (HIV). Yet female genital schistosomiasis itself is linked to pain, bleeding and sub- or infertility, leading to social stigma, and is a common issue for women in schistosomiasis-endemic areas in sub-Saharan Africa. The disease should therefore be recognized as another component of a comprehensive health and human rights agenda for women and girls in Africa, alongside HIV and cervical cancer. Each of these three diseases has a targeted and proven preventive intervention: antiretroviral therapy and pre-exposure prophylaxis for HIV; human papilloma virus vaccine for cervical cancer; and praziquantel treatment for female genital schistosomiasis. We discuss how female genital schistosomiasis control can be integrated with HIV and cervical cancer care. Such a programme will be part of a broader framework of sexual and reproductive health and rights, women's empowerment and social justice in Africa. Integrated approaches that join up multiple public health programmes have the potential to expand or create opportunities to reach more girls and women throughout their life course. We outline a pragmatic operational research agenda that has the potential to optimize joint implementation of a package of measures responding to the specific needs of girls and women.