Schistosomiasis PCR in Vaginal Lavage as an Indicator of Genital Schistosoma haematobium Infection in Rural Zimbabwean Women

Eyrun Floerecke Kjetland Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Robert Jan Ten Hove Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Exenevia Gomo Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Nicholas Midzi Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Lovemore Gwanzura Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Peter Mason Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Henrik Friis Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Jaco J. Verweij Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Svein Gunnar Gundersen Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Patricia D. Ndhlovu Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Takafira Mduluza Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Lisette Van Lieshout Centre for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway; Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands; College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe; International Nutrition and Health Department, University of Copenhagen, Denmark; Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway

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Schistosoma real-time polymerase chain reaction (PCR) is sensitive and specific in urine and stool. We sought to explore the relationship between genital schistosomiasis and the Schistosoma PCR in women. PCR was run on 83 vaginal lavage samples from a rural Zimbabwean population. Women underwent clinical and colposcopic investigations, analyses for sexually transmitted infections, and genital schistosomiasis. Thirty samples were positive for Schistosoma PCR: 12 were strong and 18 were weak positive. Sensitivity (67%) and specificity (83%) were best in women below the age of 25 years. A positive schistosome PCR result was associated with S. haematobium ova in genital tissue, so-called sandy patches, and bleeding. Prevalence determined by PCR were lower and real-time PCR values were weaker in older women. The presence of Schistosoma DNA may be greater in the recent lesions (e.g., in younger women). For diagnosis in rural areas and in large studies, Schistosoma PCR could become a supplement to gynecologic examinations.

Author Notes

  • 1

    WHO, 2002. Schistosomiasis. Epidemiological data/geographical distribution. Geneva: World Health Organization.

    • PubMed
    • Export Citation
  • 2

    Renaud G, Devidas A, Develoux M, Lamothe F, Bianchi G, 1989. Prevalence of vaginal schistosomiasis caused by Schistosoma haematobium in an endemic village in Niger. Trans R Soc Trop Med Hyg 83 :797.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Poggensee G, Kiwelu I, Saria M, Richter J, Krantz I, Feldmeier H, 1998. Schistosomiasis of the lower reproductive tract without egg excretion in urine. Am J Trop Med Hyg 59 :782–783.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Kjetland EF, Ndhlovu PD, Mduluza T, Gomo E, Gwanzura L, Mason P, Kurewa EN, Midzi N, Friis H, Gundersen SG, 2005. Simple clinical manifestations of genital Schistosoma haematobium infection in rural Zimbabwean women. Am J Trop Med Hyg 72 :311–319.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Badawy A, 1962. Schistosomiasis of the cervix. BMJ 5275 :369–372.

  • 6

    Kjetland EF, Kurewa EN, Ndhlovu PD, Gwanzura L, Mduluza T, Gomo E, Midzi N, Mason PR, Friis H, Gundersen SG, 2008. Female genital schistosomiasis—a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital S. haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe. Trop Med Int Health 13 :1509.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Feldmeier H, Krantz I, Poggensee G, 1994. Female genital schistosomiasis as a risk-factor for the transmission of HIV. AIDS 5 :368–372.

  • 8

    Chenine AL, Shai-Kobiler E, Steele LN, Ong H, Augostini P, Song R, Lee SJ, Autissier P, Ruprecht RM, Secor WE, 2008. Acute Schistosoma mansoni infection increases susceptibility to systemic SHIV clade C infection in rhesus macaques after mucosal virus exposure. PLoS Negl Trop Dis 2 :e265.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Kjetland EF, Ndhlovu PD, Gomo E, Mduluza T, Midzi N, Gwanzura L, Mason P, Sandvik L, Friis H, Gundersen SG, 2006. Association between genital schistosomiasis and HIV in rural Zimbabwean women. AIDS 20 :593–600.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Poggensee G, Sahebali S, Van Marck E, Swai B, Krantz I, Feldmeier H, 2001. Diagnosis of genital cervical schistosomiasis: comparison of cytological, histopathological and parasitological examination. Am J Trop Med Hyg 65 :233–236.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Wright TC Jr, Subbarao S, Ellerbrock TV, Lennox JL, Evans-Strickfaden T, Smith DG, Hart CE, 2001. Human immunodeficiency virus 1 expression in the female genital tract in association with cervical inflammation and ulceration. Am J Obstet Gynecol 184 :279–285.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Obeng BB, Aryeetey YA, de Dood CJ, Amoah AS, Larbi IA, Deelder AM, Yazdanbakhsh M, Hartgers FC, Boakye DA, Verweij JJ, van Dam G, van Lieshout L, 2008. Application of a circulating-cathodic-antigen (CCA) strip test and real-time PCR, in comparison with microscopy, for the detection of Schistosoma haematobium in urine samples from Ghana. Ann Trop Med Parasitol 102 :625–633.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    ten Hove R, Verweij J, Vereecken K, Polman K, Dieyec L, Lieshout L, 2008. Multiplex real-time PCR for the detection and quantification of Schistosoma mansoni and S. haematobium infection in stool samples collected in northern Senegal. Trans R Soc Trop Med Hyg 102 :179–185.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Hindin MJ, 2003. Understanding women’s attitudes towards wife beating in Zimbabwe. Bull World Health Organ 81 :501–508.

  • 15

    Lessing C, 1998. Essential Drugs List and Standard Treatment Guidelines for Zimbabwe. EDLIZ. Harare, Zimbabwe: NDTPAC Publishing.

    • PubMed
    • Export Citation
  • 16

    Doehring E, Feldmeier H, Dafalla AA, 1983. Day-to day variation and circadian rhythm of egg excretion in urinary schistosomiasis in the Sudan. Ann Trop Med Parasitol 77 :587–594.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Katz N, Chaves A, Pellegrino J, 1972. A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo 14 :397–400.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Baay MFD, Kjetland EF, Ndhlovu PD, Deschoolmeester V, Mduluza T, Gomo E, Friis H, Midzi N, Gwanzura L, Mason PR, Vermorken JB, Gundersen SG, 2004. Human papillomavirus in a rural community in Zimbabwe: the impact of HIV co-infection on HPV genotype distribution. J Med Virol 73 :481–485.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Joesoef MR, Hillier SL, Josodiwondo S, Linnan M, 1991. Reproducibility of a scoring system for gram stain diagnosis of bacterial vaginosis. J Clin Microbiol 29 :1730–1731.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Saiki RK, Gelfand DH, Stoffel S, Scharf SJ, Higuchi R, Horn GT, Mullis KB, Erlich HA, 1988. Primer-directed enzymatic amplification of DNA with a thermostable DNA polymerase. Science 239 :487–491.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Niesters HG, 2002. Clinical virology in real time. J Clin Virol 25 (Suppl 3):S3–S12.

  • 22

    Leutscher PD, Pedersen M, Raharisolo C, Jensen JS, Hoffman S, Lisse I, Ostrowski SR, Reimert CM, Mauclere P, Ullum H, 2005. Increased prevalence levels of leukocytes and elevated cytokine levels in semen from Schistosoma haematobium-infected individuals. J Infect Dis 191 :1639–1647.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Oliveira FA, Soares VL, Dacal AR, Cavalcante FG, Mesquita AM, Fraga F, Lang K, Feldmeier H, 2006. Absence of cervical schistosomiasis among women from two areas of north-eastern Brazil with endemic Schistosoma mansoni. Ann Trop Med Parasitol 100 :49–54.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Richter J, 2003. The impact of chemotherapy on morbidity due to schistosomiasis. Acta Trop 86 :161–183.

  • 25

    Smith J, Christie J, 1986. The pathobiology of Schistosoma haematobium infection in humans. Hum Pathol 17 :333–345.

  • 26

    Kjetland EF, Ndhlovu PD, Kurewa EN, Midzi N, Gomo E, Mduluza T, Friis H, Gundersen SG, 2008. Prevention of gynecologic contact bleeding and genital sandy patches by childhood anti-schistosomal treatment. Am J Trop Med Hyg 79 :79–83.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Berry AV, 1976. The cytology and pathology of schistosomiasis of the female genital tract. Faculty of Medicine. Johannesburg: Witwatersrand, 144.

    • PubMed
    • Export Citation
  • 28

    Helling-Giese G, Sjaastad A, Poggensee G, Kjetland EF, Richter J, Chitsulo L, Kumwenda N, Racz P, Roald B, Gundersen SG, Krantz I, Feldmeier H, 1996. Female genital schistosomiasis (FGS): relationship between gynecological and histopathological findings. Acta Trop 62 :257–267.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Cohen MS, Pilcher CD, 2005. Amplified HIV transmission and new approaches to HIV prevention. J Infect Dis 191 :1391–1393.

  • 30

    Mayaud P, McCormick D, 2001. Interventions against sexually transmitted infections (STI) to prevent HIV infection. Br Med Bull 58 :129–153.

  • 31

    Orroth KK, Gavyole A, Todd J, Mosha F, Ross D, Mwijarubi E, Grosskurth H, Hayes RJ, 2000. Syndromic treatment of sexually transmitted diseases reduces the proportion of incident HIV infections attributable to these diseases in rural Tanzania. AIDS 14 :1429–1437.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Kaul R, Pettengell C, Sheth PM, Sunderji S, Biringer A, MacDonald K, Walmsley S, Rebbapragada A, 2008. The genital tract immune milieu: an important determinant of HIV susceptibility and secondary transmission. J Reprod Immunol 77 :32–40.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Sheffield JS, Wendel GD Jr, McIntire DD, Norgard MV, 2007. Effect of genital ulcer disease on HIV-1 coreceptor expression in the female genital tract. J Infect Dis 196 :1509–1516.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Fenwick A, 2006. Waterborne infectious diseases–could they be consigned to history? Science 313 :1077–1081.

  • 35

    Feldmeier H, Poggensee G, Krantz I, Helling-Giese G, 1995. Female genital schistosomiasis. New challenges from a gender perspective. Trop Geogr Med 47 :S2–S15.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Baay MF, Verhoeven V, Lambrechts HA, Pattyn GG, Lardon F, Van Royen P, Vermorken JB, 2009. Feasibility of collecting self-sampled vaginal swabs by mail: quantity and quality of genomic DNA. Eur J Clin Microbiol Infect Dis. [Epub ahead of print].

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Serwadda D, Wawer MJ, Shah KV, Sewankambo NK, Daniel R, Li C, Lorincz A, Meehan MP, Wabwire-Mangen F, Gray RH, 1999. Use of a hybrid capture assay of self-collected vaginal swabs in rural Uganda for detection of human papillomavirus. J Infect Dis 180 :1316–1319.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Wright TC Jr, Denny L, Kuhn L, Pollack A, Lorincz A, 2000. HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA 283 :81–86.

    • PubMed
    • Search Google Scholar
    • Export Citation
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