Elsevier

Acta Tropica

Volume 77, Issue 2, 2 November 2000, Pages 179-183
Acta Tropica

Investigation of association between female genital tract diseases and Schistosomiasis japonica infection

https://doi.org/10.1016/S0001-706X(00)00129-7Get rights and content

Abstract

With the support of WHO/TDR, a case-control study was undertaken to explore the association between female genital tract manifestation and Schistosomiasis japonica. Two thousand one hundred and six women aged 18–50 in a township with schistosomiasis japonica infection rate of >15% were surveyed using modified Kato-Katz method qualitatively and quantitatively. Two hundred and forty four women with schistosomiasis japonica were selected as experimental group and 236 matched healthy women as control group. Sixty nine items including cervix smear and the S. japonicum circulating antigen in intrauterine lavage were investigated. The results showed that physically, menstrual disorder and shorter stature and lighter weight of the first newborn occurred more frequently in the experimental group than that in control group. As for female genital tract manifestation, there were more cases with chronic cervicitis and uterine enlargement in the experimental group than that in the control group. Schistosome circulating antigen was detected in intrauterine lavage from 13 cases with schistosomiasis by ELISA. No evidence was found to show that female genital tract diseases be directly caused by S. japonicum, but the findings emerging from this survey merit further study.

Introduction

Female genital tract diseases are mainly seen in connection with schistosomiasis haematobia and mansoni, and less frequently linked with schistosomiasis japonica. An infant infected with schistosomiasis japonica through placenta was first reported in 1914 (Narabayashi, 1914). After that, there were some case reports indicating an association between female genital tract diseases and schistosomiasis japonica, as for example enlargement of uterus, fallopian tube and ovarian cyst (Ching-Chien, 1951, Carpenter et al., 1964). However, there is a need to verify these claims. So an investigation was carried out in Panao Township of Meishan County in Sichuan Province in 1996 to ascertain whether any association between female genital tract diseases and schistosomiasis japonica could be established.

Section snippets

General information on experimental area

Panao Township of Meishan County is located in the mid-west of the plain of Sichuan. In the past, the cumulative area of snail habitats has reached more than 5.09 million m2 at its highest. The highest human infection rate was 30.4%. In 1989 when 11 villages were sampled, seven had a human infection rate of ≥15% with the highest at 34.3%. During recent years, due to snail control in large areas and mass chemotherapy with praziquantel once a year, the human infection rate has decreased to about

Findings from gynecological examinations

Two hundred and forty four women with schistosomiasis japonica and 236 healthy women actually took part in this research. The average age of the sample population was 32 years with average body weight of 50 kg and average menarche at 15. Their mean age of marriage was 21. There were significant differences between the experiment group and the control group for the height, bleeding period and weight of the first new-born (Table 1).

Four hundred and ten cervical smears were eligible for

Discussion

Previously, no systematic investigation of female genital tract diseases due to schistosomiasis japonica in a community had ever been conducted. In 1996, we conducted a case-control study of female genital tract diseases and its association with schistosomiasis japonica in a township where schistosomiasis infection rate for married women aged between 18 and 50 was about 15%. A total of 480 women (244 women with schistosomiasis japonica infection and 236 healthy women) were studied.

This research

Acknowledgements

The study was supported by funding from UNDP/World Bank/WHO/TDR. We are indebted to Dr. Xu Kehui, Dr. Zhou Chuntao, Dr Zhen Yun and Yi Haiyan of Second University Hospital, West China University of Medical Sciences, Sichuan Province. Special thanks go to Professor M.Tanner for his kind help and cooperation.

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Present address: Southeast Asia HIV and Development Project, UNDP, Bangkok, Thailand.

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