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Am. J. Trop. Med. Hyg., 81(6), 2009, pp. 1050-1055
doi:10.4269/ajtmh.2009.09-0081;
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Right arrow Schistosomiasis

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

Eyrun Floerecke Kjetland*, Robert Jan Ten Hove, Exenevia Gomo, Nicholas Midzi, Lovemore Gwanzura, Peter Mason, Henrik Friis, Jaco J. Verweij, Svein Gunnar Gundersen, Patricia D. Ndhlovu, Takafira Mduluza, AND 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

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.

Received February 11, 2009. Accepted for publication September 9, 2009.

Acknowledgments: Technical, medical, or cultural assistance were provided by the Provincial Medical Director and Supervisor, Dr. Charimari, the Mupfure community, staff at Madziwa, Harare Central, and Mt. Darwin Hospitals, personnel from Blair Research Laboratory and the library at the Ministry of Health, Drs. T. Magwali, B. Mhlanga, I. Lyngstad-Vik, M.F.D. Baay, and professors B. Myrvang and L. Sandvik. The authors are indebted to the Medical Research Council of Zimbabwe, staff at Mupfure Secondary School, headmistress V. Mugabe, and the following indispensable people: Sister J. Chikoore and late sister P. Dungare, Councillor Chadzimura, Village Health Workers, Environmental Health Technicians, and in particular, N. Taremeredzwa, C. Mukahiwa, R. Manyaira, and T. Mushipe for prolonged hard work under very difficult circumstances. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.

Financial support: Director’s Initiative Grant, UNDP/WB/WHO Special Programme for Research and Training in Tropical Diseases, The Norwegian Research Council, NORAD, GlobInf, the University of Oslo, Norway, the Department for Infectious Diseases, Centre for Imported and Tropical Diseases and Research Forum, and Ullevaal University Hospital, Oslo, Norway.

* Address correspondence to Eyrun Floerecke Kjetland, Center for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, 0407 Oslo, Norway. E-mail: e.f.kjetland{at}medisin.uio.no

Authors’ addresses: Eyrun Floerecke Kjetland, Center for Imported and Tropical Diseases, Ullevaal Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway, E-mail: e.f.kjetland{at}medisin.uio.no. Robert Jan Ten Hove, Jaco Verweij, and Lisette Van Lieshout, Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands, E-mails: robtenhove{at}gmail.com, j.j.verweij{at}lumc.nl, and E.A.van_Lieshout{at}lumc.nl. Exenevia Gomo, Patricia D. Ndhlovu, and Takafira Mduluza, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe, E-mails: egomo{at}rsc.medcol.mw, p.ndhlovu{at}imperial.ac.uk, and mduluza{at}medic.uz.ac.zw. Nicholas Midzi, National Institute for Health Research (formerly Blair Research Institute), Harare, Zimbabwe, E-mail: nicholas.midzi{at}yahoo.com. Henrik Friis, International Nutrition and Health Department, University of Copenhagen, Denmark, E-mail: hfr{at}life.ku.dk. Svein Gunnar Gundersen, Research Unit, Sorlandet Hospital HF, Kristiansand, Norway and University of Agder, Kristiansand, Norway, E-mails: s.g.gundersen{at}sshf.no and s.g.gundersen{at}hia.no.






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