Volume 84, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We conducted a community-based study of 457 women aged 18–50 years living in eight rural villages in northwest Tanzania. The prevalence of female urogenital schistosomiasis (FUS) was 5% overall but ranged from 0% to 11%. FUS was associated with human immunodeficiency virus (HIV) infection (odds ratio [OR] = 4.0, 95% confidence interval [CI] = 1.2–13.5) and younger age (OR = 5.5 and 95% CI = 1.2–26.3 for ages < 25 years and OR = 8.2 and 95% CI = 1.7–38.4 for ages 25–29 years compared with age > 35 years). Overall HIV prevalence was 5.9% but was 17% among women with FUS. We observed significant geographical clustering of schistosomiasis: northern villages near Lake Victoria had more infections ( < 0.0001), and southern villages farther from the lake had more ( = 0.002). Our data support the postulate that FUS may be a risk factor for HIV infection and may contribute to the extremely high rates of HIV among young women in sub-Saharan Africa.


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  1. World Health Organization WHO Working Group on Urogenital Schistosomiasis and HIV Transmission, 2009. World Health Organization Neglected Tropical Diseases Website. Available at: http://www.who.int/neglected_diseases/integrated_media_urogenital_schistosomiasis/en/index.html. Accessed August 3, 2010.
  2. Kjetland EF, Kurewa EN, Ndhlovu PD, Midzi N, Gwanzura L, Mason PR, Gomo E, Sandvik L, Mduluza T, Friis H, Gundersen SG, , 2008. Female genital schistosomiasis—a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe. Trop Med Int Health 13: 15091517.[Crossref]
  3. Poggensee G, Kiwelu I, Weger V, Goppner D, Diedrich T, Krantz I, Feldmeier H, , 2000. Female genital schistosomiasis of the lower genital tract: prevalence and disease-associated morbidity in northern Tanzania. J Infect Dis 181: 12101213.[Crossref]
  4. Leutscher PDC, Ramarokoto CE, Hoffmann S, Jensen JS, Ramaniraka V, Randrianasolo B, Raharisolo C, Migliani R, Christensen N, , 2008. Coexistence of urogenital schistosomiasis and sexually transmitted infection in women and men living in an area where Schistosoma haematobium is endemic. Clin Infect Dis 47: 775782.[Crossref]
  5. Kjetland EF, Poggensee G, Helling-Giese G, Richter J, Sjaastad A, Chitsulo L, Kumwenda N, Gundersen SG, Krantz I, Feldmeier H, , 1996. Female genital schistosomiasis due to Schistosoma haematobium. Clinical and parasitological findings in women in rural Malawi. Acta Trop 62: 239255.[Crossref]
  6. Poggensee G, Feldmeier H, , 2001. Female genital schistosomiasis: facts and hypotheses. Acta Trop 79: 193210.[Crossref]
  7. Kjetland EF, Ndhlovu PD, Gomo E, Mduluza T, Midzi N, Gwanzura L, Mason PR, Sandvik L, Friis H, Gundersen SG, , 2006. Association between genital schistosomiasis and HIV in rural Zimbabwean women. AIDS 20: 593600.[Crossref]
  8. Feldmeier H, Krantz I, Poggensee G, , 1994. Female genital schistosomiasis as a risk factor for the transmission of HIV. Int J STD AIDS 5: 368372.[Crossref]
  9. Hotez PJ, Fenwick A, Kjetland EF, , 2009. Africa's 32 cents solution for HIV/AIDS. PLoS Negl Trop Dis 3: e430.[Crossref]
  10. Clements ACA, Lwambo NJ, Blair L, Nyandindi U, Kaatano G, Kinung'hi S, Webster JP, Fenwick A, Brooker S, , 2006. Bayesian spatial analysis and disease mapping: tools to enhance planning and implementation of a schistosomiasis control programme in Tanzania. Trop Med Int Health 11: 490503.[Crossref]
  11. Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK, , 1983. Non-specific vaginitis: diagnostic criteria and microbial and epidemiologic associations. Am J Med 74: 1422.[Crossref]
  12. Feldmeier H, Zwingenberger K, Steiner A, Dietrich M, , 1981. Diagnostic value of rectal biopsy and concentration methods in schistosomiasis intercalctum: quantitative comparison of three techniques. Trop Med Parasitol 32: 243246.
  13. Omoro SAO, Fann JR, Weymuller EA, Macharia IM, Yueh B, , 2006. Swahili translation and validation of the Patient Health Questionnaire-9 depression scale in the Kenyan head and neck cancer patient population. Int J Psychiatry Med 36: 367381.[Crossref]
  14. Monahan PO, Shacham E, Reece M, Kroenke K, Ong'or WO, Omollo O, Yebei VN, Ojwang C, , 2009. Validity/reliability of PHQ-9 and PHQ-2 depression scales among adults living with HIV/AIDS in western Kenya. J Gen Intern Med 24: 189197.[Crossref]
  15. Kroenke K, Spitzer RL, Williams JBW, , 2001. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16: 606613.[Crossref]
  16. Secor WE, , 2006. Interactions between schistosomiasis and infection with HIV-1. Parasite Immunol 28: 597603.
  17. Modjarrad K, Vermund SH, , 2010. Effect of treating co-infections on HIV-1 viral load: a systematic review. Lancet Infect Dis 10: 455463.[Crossref]
  18. Modjarrad K, Chamot E, Vermund SH, , 2008. Impact of small reductions in plasma HIV RNA levels on the risk of heterosexual transmission and disease progression. AIDS 22: 21792185.[Crossref]
  19. Woolhouse MEJ, Taylor P, Matanhire D, Chandiwana SK, , 1991. Acquired immunity and epidemiology of Schistosoma haematobium . Nature 351: 757759.[Crossref]
  20. Huang Y, Manderson L, , 1992. Schistosomiasis and the social patterning of infection. Acta Trop 51: 175194.[Crossref]
  21. Woolhouse MEJ, , 1998. Patterns in parasite epidemiology: the peak shift. Parasitol Today 14: 428434.[Crossref]
  22. Joint United Nations Program on HIV/AIDS (UNAIDS), 2008. 2008 Report on the Global AIDS Epidemic. Available at: http://www.unaids.org/en/knowledgecentre/hivdata/globalreport/2008/2008_global_report.asp. Accessed September 15, 2010.
  23. Ahmed EF, Daffalla A, Christensen NO, Madsen H, , 1996. Patterns of infection and transmission of human schistosomiasis haematobium in White Nile Province, Sudan. Ann Trop Med Parasitol 90: 173180.[Crossref]
  24. Brooker S, Kabatereine NB, Smith JL, Mupfasoni D, Mwanje MT, Ndayishimiye O, Lwambo NJ, Mbotha D, Karanja P, Mwandawiro C, Muchiri E, Clements AC, Bundy DA, Snow RW, , 2009. An updated atlas of human helminth infections: the example of East Africa. Int J Health Geogr 8: 42.[Crossref]
  25. Lwambo NJS, Siza JE, Brooker S, Bundy DAP, Guyatt H, , 1999. Patterns on concurrent hookworm infection and schistosomiasis in schoolchildren in Tanzania. Trans R Soc Trop Med Hyg 93: 497502.[Crossref]
  26. Webbe G, , 1962. The transmission of Schistosoma haematobium in an area of Lake Province, Tanganyika. Bull World Health Organ 27: 5985.
  27. Amoran O, Lawoyin T, Lasebikan V, , 2007. Prevalence of depression among adults in Oyo State, Nigeria: a comparative study of rural and urban communities. Aust J Rural Health 15: 211215.[Crossref]
  28. Chipimo PJ, Fylkesnes K, , 2009. Mental distress in the general population in Zambia: impact of HIV and social factors. BMC Public Health 9: 298.[Crossref]

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  • Received : 15 Oct 2010
  • Accepted : 06 Dec 2010

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