Case Report: Highlighting Male Genital Schistosomiasis (MGS) in Fishermen from the Southwestern Shoreline of Lake Malawi, Mangochi District

Sekeleghe A. Kayuni Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;
MASM Medi Clinics Limited, Medical Society of Malawi (MASM), Blantyre, Malawi;

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E. James LaCourse Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;

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Peter Makaula Research for Health Environment and Development (RHED), Mangochi, Malawi;

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Fanuel Lampiao Physiology Department, College of Medicine, University of Malawi, Blantyre, Malawi;

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Lazarus Juziwelo National Schistosomiasis and STH Control Program, Community Health Sciences Unit (CHSU), Ministry of Health, Lilongwe, Malawi;

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Joanna Fawcett Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;

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Alexandra Shaw Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;

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Mohammad H. Alharbi Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;

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Jaco J. Verweij Elisabeth-TweeSteden Hospital Tilburg, Laboratory for Medical Microbiology and Immunology, Tilburg, The Netherlands

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J. Russell Stothard Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;

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Urogenital schistosomiasis causes morbidity within the genitalia but is underreported and infrequently examined in men. To draw attention to male genital schistosomiasis (MGS), a longitudinal cohort study was conducted among fishermen along the southwestern shoreline of Lake Malawi. A case series of five participants is presented inclusive of questionnaire interviews, parasitological examinations, ultrasonography, and provision of a standard dose (40 mg/kg) of praziquantel (PZQ) treatment at baseline, 1-, 3-, 6-, and 12-month follow-up time points. Eggs of Schistosoma haematobium were observed in urine or semen across all time points; parasitological diagnostics were bolstered by real-time PCR for Schistosoma DNA in semen and by portable ultrasonography to document putative MGS-associated morbidity. We highlight the importance of developing standard diagnostic tests for MGS and increasing the accessibility of PZQ treatment to men, especially those in at-risk endemic areas.

Author Notes

Address correspondence to Sekeleghe A. Kayuni, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, University of Liverpool, 3rd floor, CTID Building, Pembroke Place, Liverpool L3 5QA, United Kingdom. E-mail: seke.kayuni@lstmed.ac.uk

Financial support: S. A. K. was funded by a PhD scholarship from Commonwealth Scholarship Commission, United Kingdom, which supported the baseline and 1-month follow-up studies. He received an International Travel Fellowship from the British Society for Parasitology to conduct 3- and 6-month follow-up studies and from World Friendship Charity to conduct 12-month follow-up studies. J. F. and A. S. were supported by LSTM Education Department MSc Degree Research Project Module funding. This publication was supported by a grant from the African Research Network for Neglected Tropical Diseases (ARNTD) through United States Agency for International Development (USAID), UK aid from the British people (UK aid) and Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD). Its contents are solely the responsibility of the authors and do not necessarily represent he views of ARNTD, COR-NTD, UK aid or the USAID.

Authors’ addresses: Sekeleghe A. Kayuni, MASM Medi Clinics Limited, Medical Society of Malawi (MASM), Blantyre, Malawi, E-mail: seke.kayuni@lstmed.ac.uk. E. James LaCourse, Joanna Fawcett, Alexandra Shaw, Mohammad H. Alharbi, and J. Russell Stothard, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom, E-mails: james.lacourse@lstmed.ac.uk, joanna_fawcett@hotmail.co.uk, alexandrashaw100@gmail.com, mohammad.alharbi@lstmed.ac.uk, and russell.stothard@lstmed.ac.uk. Peter Makaula, Research for Health Environment and Development (RHED), Mangochi, Malawi, E-mail: petmakau@yahoo.co.uk. Fanuel Lampiao, Physiology Department, College of Medicine, University of Malawi, Blantyre, Malawi, E-mail: flampiao@medcol.mw. Lazarus Juziwelo, National Schistosomiasis and STH Control Program, Community Health Sciences Unit, Ministry of Health, Lilongwe, Malawi, E-mail: juziwelol@gmail.com. Jaco J. Verweij, Elisabeth-TweeSteden Hospital Tilburg, Laboratory for Medical Microbiology and Immunology, Tilburg, The Netherlands, E-mail: j.verweij@etz.nl.

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