Schistosomiasis is common in tropical and subtropical areas among communities who have limited access to safe water or adequate sanitation.  Transmission of FGS can only occur when humans are in contact with a contaminated water source. Female genital schistosomiasis (FGS) is thought by many to be the most neglected gynaecological condition across sub-Saharan Africa. It affects tens of millions of girls and women in countries where schistosomiasis is present, particularly across Africa. 

FGS is largely linked to cases of schistosomiasis caused specifically by S. haematobium (the urinary blood fluke), and it is estimated that up to three-quarters of those infected with S. haematobium will develop FGS, this translates to approximately 56 million girls and women. Yet despite how common it is, there is very low awareness about the condition. It is not mentioned in most medical textbooks and is not known about by many healthcare workers. 

Yes. Genital schistosomiasis affects both women and men, however there is much more research and awareness about the clinical signs and complications that present themselves in women. In men it is called male genital schistosomiasis (MGS). MGS is a severely neglected disease and much more research is needed to better understand the impact of genital schistosomiasis on men.

What we do know is that symptoms in men include inflammation of the genitals, painful erection and ejaculation, frequent urination, a burning sensation when urinating, blood in semen and glandular tumours near the prostate. 
 

MGS can affect the seminal glands, testicals, prostate and other organs, with schistosome eggs causing tissue damage and inflammation.
 

As with FGS, genital sores and inflammation can lead to an increased risk of getting HIV.
 

It is important for men to seek treatment if they think they are at risk or have signs of MGS. Praziquantel (PZQ) is the drug used to treat all types of schistosomal disease, including MGS.

There is a growing body of research looking into the link between genital schistosomiasis and HIV and it is now widely accepted that women and girls living with FGS are more at risk of getting HIV. Several large studies have shown that adult women with FGS are three to four times more likely to be infected with HIV than women without FGS. 

There is also a strong geographic overlap of FGS with HIV in countries such as Malawi, Mozambique, South Africa, Tanzania, and Zimbabwe. Based on this evidence, FGS could be seen as a leading HIV cofactor across the African continent. As a result, mass drug administration programmes (MDAs) using praziquantel (PZQ) could be a way of preventing FGS and new HIV infections in Africa.