Acceptability and feasibility of genital self-sampling for the diagnosis of female genital schistosomiasis: a cross-sectional study in Zambia

Wellcome Open Research

article

Comfort Rutty Phiri¹  Amy S. Sturt²  Emily L. Webb³  Namakau Chola¹  Richard Hayes³  Kwame Shanaube¹  Helen Ayles²  Isaiah Hansingo⁴  Amaya L. Bustinduy² 

[1] Zambart;Department of Clinical Research, London School of Hygiene & Tropical Medicine;MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine;Gynecology Department, Livingstone Central Hospital

关键词: female genital schistosomiasis;    acceptability;    feasibility;    self-sampling;    self-collection;    vaginal self-sampling;    cervical self-sampling;    genital self-sampling;   

DOI  :  10.12688/wellcomeopenres.15482.2

学科分类：内科医学

来源: Wellcome

【 摘 要 】

Background: Female genital schistosomiasis (FGS) is a neglected and disabling gynaecological disorder that is difficult to diagnose and is part of the wider spectrum of urogenital disease caused by the waterborne parasite Schistosoma haematobium. Over 90% of human schistosomiasis cases are found in sub-Saharan Africa with 3.8 million people infected with schistosomes in Zambia. Reported FGS prevalence ranges from 33-75% of those with urinary schistosomiasis in endemic areas, suggesting a potentially high FGS burden in Zambia alone. The Bilharzia and HIV (BILHIV) study evaluated home self-sampling genital collection methods for the diagnosis of FGS.Methods: Eligible participants included non-pregnant, sexually active women aged 18-31 who were previously recruited for the HPTN 071 (PopART) trial in Livingstone, Zambia. Household demographic and symptom questionnaires were administered by community workers. Participants were offered vaginal and cervical self-swabs and a urine cup. Cervicovaginal lavage (CVL) was performed in clinic by midwives. Information was collected from participants on the acceptability and feasibility of genital self-sampling.Results: From January-August 2018, 603 women were enrolled, and 87.3% (527/603) completed clinic follow up. A high proportion of participants indicated that self-collection of specimens was “easy” or “very easy” on a 5-point Likert scale. A high proportion of women would be willing to self-collect all three specimens again in future: vaginal swab 96.7% (583/603), cervical swab 96.5% (582/603), and urine 96.2% (580/603). Overall, 90.0% (543/603) preferred to self-collect samples at home, compared with sampling in the clinic Home-based self-sampling was preferred over provider-based sampling in the clinic due to greater privacy 65.0% (353/543), convenience 51.4% (279/543) and lack of needed transportation 17.7% (96/543).Conclusions: Home based genital self-sampling for FGS diagnosis is highly acceptable. This scalable method may inform future efforts for community-based diagnosis of FGS.

【 授权许可】

CC BY