Bilharzia and HIV (BILHIV)
Female genital schistosomiasis (FGS) affects over 45 million women worldwide and in sub-Saharan Africa it is possibly the most underestimated gynecological affliction caused by an infectious agent, the waterborne parasite S. haematobium (Sh). FGS is associated with genital symptoms and infertility.Diagnosis is challenging, as it relies on expensive equipment that is seldom available in resource limited areas. Furthermore, there is very compelling evidence of a fourfold increase in HIV prevalence in women with Sh infection.
The BILHIV study aims to validate community based diagnosis of FGS in Zambia. Women are offered genital self-swabs at home and then invited to attend a local cervical cancer screening clinic to have a vaginal lavage performed and a colposcopic examination utilizing a point-of-care device for image capture.
Results from both sampling techniques (swabs and lavage) will be compared for accuracy in molecular detection of S.haematobium, If validated, genital self-swabbing may become an important and low cost approach for the diagnosis of FGS. Moreover, point-of-care colposcopy operated by midwives could become a feasible integration strategy in ongoing cervical cancer clinics across sub-Saharan Africa for the diagnosis of FGS.
The BILHIV study brings together LSHTM, Zambart Institute, University of Zambia and collaborators from Leiden Medical Center, Oslo University, the Natural History Museum and The Liverpool School of Tropical Medicine.