Diagnostic competence and health worker knowledge of female genital schistosomiasis management in a rural Ghanaian district
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Background
Schistosomiasis is a neglected tropical disease with a greater burden in Africa, including Ghana. Female Genital Schistosomiasis (FGS), a gynaecological manifestation of urogenital schistosomiasis, is often missed or misdiagnosed due to similarities with sexually transmitted infections and other gynaecological infections, with limited ease of health worker identification and diagnostic capability. This study assessed healthcare workers’ knowledge and diagnostic capacity for FGS in the Central Gonja District of Ghana.
Methods
A quantitative cross-sectional study sampled 237 healthcare workers from 19 facilities near the Black and White Volta rivers using a three-phase multistage sampling process. Data was collected via a self-administered Kobo Toolbox questionnaire, focusing on sociodemographic factors, whether facilities had functional screening tools for FGS and health workers’ capacity to diagnose and treat these conditions. Analysis was conducted in SPSS, employing descriptive statistics and Pearson’s chi-square tests to assess inferential associations between variables and health workers’ knowledge of FGS/schistosomiasis, which served as the main outcome variable.
Results
The study involved health workers with a mean age of 31.6 ± 4.18 years, of whom 52.3% were male. Knowledge gaps were significant: only 30% (71/237) demonstrated good understanding of schistosomiasis and merely 16.9% (40/237) showed adequate knowledge of FGS. Despite 91.6% recognition of schistosomiasis (‘Bilharzia’), knowledge of genital manifestations lagged severely (FGS: 26.8%, MGS (Male genital schistosomiasis): 18.1%). While demographic factors showed no association, experienced staff demonstrated better FGS knowledge (p = 0.003). Critical health system deficiencies emerged; 74% of facilities lacked laboratories, 90% lacked praziquantel and 100% lacked FGS diagnostic capacity. Even among clinicians, <43% knew standard FGS treatment and only 1/3 considered FGS in relevant diagnoses.
Conclusion
Healthcare workers lack FGS knowledge and diagnostic capacity, urgently requiring integration into reproductive health guidelines, training, and better resources for early detection and management
Author Summary
Female Genital Schistosomiasis is a neglected yet serious health condition affecting women, especially in sub-Saharan Africa. It often goes undiagnosed or is mistaken for sexually transmitted or other gynaecological infections due to overlapping symptoms and limited awareness among healthcare providers. This study explored how well healthcare workers in the Central Gonja District of Ghana understand and diagnose FGS. Through a survey of 237 healthcare workers from 19 health facilities located near the Black and White Volta rivers, we uncovered significant knowledge gaps; only a small number had a clear understanding of FGS and how to treat it. Most health facilities lacked the necessary resources, including diagnostic tools and essential medication like praziquantel. Our findings highlight an urgent need to train healthcare workers and integrate FGS into routine reproductive health services to improve detection and care for affected women.
