Integrating female genital schistosomiasis services with paediatric praziquantel delivery in Tanzania: A feasibility study

Background: Female genital schistosomiasis (FGS) is a gynaecological manifestation of a chronic Schistosoma haematobium infection affecting over 40 million women and girls, mostly in sub-Saharan Africa. In low- and middle-income countries like Tanzania diagnosis and treatment of FGS is a challenge due to limited healthcare capacity for neglected tropical diseases (NTDs). This leaves many women suffering from untreated FGS and its complications. The upcoming distribution of paediatric praziquantel (arPZQ) through routine healthcare in Tanzania presents a unique opportunity to integrate FGS care. Objective: This study assessed the feasibility of integrating FGS diagnosis and treatment services with arPZQ delivery using a mother and child integrated model for schistosomiasis intervention. Methods: A cross-sectional study employed both qualitative and quantitative data collection and analysis methods. Results: Integrating FGS services with the delivery of arPZQ was supported by healthcare workers (HCW) and the communities as a feasible strategy. This is only if diagnostic and treatment capacities for FGS at the primary healthcare facilities are strengthened. The study has revealed that over 70% of HCW lacked FGS awareness and experience in its diagnosis and treatment. Consequently, there have been frequent misdiagnosis of FGS as UTI, STIs or fungal infections, resulting in ineffective treatment. Similarly, communities were unaware of FGS and its symptoms. The repeated treatment failure which has been manifested by the recurrence of heinous symptoms affected their health seeking behavior. Majority of the FGS affected women have resorted to traditional medicines, unfortunately with no success. After learning about FGS and its symptoms, women expressed their readiness to seek treatment at the nearest health facility. The healthcare workers as providers of services expressed their willingness to provide integrated services for FGS and paediatric schistosomiasis. Conclusion: The integration of healthcare services for FGS and paediatric schistosomiasis is a feasible strategy. The two diseases share a common etiology, share some diagnosis techniques, and all are new in the healthcare service delivery system therefore have similar implementation or operational gaps. Consequently, when addressing the gaps for diagnosing and treating paediatric schistosomiasis, one can easily integrate the needs of FGS.