Imported female genital schistosomiasis: a neglected health issue across borders

Female genital schistosomiasis (FGS) is one of the most neglected tropical diseases in the world, affecting over 56 million women and girls in Africa alone. It is a sequala of Schistosoma haematobium infection and is characterised by lesions on the cervix and other reproductive structures. Schistosomiasis and FGS are prevalent in women living in, migrating from, or traveling to Schistosoma haematobium-endemic countries. FGS is associated with significant morbidity, including adverse pregnancy outcomes. Unfortunately, imported schistosomiasis and FGS often remain undiagnosed or are diagnosed only at late stages of disease progression, months to years after arrival in non-endemic settings. This is due to limited diagnostic and screening test availability for schistosomiasis and an absence of awareness and guidelines to diagnose imported FGS, especially among sexual and reproductive health providers. Fragmented care pathways between infectious disease, travel/tropical medicine, and reproductive health services further contribute to missed diagnoses, while structural and social inequities due to migration status and stigma lead to barriers in FGS diagnosis and management.