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Bilharzia and HIV (BILHIV)

Bilharzia and HIV (BILHIV)

The BILHIV study aims to explore the innovative role of self-swabs for the diagnosis of female genital schistosomiasis and its association with HIV transmission.

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About us

The BILHIV study aims to validate community based diagnosis of FGS in Zambia.

Who we are

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.

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BILHIV
Bilharzia and HIV (BILHIV) team

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.

BILHIV logos
Who we are

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.

Profiles

Amaya
Bustinduy

Associate Professor
Project Principal Investigator (LSHTM)

Amy
Sturt

Research Degree Student
Study Manager (LSHTM)

Comfort Rutty Phiri

In country Project Manager

Helen
Ayles

Professor
Professor (LSHTM)

Richard
Hayes

Professor
Professor (LSHTM)

Eyrun Kjetland

(University of Oslo)

Bellington Vwalika

(University of Zambia)
Updates
Updates
Workshop on The Challenges for Women’s Health in Sub-Saharan Africa

Training on point of care colposcopy and self-swabs for midwives at the 'Workshop on The Challenges for Women’s Health in Sub-Saharan Africa' organised by the Technical University of Munich and University of Tubingen in Lamberene, Gabon.

Women in colposcopy training
Midwives with self swabs

 

Preliminary results of the BILHIV study

Preliminary results of the BILHIV study show that genital swabs performed as well as cervicovaginal lavage for the detection of S.haematobium and could be an alternative to clinic based diagnosis of FGS. 

Results were presented at the American Society of Tropical Medicine & Hygiene in Maryland, November 2019 

Publications
Publications
Genital self-sampling compared with cervicovaginal lavage for the diagnosis of female genital schistosomiasis in Zambian women: The BILHIV study
Amy S. Sturt, Emily L. Webb, Comfort R. Phiri, Tobias Mweene, Namakau Chola, Govert J. van Dam, Paul L. A. M. Corstjens, Els Wessels, J. Russell Stothard, Richard Hayes, Helen Ayles, Isaiah Hansingo, Lisette van Lieshout, Amaya L. Bustinduy
2020
PLoS Negl Trop Dis
Acceptability and feasibility of genital self-sampling for the diagnosis of female genital schistosomiasis: a cross-sectional study in Zambia
Comfort Rutty Phiri, Amy S. Sturt, Emily L. Webb, Namakau Chola, Richard Hayes, Kwame Shanaube, Helen Ayles, Isaiah Hansingo, Amaya L. Bustinduy, BILHIV study team
2020
Wellcome Open Res; 2020, 5:61
Beyond the barrier: Female Genital Schistosomiasis as a potential risk factor for HIV-1 acquisition
A S Sturt, E L Webb, S C Francis, R J Hayes, A L Bustinduy
2020
Acta Trop; Sep 2020, 209:105524
Integration of prevention and control measures for female genital schistosomiasis, HIV and cervical cancer
Dirk Engels, Peter J Hotez, Camilla Ducker, Margaret Gyapong, Amaya L Bustinduy, William E Secor, Wendy Harrison, Sally Theobald, Rachael Thomson, Victoria Gamba, Makia C Masong, Patrick Lammie, Kreeneshni Govender, Pamela S Mbabazi and Mwelecele N Malecela
2020
Bulletin of the World Health Organization
Female genital schistosomiasis and HIV/AIDS: Reversing the neglect of girls and women
Hotez PJ, Harrison W, Fenwick A, Bustinduy AL, Ducker C, Sabina Mbabazi P, Engels D, Ktejland E.F
2019
PLoS Negl Trop Dis 13(4): e0007025
Female Genital Schistosomiasis
Hotez PJ, Engels D, Gyapong M, Ducker C, Malecela M.N
2019
N Engl J Med 2019; 381:2493-2495, DOI: 10.1056/NEJMp1914709