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Lifting the neglect of female genital schistosomiasis in a Schistosoma haematobium endemic country - NU/LSHTM project

Title of PhD project / theme

Lifting the neglect of female genital schistosomiasis in a Schistosoma haematobium endemic country

Supervisory team

Amaya Bustinduy (LSHTM, Lead) Amaya.Bustinduy@lshtm.ac.uk

Kiyoshi Kita, PhD (NU) kitak@nagasaki-u.ac.jp

Daniel Ken Inaoka (NU)

Brief description of project / theme

Female genital schistosomiasis (FGS) is a neglected gynaecological disorder caused by the waterborne parasite Schistosoma haematobium. FGS affects women of all ages and impairs their normal sexual and reproductive life. FGS has been linked to infertility, ectopic pregnancy and painful sexual encounters among others. Moreover, there is mounting evidence of  an association between FGS and HIV and persistent high risk HPV infection. Community and health professional’s knowledge and awareness on the disease and its consequences is often lacking.

FGS diagnosis remains challenging as it relies on costly resources that are often unavailable in resource limited settings. This limits accurate burden of disease estimations and hinders the establishment of detection and treatment programmes across Schistosoma haematobium endemic countries in Sub-Saharan Africa.

In Malawi where S.haematobium is hyper-endemic, there have been very few studies on FGS, and none in recent years. There is therefore little knowledge on the burden of disease and its clinical consequences. This PhD would help lift the neglect on FGS in Malawi and explore potential associations between FGS and sexually transmitted diseases.

Dr. Bustinduy is the PI of an ongoing FGS study in Malawi (FGS Morbid) in two endemic areas in the country: Sanjay and Chikwawa. A total of 1,000 women of different age groups will participate in the current study. Potential projects synergising from these resources include but not exclusively:

  • Diagnostic validation of different diagnostic methods for FGS
  • A multilayer approach to quantifying the effects on the reproductive health of girls and women
  • Evaluation of the feasibility and acceptability of the Point-of-care colposcopy compared to more traditional colposcopy methods.
  • Identification of association between FGS and HIV/HPV through immune phenotyping.
  • Evaluation of the effectiveness of the treatment with for FGS
  • Development and testing computer-assisted-image analysis
  • Development and evaluation of e-training modules for midwives and other health-care personnel for FGS diagnosis.

The role of LSHTM and NU in this collaborative project

The field survey including sample collection will be conducted at Malawi. Sample processing and analysis can take place at LSHTM and NU.

Biochemical studies with recombinant enzymes will take place at Nagasaki in collaboration with LSHTM.

We will collaborate with Prof. Hamano, Nekken (NU) for serological diagnosis.

Particular prior educational requirements for a student undertaking this project

Master’s degree in Public Health or Epidemiology.

Experience of clinical gynaecological and infectious diseases and training in epidemiology would be advantageous but not essential.

Skills we expect a student to develop/acquire whilst pursuing this project

  • Diagnostics for schistosomiasis
  • Epidemiological study design
  • Statistical analysis