A comprehensive review of secondary data sources has confirmed a long-suspected link between female genital schistosomiasis (FGS) and HIV infection for women in southern Africa. A researcher from the UNC Gillings School of Global Public Health was one of two co-authors of the resulting article, titled “Association Between Schistosoma haematobium Exposure and Human Immunodeficiency Virus Infection Among Females in Mozambique,” published online March 14 in the American Journal of Tropical Medicine and Hygiene.
[Photo: Dr. Kavita Singh Ongechi]
Researchers confirmed the FGS-HIV link in Mozambique, finding that exposure to schistosomiasis, combined with HIV prevalence, increases the odds of HIV infection by three times. They also concluded that treating young girls for schistosomiasis could avert millions of new cases of HIV infection at far less cost than treating HIV infection once it has occurred.
Schistosomiasis is a freshwater-borne parasitic infection, usually contracted in childhood through activities such as swimming, bathing, fishing and fetching water. It affects 261 million people worldwide and is known to be highly endemic in sub-Saharan Africa. Domestic chores can place girls and women at greater risk of contracting FGS, which may help explain the fact that only in sub-Saharan Africa are HIV infections higher among females than among males.
Dr. Kavita Singh Ongechi, research associate professor of maternal and child health at the Gillings School, wrote the paper with Dr. Paul Henry Brodish, applications analyst at MEASURE Evaluation, where Dr. Singh is senior technical adviser for maternal and child health. The co-authors conducted the study for MEASURE Evaluation, funded by the U.S. Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR), a project of the Carolina Population Center, where Dr. Singh is a faculty fellow.
The researchers confirmed the link in Mozambique by investigating two high-quality secondary data sources on HIV prevalence and FGS – the 2009 National Survey on Prevalence, Behavioral Risks and Information about HIV and AIDS in Mozambique (INSIDA) and the Global Neglected Tropical Diseases (GNTD) open source database. Their results can be applied generally to sub-Saharan Africa and perhaps especially to South Africa, Tanzania and Zimbabwe, where field studies showed women whose vaginal mucosal barrier tissue was compromised due to FGS were three times as likely as their neighbors to be infected with HIV.