Using precision mapping of schistosomiasis to guide female genital schistosomiasis (FGS) screening in Cameroon, sub-Saharan Africa

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Abstract Schistosomiasis remains a significant public health concern in sub-Saharan Africa, particularly among women and children. In Cameroon, urogenital and intestinal schistosomiasis affect the lives of millions of impoverished populations, and female genital schistosomiasis (FGS) remains a serious threat which has not been quantified explicitly. The extent of stigmatization and discrimination related to FGS is currently unknown. This study explores the use of precision mapping to identify high-risk communities for urogenital schistosomiasis and guide targeted screening for FGS. Parasitological surveys were conducted between November 2020 and July 2021 in four health districts using urine filtration and Kato-Katz techniques, first in schools to identify areas of higher transmission, and secondly in selected high-risk communities. Geographic information system tools were employed to identify high transmission foci and households of targeted infected women. Results of surveys in schools showed no schistosomiasis transmission in Ayos (0%) and low prevalence in Akonolinga (8%), while Bertoua and Doume had high prevalence, up to 33% and 48% infection with Schistosoma haematobium , respectively. These results made the two health districts of Bertoua and Doume suitable for focused FGS investigations. Surveys in communities revealed higher schistosomiasis prevalence and infection intensity in Doume compared to Bertoua. Precision mapping effectively identified infected women and enabled targeted recruitment for further clinical studies, facilitating efficient resource allocation for gynaecological follow-up. This approach demonstrates the value of geospatial tools in enhancing targeted public health interventions, disease surveillance and control strategies.

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