Cross-sectional assessment of feasibility and acceptability in screening for female genital schistosomiasis (FGS) in two clinical settings in East Province, Cameroon

In Africa, female genital schistosomiasis (FGS) damages women's health. In Cameroon, diagnosis is rare and healthcare workers lack knowledge. Clinicians can be trained to identify FGS lesions, but the accuracy is uncertain. We assessed the acceptability and feasibility of FGS screening in Cameroon's East Province by comparing static HIV clinics and mobile pop-up clinics through consultations and acceptance rates, guided by precise disease mapping. A clinician was remotely trained to diagnose FGS lesions, with success measured by expert comparison using cervix images. The proportion of FGS was compared between settings. A total of 1242 women were approached, 624 in the HIV clinics and 618 in the mobile clinics, respectively. Women at HIV clinics were significantly older [37.0 years (interquartile range, IQR: 31-43)] than those at mobile clinics [28.5 years (IQR: 23-36)]. Refusal of the screening procedures was significantly higher in the HIV clinics (50%) than in the mobile clinics (31%). FGS lesions were present in over half of women examined, 51% in the HIV clinic and 56% in the community. The diagnostic concordance between clinicians was more than 90%. It is both feasible and acceptable to identify and treat FGS lesions in areas without specialized care. Mobile pop-up clinics' acceptability is better, with younger women participating which helps to better rectify age-inequities in FGS surveillance, and remote telemedicine training is effective. Prevalence of FGS suspect lesions was very high in both settings.