Scoping a social science agenda for male genital schistosomiasis in sub-Saharan Africa: posing key questions to frame appropriate research themes

The prevalence of female genital schistosomiasis (FGS) and male genital schistosomiasis (MGS) remains high in many low-to-medium-income countries, and each has sex-specific disease sequelae with wider detrimental gender and health impacts. Social science research studies on the former outnumber those on the latter. Indeed, in many countries across sub-Saharan Africa (SSA), MGS (as with male reproductive and sexual health issues in general) is overlooked, underappreciated, and broadly orphaned within urogenital and intestinal schistosomiasis research and control. Similarly, in those countries where MGS has been reported formally, its psychosocial dimensions and effects remain poorly understood, especially in terms of context-specific cultural and societal factors. In this scoping review, we attempt to better contextualize MGS within men's sexual and reproductive health and rights (SRHR) and general wellbeing, as it often draws parallels with social science research in FGS. We discuss common psychosocial determinants, highlighting why current surveillance of MGS is particularly poor and the primary health care response to mitigate it is bottlenecked and largely stalled within the wider health system, from both top-down and bottom-up perspectives. Our specific approach remains cognisant of the context of infected households where all members could be suffering from urogenital and/or intestinal schistosomiasis. Looking ahead, we develop and frame a pragmatic social science research agenda to encourage and better explore and assess the detrimental impact of MGS on infected men and boys, considering appropriate ameliorations more holistically within primary care.