Female genital schistosomiasis (FGS) in migrants - a systematic review of reported cases

Female genital schistosomiasis (FGS) is the manifestation of schistosomiasis in the lower and the upper reproductive organs. In endemic areas FGS is frequent with a tremendous impact on reproductive health. Anecdotal observations indicate that FGS also occurs in women emigrating from endemic areas who had moved to countries of the Global North. The objective of this study is to summarize existing knowledge on FGS in migrants with a focus on morbidity, diagnosis, and treatment. For this systematic review, electronic medical databases including are PubMed/Medline, ScienceDirect and Google Scholar were searched for reports on FGS in migrants from January 1980 to October 2024. Additionally, literature not listed in PubMed such as Ph.D. thesis and other types of research documents not published in scientific journals was also investigated by looking into and by contacting scientists known to have worked on female genital schistosomiasis in the past. After screening, 35 cases of FGS in migrants were identified. The most common manifestation of FGS was at the Fallopian tubes (= 16), followed by the cervix (= 6), the ovaries, the uterus (each = 4), the breasts and the vulva (each = 2), and in one case in the vagina. In all cases the diagnosis was spurious. This study shows that the manifestations of FGS in migrants are different from manifestations of FGS in travellers returning from endemic areas after holidays, and include life-threatening sequelae, such as extra-uterine pregnancy. Frequently, the diagnosis was established after years of suffering.