*1Nguepi, M. S. D., 1Ubre, S. I., 1Tincho, M. B., 1Egoko, M. D., 2Nanfack, C. D., 1Noubissi, P. A., 1Agbor, F. I., and 1Lambou, A. F.
1Faculty of Health Science, University of Buea, Cameroon
2University of Yaounde I, Cameroon
*Correspondence to: syldong@yahoo.fr; Tel: 696510217
Abstract:
Background: Schistosomiasis is a disease affecting particularly people living in low-income countries. Egg sequestration in the female genitalia, leading to female genital schistosomiasis (FGS), is associated with the release of reactive oxygen species (ROS) that can lead to secondary infertility, which remains underdiagnosed. This study was conducted to determine the prevalence and risk factors associated with FGS and urogenital schistosomiasis (UGS) and to assess some biochemical markers associated with these conditions.
Methodology: This was a descriptive cross-sectional survey of 330 women aged 15 to 50 years, conducted in selected fishing communities in the Matta health area of Western Cameroon. Information on socio-demographic characteristics and risk factors were collected from each participant using a structured questionnaire. UGS and FGS were diagnosed from analysis of urine and vaginal secretion respectively by microscopy and PCR amplification of extracted DNA of Schistosoma haematobium and Schistosoma mansoni. Biochemical analyses of markers of oxidative stress [levels of malondialdehyde (MDA), nitric oxide (NO) and reduced glutathione (GSH), and activities of superoxide dismutase (SOD) and catalase (CAT)] and cytokine profiling (TNF-α, INF-γ, IL-1β, IL-6 and IL-10) were determined in serum samples and vaginal secretions. Univariate and multivariate logistic regression analyses were used to determine associations of FGS, UGS, and potential risk factors.
Results: The prevalence of UGS and FGS was 45.7% and 60.0% respectively. Detection of schistosome DNA by PCR revealed a prevalence of 100.0% and 94.5% for S. haematobium and S. mansoni infection respectively. Nevertheless, among those infected, just 23.5% shed eggs in urine. Marital status was a risk factor of infection. Analysis of the oxidative stress markers revealed significantly higher levels of NO and MDA in serum and vaginal secretions of infected persons with highest level in women with FGS. Lower levels of GSH, CAT and SOD activity in serum and vaginal secretion in women with UGS and FGS was observed particularly in women with FGS. High IL-10 level was observed in both urine and vaginal secretions.
Conclusion: These results indicate increased oxidative stress in UGS and FGS particularly in the cervicovaginal tract. However, high levels of IL-10 might prevent immunopathology and limit severity of the disease, from a shift to Th2 immune response.
Keywords: Schistosomiasis, female genital, urogenital, inflammation, oxidative stress
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