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. 2024 Mar 18;4(3):e0002249.
doi: 10.1371/journal.pgph.0002249. eCollection 2024.

The WHO atlas for female-genital schistosomiasis: Co-design of a practicable diagnostic guide, digital support and training

Santiago Gil Martinez  1 , Pamela S Mbabazi  2 , Motshedisi H Sebitloane  3 , Bellington Vwalika  4 , Sibone Mocumbi  5 , Hashini N Galaphaththi-Arachchige  6 , Sigve D Holmen  6 , Bodo Randrianasolo  7 , Borghild Roald  8 , Femi Olowookorun  9 , Francis Hyera  10 , Sheila Mabote  11 , Takalani G Nemungadi  12 , Thembinkosi V Ngcobo  12 , Tsakani Furumele  12 , Patricia D Ndhlovu  13 , Martin W Gerdes  14 , Svein G Gundersen  15 , Zilungile L Mkhize-Kwitshana  16   17 , Myra Taylor  16 , Roland E E Mhlanga  18 , Eyrun F Kjetland  6   16
Affiliations

The WHO atlas for female-genital schistosomiasis: Co-design of a practicable diagnostic guide, digital support and training

Santiago Gil Martinez et al. PLOS Glob Public Health. .

Erratum in

Abstract

Up to 56 million young and adult women of African origin suffer from Female Genital Schistosomiasis (FGS). The transmission of schistosomiasis happens through contact with schistosomiasis infested fresh water in rivers and lakes. The transmission vector is the snail that releases immature worms capable of penetrating the human skin. The worm then matures and mates in the blood vessels and deposits its eggs in tissues, causing urogenital disease. There is currently no gold standard for FGS diagnosis. Reliable diagnostics are challenging due to the lack of appropriate instruments and clinical skills. The World Health Organisation (WHO) recommends "screen-and-treat" cervical cancer management, by means of visual inspection of characteristic lesions on the cervix and point-of-care treatment as per the findings. FGS may be mistaken for cervical cancer or sexually transmitted diseases. Misdiagnosis may lead to the wrong treatment, increased risk of exposure to other infectious diseases (human immunodeficiency virus and human papilloma virus), infertility and stigmatisation. The necessary clinical knowledge is only available to a few experts in the world. For an appropriate diagnosis, this knowledge needs to be transferred to health professionals who have minimal or non-existing laboratory support. Co-design workshops were held with stakeholders (WHO representative, national health authority, FGS experts and researchers, gynaecologists, nurses, medical doctors, public health experts, technical experts, and members of the public) to make prototypes for the WHO Pocket Atlas for FGS, a mobile diagnostic support tool and an e-learning tool for health professionals. The dissemination targeted health facilities, including remote areas across the 51 anglophone, francophone and lusophone African countries. Outcomes were endorsed by the WHO and comprise a practical diagnostic guide for FGS in low-resource environments.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. FGS Atlas image selection.
A group working on the selection of images for disease manifestation.
Fig 2
Fig 2. Plenary discussion.
Image selection and significance discussion in the plenary with all the groups present.
Fig 3
Fig 3. FGS Atlas prototype.
Fig 4
Fig 4. The WHO FGS atlas.
Cover and third pages [50].
Fig 5
Fig 5. FGS diagnosis support: functionalities.
Co-designed example based on groups outputs.
Fig 6
Fig 6. FGS digital diagnosis support: FGS detection.
Co-designed example based on groups outputs.
Fig 7
Fig 7. FGS e-learning.
Co-designed example based on the groups’ outputs shown on a smartphone interface.
See this image and copyright information in PMC

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