Absence of cervical schistosomiasis among women from two areas of north-eastern Brazil with endemic Schistosoma mansoni

Genital manifestations in schistosomiasis haematobium are common and are associated with considerable morbidity. Although Schistosoma mansoni may also cause genital disease, the frequency of this complication is not known. Cervical biopsies (N=401) and Pap smears (N=981) were therefore collected from women living in two S. mansoni-endemic areas (in the states of Alagoas and Ceará, in north-eastern Brazil). The women were screened for the presence of sexually transmitted diseases and for the presence, in their cervical smears and/or biopsies, of S. mansoni eggs. Attempts at schistosomiasis control, which began in both study areas in 1977, have led to generally low intensities of infection (<30 eggs/g faeces in 99% of infections) and community prevalences of infection that range between 1% and 52%. As no schistosome ova were detected in any of the biopsies or smears, it appears that the risk, among women, of genital manifestations of S. mansoni infection is small in areas where the parasite load in the population is low (as the result of interventions to control intestinal schistosomiasis).