Schistosomiasis, also known as bilharzia, is a neglected tropical disease caused by worms of the genus Schistosoma. The disease is transmitted through water contamination by excreta, freshwater snails acting as intermediate hosts, and human contact with infected water (1). Key species include Schistosoma mansoni (found in Africa and South America), S. japonicum (found in South and East Asia), causing intestinal and hepatosplenic schistosomiasis, and S. haematobium (found in Africa) responsible for urinary schistosomiasis (2). Schistosomiasis is highly prevalent in sub-Saharan Africa (SSA), accounting for over 80% of the global disease burden (3). Worldwide, approximately 200 million people are infected, with 90% of those needing treatment residing in Africa. This disease remains a significant cause of parasitic morbidity and mortality globally (4).

In women, the cervix is commonly affected by S. haematobium, leading to female genital schistosomiasis (FGS). This is particularly prevalent among women who perform domestic chores in water infested with the parasite (1). FGS increases the risk of HIV infection, which has significant implications for the HIV epidemic in SSA (2). HIV worsens the severity of the disease, increases the risk of cervical cancer, and can lead to infertility (3). Urogenital schistosomiasis is widespread and often goes undiagnosed in individuals of childbearing age. FGS affects approximately 50 million women globally, creating an unmet medical need. Diagnostic tests for FGS are rarely available in rural endemic areas, resulting in inadequate care for at-risk women (4). FGS is a common complication of S. haematobium infection, affecting 33-75% of infected women, totalling around 40 million girls and women. This makes it one of the most prevalent gynaecological conditions in Africa. Social stigma exacerbates the problem, as FGS can be mistaken for sexually transmitted infections and cause hymen damage, leading to accusations of promiscuity (5).

Despite the increasing recognition of FGS as a significant yet often overlooked neglected tropical disease, there remains a substantial gap in knowledge among healthcare professionals (6). Research concerning the awareness, diagnostic capacity, and management practices related to FGS among healthcare professionals remains insufficient, particularly in endemic regions such as Mabalako, Democratic Republic of the Congo. Many healthcare professionals lack awareness of the clinical manifestations of FGS, which often resemble other reproductive health conditions, resulting in misdiagnosis or underdiagnosis. Furthermore, individual preventive behavior regarding vector-borne diseases is significantly influenced by perceived risk; a low perception of risk can consequently lead to a decrease in the adoption of preventive measures (7). The capacity for diagnosis presents a significant challenge, as FGS is seldom included in differential diagnoses due to limited access to diagnostic tools, insufficient training, and the absence of standardized clinical guidelines. Furthermore, management practices for FGS are inadequately developed, characterized by a lack of clear treatment protocols, insufficient knowledge regarding the administration of praziquantel among affected women, and inadequate integration of FGS management within reproductive and sexual health services. These deficiencies underscore the urgent necessity for targeted educational interventions, improved diagnostic resources, and the enhanced incorporation of FGS awareness into healthcare training programs. Elevating knowledge and awareness of FGS is essential for improving women’s reproductive health and mitigating the burden of this preventable and treatable condition.

This study focuses on the Mabalako health zone, an area where schistosomiasis is endemic. The primary objective is to collect pertinent data to formulate effective strategies for addressing female genital schistosomiasis (FGS) and to identify and bridge existing gaps in the knowledge, prevention, diagnosis, and management of FGS among healthcare professionals.