Community-based study of genital schistosomiasis in men from Madagascar

Lancet. 2000 Jan 8;355(9198):117-8. doi: 10.1016/S0140-6736(99)04856-4.


Detection of Schistosoma haematoblum eggs in 43% of semen samples with Increased levels of eosinophil cationic protein suggests that the genital organs of men are frequently affected with schistosomiasis.

PIP: This community-based cross-sectional study was undertaken to assess the frequency of genital schistosomiasis among men in Androvakely, Madagascar, where Schistosoma haematobium is prevalent. Egg excretion and levels of eosinophil cationic protein (ECP) were measured in paired urine and semen samples obtained from 44 males eligible for the study. Findings revealed that the eggs of S. haematobium were detected in 25 urine samples (57%) and in 19 semen samples (43%). The median egg output (range) in urine was 10 eggs/ml (1-950); in semen, 3 eggs/ejaculate (1-19). Median ECP concentration in urine was 2.2 mcg/l; in semen, 109.0 mcg/l. Moreover, the concentration of ECP in urine was positively correlated with the number of eggs excreted in urine, and increased levels of seminal ECP were significantly associated with the presence of eggs in semen. The presence of eggs in 43% of the semen samples indicated that genitals were common sites for oviposition in men with S. haematobium infection. Based on the findings, a similar effect of genital schistosomiasis on HIV shedding in men, with egg deposition in the genital organs, can lead to an inflammatory response, which may then increase the viral load in semen from HIV-positive people.

Publication types

  • Letter

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Blood Proteins / urine
  • Cross-Sectional Studies
  • Eosinophil Granule Proteins
  • Eosinophils
  • Genital Diseases, Male / epidemiology*
  • Genital Diseases, Male / microbiology
  • Humans
  • Madagascar / epidemiology
  • Male
  • Middle Aged
  • Ribonucleases*
  • Schistosoma haematobium / isolation & purification
  • Schistosomiasis haematobia / epidemiology*
  • Semen / microbiology


  • Blood Proteins
  • Eosinophil Granule Proteins
  • Ribonucleases