'Editorial: Female Genital Schistosomiasis: Research Needed to Raise Awareness and Deliver Action."

Margaret Gyapong^1,2,3*

• ¹Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
• ²University of Health and Allied Sciences, Ho, Ghana, Ghana
• ³Institute of Health Research, University of Health and Allied Sciences, Ho, Sokode, Ghana

For this research topic, we sought original research focused on the natural history and/or epidemiology of FGS, including consequences of FGS infection, FGS infection in vulnerable populations (adolescents, pregnant women, women living with HIV), FGS treatment, FGS diagnostics, Education and training of healthcare professional, community workers, or other key groups regarding FGS, Integration of FGS services into the existing healthcare structure or programmes (family planning, youth services, antenatal care, cervical cancer screening, HIV care)We identified 77 contributors for this special issue. 16 authors confirmed their intention to submit, 3 declined, 45 were unresponsive and 13 were withdrawn. We finally received 15 from a wide range of institutions and countries in the global North and South. After a series of deliberations we are pleased to present the final 14 manuscripts that make up this special issue.With papers published between October 2023 and October 2024, this special issue begins with a case report by Marchese et al (2023) who performed an experimental screening via colposcopy for FGS at primary healthcare centers (PHCCs) in the Boeny region of Madagascar, allowing for the detection of patients with both FGS signs and HPV-related dysplasia (HPV-dy). The first two cases highlight how strengthening competencies in both the diagnosis and clinical management of precancerous lesions, as well as the presence of accessible and applicable local guidelines for the providers of health services, could contribute to improving the quality of integrated screening and clinical management processes for both FGS and CC. The third on the other hand, despite the accessibility of free health services, decided not to use them owing to the discovery of a pregnancy and fear of the possible clinical consequences of continuing the follow-up. The authors show that the screening for FGS by colposcopy, as recommended by the WHO atlas, can contribute to the early identification of CC or precancerous lesions, despite the current diagnostic limitations. https://www.frontiersin.org/journals/tropicaldiseases/articles/10.3389/fitd.2023.1270852/full Mwanzha et al in a 5 year retrospective histopathologic review in South Africa were surprised to find schistosomiasis present in the appendix, uterine cervix, urinary bladder, lung, liver, fallopian tube and prostate with FGS forming 49% of cases emphasising the need for awareness creation among care providers in the identification, diagnosis and treatment of FGS. (https://www.frontiersin.org/journals/tropical-diseases/articles/10.3389/fitd.2023.1301485/full Praziquantel has been and continues to be the main treatment for Schistosomiasis and it is interesting that in the Arenholt et al ( 2023) study on repeated versus single praziquantel dosing regimen in the treatment of female genital schistosomiasis showed no difference in efficacy. They observed that Irrespective of the dosing regimen, pelvic exam abnormalities, and urogenital complaints saw equal reductions at follow-up. They emphasize the need for initiation of praziquantel early in life and a persistent treatment strategy throughout childhood and adolescence to prevent lesions from establishing. https://www.frontiersin.org/journals/tropical-diseases/articles/10.3389/fitd.2024.1322652/full Integration of NTD into routine service delivery and other sexual and reproductive health services has been a matter of interest if Universal health coverage is to be achieved. It was therefore a pleasure to read articles from Rogers et al (2023), Preston (2023) and Pillay (2023) as they assess various ways to integrate FGS into the health system in Zambia, Ivory Coast and into Reproductive health services through a virtual international workshop bringing together health practitioners from various sectors. Lessons from the FAST package an integrated approach to dealing with FGS implemented in Ghana and Madagascar are reported by Krentel et al (2024) and Manyeh et al (2024). With the increasing interest to ensure that men are involved in reproductive health issues, Lambert and team report on the value of involving men in promoting care for FGS in mainland Tanzania and conclude that Including men more explicitly in FGS community education efforts could facilitate the provision of high-quality sexual and reproductive health care for women living in many communities where FGS is endemic but Thank you to all those who submitted paper proposals, the authors of the final manuscripts and to our reviewers who kindly gave up their valuable time and used their expertise to improve the quality of this collection. We are sure that after reading this special issue you will have a better understanding of FGS a gynaecological condition but also an NTD which is increasingly being put on the global health agenda. Together the papers underscore the importance of working together across disciplines and health sectors in order to deal with this hidden condition that women experience.