Urogenital schistosomiasis in women of reproductive age in Tanzania's Lake Victoria region

We conducted a community-based study of 457 women aged 18 - 50 years living in eight rural villages in northwest Tanzania. The prevalence of female urogenital schistosomiasis (FUS) was 5% overall but ranged from 0% to 11%. FUS was associated with human immunodeficiency virus (HIV) infection (odds ratio [OR] = 4.0, 95% confidence interval [CI] = 1.2 - 13.5) and younger age (OR = 5.5 and 95% CI = 1.2 - 26.3 for ages < 25 years and OR = 8.2 and 95% CI = 1.7 - 38.4 for ages 25 - 29 years compared with age > 35 years). Overall HIV prevalence was 5.9% but was 17% among women with FUS. We observed significant geographical clustering of schistosomiasis: northern villages near Lake Victoria had more Schistosoma mansoni infections (P < 0.0001), and southern villages farther from the lake had more S. haematobium (P = 0.002). Our data support the postulate that FUS may be a risk factor for HIV infection and may contribute to the extremely high rates of HIV among young women in sub-Saharan Africa.