Prevalence and Associated Factors of Female Genital Schistosomiasis in Nkhotakota District, Malawi.

Background Female Genital Schistosomiasis (FGS) is an critical complication of schistosome infection, especially in schistosomiasis-endemic areas. It is a neglected disease and remains under-recognized in many areas. The prevalence of visual FGS in the endemic areas of Southern Malawi is 26.9%. This is higher in other African countries including Zambia and Tanzania and nosuch studies have been conducted in endemic areas in the Central Region of Malawi. The study aimed to determine the prevalence and risk factors for FGS in Nkhotakota district, Central Malawi. Methods The cross-sectional study was conducted from November 2024 to March 2025. Two hundred and sixty women (N=260) of childbearing age accessing healthcare services were consecutively sampled from the selected healthcare facilities. An interviewer-guided questionnaire was used to collect data regarding the demographics and FGS symptoms of the participants. Colposcopy was conducted by an experienced gynecological clinical officer to identify FGS lesions and was supervised by a specialist gynecologist. Data were coded, cleaned, and analyzed using the R software (version 4.3.1). Results The prevalence of FGS using colposcope as a diagnostic tool in women of childbearing age was 32.6%(84/258). Age and a history of cervical cancer screening were associated with increased odds of FGS. The odds of FGS increased by 5% for each additional year (OR, 1.05; 95% CI: 1.02-1.09; p = 0.003). Women with a history of cervical cancer screening were twice as likely to have FGS than those without a history of cervical cancer screening (OR, 1.91; 95% CI: 1.01-3.70; p = 0.05). Conclusion We found a huge burden of undetected FGS in Nkhotakota district, Central Malawi. Integrated interventions are needed to reduce the burden of FGS and improve its early detection, particularly in schistomiasis-endemic areas.