Diagnosis
The crushed biopsy of genital tissue is considered the gold standard for the parasitological diagnosis of genital S. haematobium. However, the ova are located in highly-focal clusters and may be missed, especially with histological sectioning of a biopsy. Because this method leaves a wound in the genital area, and because women in parts of the schistosomiasis- and HIV-endemic areas might not have any choice regarding sexual intercourse or be able to suggest the use of a barrier contraceptive method, taking a biopsy is an HIV transmission risk for the patient (and her partner) until the wound has healed.
Wet smears and Pap tests can contribute to the diagnosis, but have low sensitivity. In a cytology laboratory in Harare, Zimbabwe, 44 of 1901 Pap smears were found positive; in Kampala, Uganda, only 1 in 30,000 smears were positive. Urinary filtration or dipsticks are insensitive indicators for genital S. haematobium. Moreover, the techniques themselves have been proven to be of poor value (or untested) in women of childbearing age. Increased levels of eosinophil cationic protein, Neopterin or Immunoglobulin A in cervico-vaginal lavage have only limited value in the diagnosis of female genital schistosomiasis.
Read more about this topic: Genital Schistosomiasis