Urogenital Schistosomiasis and Sexually Transmitted Infections in Madagascar


A cross-sectional study of urogenital schistosomiasis and sexually transmitted infections (STI) prevalence and associated morbidity in a rural community in Madagascar. Clearance of infections and resolution of morbidity were subsequently studied in two phases following systematic anti-STI and anti-schistosoma treatment, respectively.

Full Title of Study: “Study of Reproductive Health in Rural Madagascar With Emphasis on Urogenital Schistosomiasis and Sexually Transmitted Infections”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Masking: None (Open Label)
  • Study Primary Completion Date: April 2002

Detailed Description

The study was conducted in the Schistosoma haematobium high-endemic SIRAMA sugarcane plantation near the Ambilobe town in the northern province of Diego Suarez in Madagascar. A neighboring low-endemic village, Mataipako, was selected a control village. Participants aged 15 to 49 years old from SIRAMA were included in the study if positive for S.haematobium egg in urine.

A questionnaire addressing previous medical history and current urogenital symptoms was applied. A physical examination, including ultrasonophical (US) examination of urinary tract by transabdominal route, was undertaken. A pelvic examination, including transvaginal US was performed in women. In men, the prostate and the seminal vesicles were examined by transrectal US.

The following sexually transmitted infections (STI) were systematically assessed:

- Neisseria gonorrheae

- Chlamydia trachomatis

- Mycoplasma genitalium

- Trichomonas

- Treponema pallidum

- Herpes simplex 1 and 2

After baseline assessment, all participants (and partners) were systematically treated with an anti-STI regimen according to the existing guidelines by the Ministry of Health in Madagascar.

Re-assessment by questionnaire, physical examination and sampling for STIs was undertaken 4 weeks later followed by systematic praziquantel treatment to general community, including study participants.

A final follow-up study following the baseline protocol was conducted 5 months later.


  • Drug: Treatment with anti-STI and anti-schistosoma regimens
    • Anti-STI regimen: ciprofloxacin 500mg orally, doxycycline 100mg BID orally 7 days and metronidazole 2g orally (cefuroxime im and/or azithromycin alternatively for pregnant and breastfeeding women) Anti-schistosoma regimen: Praziquantel 40mg/kg

Arms, Groups and Cohorts

  • Experimental: STI/PZQ 1
    • Baseline and post-treatment follow-up (anti-STI and praziquantel Rx)

Clinical Trial Outcome Measures

Primary Measures

  • Measurement of urogenital schistosomiasis and STI prevalence
    • Time Frame: 2 months

Secondary Measures

  • Urogenital and STI associated morbidity
    • Time Frame: 2 months

Participating in This Clinical Trial

Inclusion Criteria

  • adults
  • positive Schistosoma haematobium egg excretion in urine
  • signed written consensus

Exclusion Criteria

  • children
  • negative Schistosoma haematobium egg excretion in urine

Gender Eligibility: All

Minimum Age: 15 Years

Maximum Age: 49 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of Aarhus
  • Collaborator
    • Statens Serum Institut
  • Provider of Information About this Clinical Study
    • Peter Derek Christian Leutscher, MD,PhD, Danish Bilharziasis Laboratory
  • Overall Official(s)
    • Peter DC Leutscher, MD, PhD, Principal Investigator, Danish Bilharziasis Laboratory

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