Genital manifestations and reproductive health in female residents of a Wuchereria bancrofti-endemic area in Tanzania

To assess the significance of lymphatic filariasis for the development of c hronic genital manifestations and for reproductive health in women, we cond ucted a cross-sectional study of 2 villages in north-eastern Tanzania inclu ding interview and gynaecological examination of adult women, focusing prim arily on reproductive history and genital health. In a population of 2165 r esidents, prevalence of Wuchereria bancrofti microfilaraemia was 28%, and g eometric mean intensity of microfilariae (mf) was 722 mf/mL. Leg lymphoedem a (elephantiasis) was present in 4.2% of adults aged greater than or equal to 15 years, and hydrocoele in 26.5% of adult males. Five hundred and thirt y women completed an interview, and 404 of these completed a gynaecological examination. Most women were Muslims (72%), polygamy was common (29%), and 49% of women had undergone circumcision (clitoridectomy). Presence of micr ofilaraemia did not influence fertility or fertility-related variables incl uding age at menarche, parity, spontaneous abortion, stillbirth, Caesarean section and premature labour, nor presence of primary or secondary infertil ity. Mf status was strongly correlated with abnormal menstruation pattern i n the 30+ years age-group (P = 0.001), but not in the <30 years age-group. Cervical, vaginal and vulval pathology was unrelated to mf status. Two wome n, aged 46 and 77 years, had vulval oedema of probable filarial origin, bot h were mf negative. Overall, microfilaraemia appeared to have no influence on genital disease or reproductive health, and chronic manifestations of ly mphatic filariasis of the genitals does not appear to be a substantial prob lem in women.