Diagnosis of genital cervical schistosomiasis: Comparison of cytological, histopathological and parasitological examination

Granulomatous inflammation of the cervix uteri is a common manifestation of infection with Schistosoma haematobium. In women the cervix is the most co mmon site of infection by S. haematobium. Three methods were used to assess the performance of three different ways of detecting schistosome eggs in c ervical tissue: cytological examination of a cervical smear, histological e xamination of a cervical biopsy, and direct examination of cervical tissue obtained by forceps biopsy (quantitative compressed biopsy technique [QCBT] ). Of 228 women studied who lived in an S. haematobium endemic area in Tanz ania, 112 (49%) had schistosome eggs detected in the cervix using QCBT Hist ological examination detected eggs in 40 of 228 (18%). The cytological exam ination of cervical smears yielded only 6 positive results (3%). The median egg load in the cervical tissue of cases correctly diagnosed by histology was significantly higher than the egg load in the misclassified cases, indi cating that the sensitivity of histological sectioning increases with egg d ensity. We conclude that the QCBT is the diagnostic test of choice for schi stosomiasis of the genital cervix.