Examining the Types and Consequences of Female Genital Mutilation in Somalia: A Cross-Sectional Study on the Burden and Impact of Acute and Long-Term Complications

Background: In Africa, female genital mutilation (FGM) is a widespread and harmful practice, with Somalia having the highest incidence at 98%. This practice has severe and long-lasting physical and mental health consequences. The aim of the study was to evaluate the different types of FGM;immediate and long-term complications associated with the practice, and identify factors related to its prevalence. Method: In a one-year cross-sectional hospital-based study, data were collected from females aged 18 - 50 with a history of FGM. Face-to-face semi-structured questionnaires were used for data collection. Data analysis was performed using SPSS version 26, utilizing univariate and bivariate analyses to identify correlations between variables, which were presented in tables. Results: In a study involving 255 female participants, 65.5% were between 18 and 30 years old. The majority (82.7%) were married, while 47.1% were illiterate. FGM cases were more prevalent in rural areas (61.6%). Among the participants, 45.1% were employed. Type 3 FGM was the most common (44.3%), followed by Type 2 (32.2%) and Type 1 (23.9%). In terms of short-term complications experienced by circumcised women, the most common were bleeding, reported by 29.8% of participants, followed by infection (25.1%), and urinary retention (19.2%). Among the long-term complications observed, recurrent vaginal infections were the most prevalent, affecting 29.8% of the surveyed females. This was episiotomy during delivery (22.3%) and genital scarring (10.2%). Conclusion: The study reveals that Type 3 FGM is highly prevalent among the surveyed females, contributing to an increased risk of recurrent vaginal infections, prolonged second stage of labor, higher likelihood of episiotomy during delivery, and genital scarring. These findings emphasize the urgent need for effective preventive strategies and implementation from both international and local organizations to eliminate the harmful practice of FGM.

A Content Analysis Study Describing Information Regarding Female Genital Mutilation Present in US Medical Textbooks

This study examines the depth of information regarding Female Genital Mutilation (FGM)/Female Cutting (FC) present in US medical textbooks. According to Klein et al. (2018) [1], despite substantial attention regarding the effects of FGM, this practice is still ongoing all over the world. Healthcare providers are very important actors who need to understand FGM in order to provide care to girls and women subjected to it, but the small amount of existing work in this area shows a low level of knowledge and training about FGM/FC among U.S. physicians. The Center for Disease Control and Prevention (CDC) first published the estimated number of girls at risk of FGM/FC in the U.S. to be about 168,000 in 1997;that number had increased to 513,000 girls in the US by 2012 (according to Goldberg et al.) In this study, a small sample of medical textbooks were analyzed for the degree to which the textbooks include information regarding FGM/FC. The results of this study show that US medical textbooks do not include information regarding FGM/FC, suggesting that most medical providers don’t have knowledge and training about FGM/FC. The inadequate information on FGM/FC in medical textbooks reflects a culturally biased lack of recognition of the number of girls and women affected in the US. This maintains an ongoing pattern of silence that reinforces gender inequality. Considering the inadequate information covered in US medical textbooks on FGM/FC, and the concordant lack of provider training to provide advice and care to affected girls and women, incorrect and missed diagnoses may lead to harm to victims of FGM/FC. Providers would be better equipped to care for women and girls if their medical training included information regarding FGM/FC.

Urological Complications of Female Genital Mutilation: A Case Report of 15 Patients

Objective background: This was a retrospective study of the clinical and therapeutic aspects of urological complications of female genital mutilation in the urology department of Bamako’s Gabriel Touré University Hospital. Methods: Our study took place from 2002 to 2017 in the urology department of the Gabriel Touré University Hospital in Bamako and concerned cases of complications of female genital mutilation. Our study included all girls or women presenting with urinary disorders related to complications of genital mutilation and received in urological consultation and surgical management. Results: The average age of our patients was 2.5 years, with extremes ranging from 3 months to 35 years. The oldest patient had presented with dystocia during both deliveries. Acute urine retention (n = 7) was the most frequent reason for consultation. Other signs included urinary incontinence, pollakiuria and burning. Physical examination revealed clitoridectomy and abrasion of the labia minora in 13 patients. Type III of the WHO classification of female genital mutilation was the most frequent and corresponded to infibulation.

Culture, Beliefs, Attitude and Peer Group Influence on Female Genital Mutilation in Southeast Nigeria

Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of Culture, Beliefs, attitude and Peer Group Influence on the persistence Female Genital Mutilation practice in the State especially in the rural areas. Materials and Methods: Qualitative study that used Focused Group Discussion and In-depth interviews for data collection. Those willing and given consent were recruited into the group discussion according to age, marital status, educational level and their location in the state. In-depth interviews were used with the Stake Holders, Opinion Leaders, Traditional Rulers and the Clergy. Result: A total of 454 participants were recruited from the 13 local government areas of Ebonyi State but only 420 (92.5%) participated. The age ranges of participants were 25 to 35 years for single males and females while the married participants male and female were aged 35 to 70 years. One hundred single females (23.8%) and 94 single males (21.4%) participated while 97 (23.1%) married women and 95 (22.6%) married men participated. Out of the 26 health workers recruited only 22 (5.2%) participated. Four traditional rulers, 4 women leaders, 4 youth leaders and 2 clergy 12 (2.9%) in number had in-depth interviews. All the participants had knowledge of FGM and its practice. Rural health workers are getting more involved. ‘Female Genital Crushing’ is replacing actual cutting. The participants all agreed there is no benefit and the practice should stop. Conclusion: Female Genital Mutilation is secretly practiced and is getting replaced by “Female Genital Crushing” perpetrated by rural health workers as well as mothers, fathers, traditional birth attendants and the peer group playing a major role with low knowledge of the Law against Female genital mutilation.

The Prevalence of Female Genital Bilharziasis (FGB) in the Northern Region of Senegal

Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth and even cervical cancer. It represents a real public health problem. We therefore conducted a study in the maternity ward of the Saint-Louis regional hospital, with the overall aim of determining the prevalence of FBG in patients undergoing colposcopy. The specific objectives were to define the patient profile, and to compare colposcopic images with the World Health Organization (WHO) atlas. Methodology: We conducted a descriptive, analytical cross-sectional study of all colposcopic images taken at the maternity ward of the Saint-Louis regional hospital from August 1, 2018, to September 30, 2020, i.e. 25 months. The images were compared with the BGF images described in the WHO atlas. Results: We collected 178 colposcopy images. FBG images numbered 50, or 28%. The mean age of the patients was 44.5 years ±11.4 at the extremes of 18 and 78 years. Mean gestational age was 4.69 ± 2.72. Among patients with a bilharzian lesion on the cervix, visual acid inspection (VIA) was negative in 60% of cases (p = 0.007, Odd Ratio = 3.6 (1.49 - 9.07)). Conclusion: the results of our study show that FBG is a reality in our daily practice. It occurs in adult, multigestating, non-occupational women whose examination reveals a negative visual inspection with acetic acid (VIA). Healthcare providers therefore need to be trained in the recognition of lesions associated with genital bilharziasis, and public awareness needs to be raised.

Perceived Effects of Female Genital Mutilation on Gender Sports Participation and Performance： Implications to Sports Administration and Management in Nigeria

The purpose of this study was to find out the perceived effects of FGM （female genital mutilation） on gender sports performance： implications to sports administration and management in Nigeria. A total of 250 purposively selected regular female athletes from five Nigerian universities （two federal universities, two state universities and one private university）, in the south-East Geopolitical zone of the country. A self structured questionnaire with reliability value of 0.73. The test-retest method was used for data collection. Data collected were subjected to descriptive statistics of frequency, percentage and Chi-square inferential statistics at 0.05 level of significance. Findings revealed that majority perceived FGM as harmful and detrimental to excellent sports performance, administration and management. Based on the result of the study, it was therefore recommended that government should design programmes aimed at improving the education of the girl-child as this has been identified as one of the factors which will help to change the attitude of mothers towards the practice of FGM.

New models to study vulvodynia: hyperinnervation and nociceptor sensitization in the female genital tract

Vulvodynia is a prevalent form of chronic pain, most com- monly affecting the vaginal vestibule （vestibulodynia） （Pukall et al., 2016）. Women with vulvodynia describe intense pain in response to light touch of the affected region, such that sexual function and other activities can be severely limited. Medical costs associated with vulvodynia are high, exceeding $21 billion annually in the United States （Xie et al., 2012）. The high level of direct medical costs has been linked to high treatment failure rates. Many women with the disorder consult multiple practitioners and undergo multiple courses of treatment with limited benefit.

Primary Malignant Amelanotic Melanoma in the Female Genital Tract:A Report of Six Cases and a Review of the Literature

OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 1991 and 2006 in our hospital were reviewed.RESULTS Of these cases,4 were preliminarily misdiagnosed as chorioepithelioma,sarcoma,adenocarcinoma or lymphoma.Two patients were determined to have AMFGT preoperatively after positive immunohistochemical staining for both S-100 protein and HMB-45.Specimens removed from all 6 cases were tested for immunohistochemical staining,as well as H&E histochemical stains.S-100 and vimentin were both positive in all patients,and HMB-45 was positive in 3 out of 5 patients.Four patients recurred(at 6,6,12 and 19 months) a er primary treatments.Three patients died(at 13,18 and 19 months) a er the initial diagnosis.CONCLUSION Because of an absence of pigmentation AMFGT is extremely difficult to diagnose.Combined immunohistochemical staining,such as the S-100 protein,HMB-45 and vimentin etc,is important in the evaluation of AMFGT.Correct diagnosis plays a crucial role in the treatment of this disease.

Bivariate Logistic Regression of Knowledge as Predictor of the Practice of Female Genital Mutilation in Ekiti State,Nigeria

Female genital mutilation/cutting(FGM/C)is a harmful traditional practice with severe health implications among women and girls.This study determined whether knowledge reduced the practice of female genital mutilation and identified the socio-demographic factors that predicted the practice of female genital among parents in Ekiti State,Nigeria.A cross-sectional quantitative research method was employed among 600 selected parents in the three senatorial districts of Ekiti-State,Nigeria between March and June 2019.A pretested structured questionnaire was used to collect data.Our analysis revealed that 468(78%)of the respondents believed that the practice was high as against 132(22%)who said the practice was low.Female is two times more likely to practice FGM than male(OR=1.614,B=0.479,p<0.05,CI=1.088-2.394).Respondents with low knowledge were significantly 11 times likely to practice female genital mutilation compared with respondents with high knowledge(OR=10.597,B=2.361,p<0.05,CI=6.813-16.483).Those who lived in rural areas were two times significantly(OR=1.690,B=0.525,p<0.05,CI=3.246-13.197)likely to practice female genital mutilation than the urban dwellers.The study concluded that respondents’knowledge,location(urban/rural),sex,age,and ethnicity were strong predictors of the practice of FGM/C in Ekiti-State,Nigeria.With these findings in mind,the community institutions would play a great role in changing the community through spreading information about the health implications of FGM/C for the practice to be drastically reduced.

Iatrogenic Female Genital Fistula, 35 Cases Report

Introduction: Female genital fistula (FGF), remains a world concern, especially in low developed country. Obstructive (blocked) delivery labor is his principal cause, sometimes by pelvic surgery (urogenital or obstetrical, rectal) more rarely by congenital urogenital malformation, excision, pelvic neoplasm, pelvic radiotherapy. We were interested in iatrogenic FGF treated in the special referral fistula center. Methodology: We report 35 cases of iatrogenic female genital fistula. Are included only cases by urogenital surgery, excision in the National Referal Center of Obstetrical Fistula. Were not included cases happened by over 12 hours blocked delivery labor, caustic destruction, pelvic cancer pelvic infection and those with incomplete file. The epidemiologic, clinical and therapeutic information were studied. All ethical protocols were respected. Results: CNRFO recorded 743 cases of female genital fistula from May 23 2013 to May 23 May 2018 within 35 iatrogenic cases (4.71%). Patients were 19 - 29 years old (42.85%), average age 35 years old, extremes 19 - 60 years, without occupation (82.86), grand multiparous 48.57%, with a mean of 4 previous deliveries. The principal constancies were hysterectomies 71.43%, caesarean section 17.14%, genital excision 11.42%, and cystocele cure 11.42%. The anatomical finds were soft vagina tissue 97.14% uretero-vaginal fistula 45.71% (2 cases post Caesarean, 14 cases post hysterectomy), vesico-vaginal 31.43% (all post hysterectomy), ureteral 11.42% (all post caesarean), 1 vesico-uterine 5.71% (case post caesarean), 1 case after a cystocele cure, 2 uretro-vaginal 11.42% secondary of genital excision. Treatment was ureteral reimplantation (18/31) cases by abdominal way, fistulorraphy (12/31) and 1uretroplasty by vaginal, 4 cases treated with transurethral bladder probe. 30 were cured by fistulas surgery, 1 urinary tress incontinency and 1 not closed, and 4 of transurethral bladder probe were cured. Conclusion: The female genital fistula is sometimes the consequence of Caesarean, hysterectomy, gynecological surgery, urologic surgery and some traditional practices.

Men＇s Perspectives on the Relationship Between Sexuality and Female Genital Mutilation in Egypt

This paper addresses men＇s perspectives on the relationship between female genital mutilation/cutting （FGM/C） and women＇s sexuality in Egypt with the purpose of studying how men and women see a relationship between FGM/C and sexual life, The study used qualitative methods and was conducted in three sites. Men saw FGM/C as the key to ensuring women＇s sexual morality, and considered FGM/C as the key to controlling sexual relationships. Men were reported to increasingly take part in the decision-making about daughters＇ FGM/C. In men＇s view, FGM/C reduces female sex drive and thereby keeps girls chaste before marriage and women faithful during marriage. Men wholeheartedly support FGM/C for these reasons. However, others are ambivalent due to a concern that the practice might have negative consequences on their own sexuality as a consequence of a negative effect on their wives＇ sexual feelings. The study concludes that men＇s role is important and that they should be involved in community activities against the practice. It also concludes that without comprehensive sexuality education, men will continue to hold on to the misconceptions that FGM/C has a positive effect on women＇s sexual morality through reducing their sexual desire.

Management of a Total Coalescence of the Labia Majora in an 11-Year-Old Girl Following a Female Genital Mutilation: A Case Report

Female genital mutilation (FGM) is still a topical practice in several African regions or countries. They constitute a violation of human rights, in particular because of their harmful consequences for the health of the people who suffer them and are the source of various complications. We report a case of FGM complications in the form of total coalescence of the labia majora with a small hole from which urine flows permanently. The management was a disinfubilation with suturing of the edges and urethral reimplantation and the evolution was favorable with complete healing after two (2) weeks.

Status Quo and Future Development of Female Genital Cosmetic Surgery(Intimate Surgery)

With advances in the standards of living and public perceptions,female genital cosmetic surgery is becoming a new hot topic in the field of plastic surgery,gaining considerable interest recently among beauty seekers and professionals alike.However,the needs of beauty pursuers seem to be exuberant but vague;on the other hand,practitioners who have received strict professional training are still desperately needed.Additionally,interestdriven marketing and promotion render the field prone to chaos,resulting in widespread attention and concerns regarding the scientificity,safety,effectiveness,and necessity of the performance of multiple treatment procedures.Extensive survey of the relevant literature was performed,and several beauty seekers as well as surgeons with working experience of pertinent techniques were consulted,in order to examine the current status and future developments of this field.

Female genital schistosomiasis,human papilloma virus infection,and cervical cancer in rural Madagascar:a cross sectional study

Background Women’s health in resource-limited settings can benefit from the integrated management of high-burden diseases,such as female genital schistosomiasis(FGS)and human papilloma virus(HPV)-related cervical cancer.In schistosomiasis-endemic countries such as Madagascar,data on FGS and HPV prevalence are lacking as well as preventive measures for both conditions.This study aims to estimate the prevalence of FGS and HPV in rural Madagascar,and to examine associated risk factors to identify opportunities for improving women’s health.Methods After initial community outreach activities,interested women aged 18-49 years were recruited consecutively in 2021 at three primary health care centers in the district of Marovoay.FGS was detected by colposcopy.Colposcopy images were double-blind reviewed by two independent specialists.A Luminex bead-based assay was performed on cervical vaginal lavage specimens for HPV typing.Crude(CPR)and adjusted prevalence ratios(APR)of associations between selected factors and FGS and HPV positivity were estimated using univariable and multivariable binary Poisson regression with 95%confidence intervals(CIs).Results Among 500 women enrolled,302 had complete information on FGS and HPV diagnosis,and were thus eligible for analysis.Within the sample,189(62.6%,95%CI:56.9-68.1)cases of FGS were detected.A total of 129 women(42.7%,95%CI:37.1-48.5)tested positive for HPV.In total,80 women(26.5%,95%CI:21.6-31.8)tested positive for both conditions.No association was observed between FGS and HPV positivity,while previous pregnancy(APR=0.65,95%CI:0.43-0.78)and older age(APR=0.59,95%CI:0.42-0.81)are showing a negative association with HPV infection compared to no previous pregnancy and younger age groups.Conclusions The results of the study show that FGS and HPV are highly prevalent in rural Madagascar.The concurrent prevalence of these two conditions requires urgent adaptations of public health strategies to improve women’s health,such as integrated services at primary level of care.

Preoperative Evaluation for Complex Female Genital Tract Malformation Using Three？dimensional Printing Technology

A 33-year-old woman, gravida 1, para 0, came to the hospital with the chief complaint of severe dysmenorrhea and infertility. Her menstrual cycle was regular, bleeding moderately for 3–5 days with an interval of 30 days. She was diagnosed with ectopic pregnancy and received the left salpingectomy in September 2014. Intraoperative exploration showed a slightly enlarged retroverted uterus with a wide fundus and a normal right fallopian tube. As a further examination of infertility, hysterosalpingography was done in January 2016, which showed a unicornuate uterus （left） with an obstructed unilateral fallopian tube. She was referred to the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital in February 2016. Her basic body temperature showed biphasic pattern. The sperm test of her husband was normal. Physical examination indicated two vaginal orifices in the vestibule, with a vertical septate lying in between. The left lateral vaginal lumen could be easily expanded and speculated, and a normal cervix was seen at its top. In contrast, the cervix was unable to be seen through the right lateral vaginal lumen, which was narrow and difficult to be exposed or inspected. Pelvic ultrasound scan showed that the uterus was 4.7 cm ×6.0 cm × 3.6 cm in size, along with the Y-shaped endometrium of 0.8 cm in thickness, and a normal echo in the muscular layer. No abnormalities were found at the bilateral adnexa areas or pelvic cavity. Besides, the bilateral renal areas and ureters were found normal in the ultrasound scan as well.

HUMAN PAPILLOMAVIRUS IN CONDYLOMA ACCUMINATA AND OTHER BENIGN LESIONS OF THE FEMALE GENITAL TRACT

PCR was used to detect (HPV) in condyloma accuminata (CA),pseudocondyloma whose cause is unclear,and the other benign lesions in female genital tract.The results showed that HPV prevalence rate in CA was 98.2%,type 6 was in 11 was 85.7%,

Clinicopathologic analysis of angiomyofibroblastoma of the female genital tract

To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry The immunohistochemical studies were performed on paraffin embedded sections using the standard ABC method with a panel of antibodies Results Angiomyofibroblastoma predominantly occurred in middle aged women in the genital region, especially in the superficial area of the vulva Clinically, most of the tumors presented as slowly growing painless masses and were often diagnosed as Bartholin's gland cysts Histologically, the tumors were all well circumscribed and characterized by alternating hypocellular and hypercellular areas with abundant thin walled blood vessels The tumor cells were bland and spindle shaped or epithelioid and tended to concentrate around the vessels or cluster in small nests Immunohistochemically, the tumor cells expressed vimentin and estrogen receptor protein in all 10 cases and desmin in 9 cases Three cases showed weak or focal immunoreactivity to alpha smooth muscle actin and muscle specific actin All ten patients were treated by local excision Follow up showed a benign course with no signs of recurrence Conclusions Angiomyofibroblastoma is a distinctive neoplasm that has a propensity to occur in the female genital tract Recognition of this entity is important to avoid misdiagnosis with other vulvar angiomyxoid neoplasms

Sperm preparation： state-of-the-art--physiological aspects and application of advanced sperm preparation methods

For assisted reproduction technologies （ART）, numerous techniques were developed to isolate spermatozoa capable of fertilizing oocytes. While early methodologies only focused on isolating viable, motile spermatozoa, with progress of ART, particularly intracytoplasmic sperm injection （ICSI）, it became clear that these parameters are insufficient for the identification of the most suitable spermatozoon for fertilization. Conventional sperm preparation techniques, namely, swim-up, density gradient centrifugation and glass wool filtration, are not efficient enough to produce sperm populations free of DNA damage, because these techniques are not physiological and not modeled on the stringent sperm selection processes taking place in the female genital tract. These processes only allow one male germ cell out of tens of millions to fuse with the oocyte. Sites of sperm selection in the female genital tract are the cervix, uterus, uterotubal junction, oviduct, cumulus oophorus and the zona pellucida. Newer strategies of sperm preparation are founded oni （i） morphological assessment by means of＇motile sperm organelle morphological examination （MSOM E）＇; （ii） electrical charge; and （ili） molecular binding characteristics of the sperm cell. Whereas separation methods based on electrical charge take advantage of the sperm＇s adherence to a test tube surface or separate in an electrophoresis, molecular binding techniques use Annexin V or hyaluronic acid （HA） as substrates. Techniques in this category are magnet-activated cell sorting, Annexin V-activated glass wool filtration, flow cytometry and picked spermatozoa for ICSI （PICSI） from HA-coated dishes and HA-containing media. Future developments may include Raman microspectrometry, confocal light absorption and scattering spectroscopic microscopy and polarization microscopy.

Metastasis to a uterine leiomyoma originating from lung cancer: a case report

The uterus is an uncommon site of metastasis espe-cially from a primary lung adenocarcinoma. More fre-quently, extragenital primary tumours, including lung cancer, metastasize to the ovaries. In the literature, lung cancer metastasizing to the uterus is rare and has been reported to involve the endometrium and uterine serosa. Here, we report an unusual case of a 58-year-old woman who had a history of lung adenocarcinoma with subsequent metastasis to a single uterine fbroid only. The patient was known to have a long history of asymptomatic fibroids. In 2008, she was diagnosed with lung adenocarcinoma which was treated with pri-mary surgery and adjuvant chemotherapy. Four years later, a routine abdominal computerised tomography scan showed an enlargement of the fibroid and she underwent a hysterectomy and bilateral salpingo-oophorectomy. Pathology reported a lung adenocarci-noma metastatic to the uterine leiomyoma with a simi-lar morphology to the original pulmonary malignancy and this was confirmed with immunohistochemical staining. She had no evidence of metastatic disease elsewhere. The final diagnosis was metastasis of a primary lung adenocarcinoma confined to a uterine leiomyoma. Our patient also fulflled the criteria for a phenomenon called tumour-to-tumour metastasis in this case a primary malignancy having metastasized to a benign tumour. In conclusion, metastasis of a pri-mary lung cancer to the female reproductive tract has been documented, but clinicians should also be aware that metastasis to benign gynaecological tumours such as fbroids can also occur, especially in the setting of tumour-to-tumour metastasis. In addition, the clinical history and use of immunohistochemistry are invalu-able in reaching a diagnosis.

Urogenital schistosomiasis and soiltransmitted helminthiasis(STH)in Cameroon:An epidemiological update at Barombi Mbo and Barombi Kotto crater lakes assessing prospects for intensified control interventions

Background:The crater lakes of Barombi Mbo and Barombi Kotto are well-known transmission foci of schistosomiasis and soil-transmitted helminthiasis having had several important control initiatives previously.To collect contemporary epidemiological information,a cross-sectional survey was undertaken inclusive of:signs and symptoms of disease,individual treatment histories,local water,sanitation and hygiene(WASH)-related factors and malacological surveillance,with molecular characterisation of specimens.Methods:At each lake,a community cross-sectional survey was undertaken using a combination of stool and urine parasitological sampling,and interview with pro-forma questionnaires.A total of 338 children and adults participated.Material from snail and parasite species were characterised by DNA methods.Results:Egg-patent prevalence of urogenital schistosomiasis was 8.7%at Barombi Mbo(all light-intensity infections)and 40.1%at Barombi Kotto(21.2%heavy-intensity infections).Intestinal schistosomiasis was absent.At Barombi Kotto,significantly more women reported signs and symptoms associated with female genital schistosomiasis.While there had been extensive recent improvement in WASH-related infrastructure at Barombi Mbo,water contact risk scores were higher among schistosomiasis-infected participants(P<0.001)and at Barombi Kotto in general(P<0.001).Across both lakes,mean prevalence of STH was very low(6.3%)evidencing an impressive decrease of 79.0%over the last decade;neither Strongyloides stercoralis nor Ascaris lumbricoides were found.A total of 29 freshwater sampling sites were inspected for snails,13 in Barombi Mbo and 16 in Barombi Kotto;water chemistry differed significantly(P<0.0001)between lakes for both mean pH(7.9 v.9.6)and mean conductivity(64.3μS v.202.1μS)respectively.Only two Bulinus camerunensis found on the central island of Barombi Kotto were observed to shed schistosome cercariae,but schistosome DNA was later detected in Bulinus sampled from both lakes as well as in Indoplanorbis exustus,an invasive species from Asia.Conclusions:STH is currently at very low levels while urogenital schistosomiasis is of greatest concern at Barombi Kotto.This assessment highlights a unique opportunity for further study of the epidemiological dynamics at these crater lakes,to evaluate future intensified interventions both in terms of gaining and sustaining control at Barombi Kotto or in moving towards local interruption of transmission of both diseases at Barombi Mbo.