Chronic Schistosomiasis, a Clinical and Laboratory Diagnostic Challenge in Malawi

Objective: Schistosomiasis cause significant morbidity and mortality worldwide. This is a retrospective cross-sectional study conducted at Mzuzu Central Hospital (MCH) from northern Malawi aiming at determining prevalence of schistosomiasis infection in cancer suspected patients. The data was collected from hospital files and the duration under review was from July 2013 to June 2018. A total of 790 Histopathological samples were analysed at University of North Carolina (UNC) Histopathology lab. Results were made available to the facility – Mzuzu Central Hospital.Results: The overall prevalence of schistosoma (S. mansoni & haematobium) infection was 1.7% (14/790). About 93% (13/14) of schistosomiasis cases were observed in female patients while 7% (1/14) from male patients. Of the 14 cases from different histopathological pattern (Cervix, Ureter, Liver, Ovary, GIT and Urinary bladder), 43% (6/14) of cases were diagnosed from cervical tissues. Correlation between HIV infection and schistosomiasis infection was not reached as Serostatus for reasonable number of patients was unknown. Schistosomiasis chronic infection is highly prevalent in Malawi. This disease is neglected and underestimated due to lack of clinical skills and capacity in most of the public laboratories to accurately diagnose it as such, most cases are misdiagnosed as cancer.