Female genital schistosomiasis (FGS) is a chronic gynaecological condition resulting from infection by the waterborne parasite Schistosoma haematobium that is found in certain freshwater sources. As many as 56 million women and girls are estimated to be affected, primarily in sub-Saharan Africa.

Despite its prevalence, major barriers exist for FGS treatment, including inadequate understanding of the disease in endemic countries and enduring social stigma. Additionally, there are no specific treatment guidelines for the clinical management of FGS beyond the administration of single-dose praziquantel through mass drug administration (MDA) programmes. Praziquantel is only effective against adult Schistosoma parasites, does not relieve the painful and stigmatizing symptoms of FGS, and does not reduce the inflammation caused by the immune reaction to parasite eggs already in urogenital tissue and blood vessels.

Through the (W)initiative for Women and Girls affected by Female Genital Schistosomiasis (WINGS-4-FGS) consortium, DNDi and partners aim to investigate the efficacy and safety of anti-inflammatory medication as add-on therapy to treatment with praziquantel in women and girls living with FGS. Currently, there are no therapeutics to halt or reduce the inflammatory reaction to the parasite, resulting in chronic granuloma and fibrosis.

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The WINGS-4-FGS randomized clinical trial aims to bridge this gap by repurposing already available anti-inflammatory drugs and combining them with praziquantel in a pioneering approach to managing morbidity associated with FGS.

Alongside the clinical trial of new treatment combinations, partners in the WINGS-4-FGS consortium aim to:

• Increase community awareness and strengthen local healthcare capacity to improve case recognition and help break the cycle of FGS-related stigma,
• Test and implement a community-based, two-step FGS diagnostic process to provide a feasible, acceptable, appropriate, and effective treatment pathway, and
• Assess barriers and facilitators for the integration of diagnosis and treatment for FGS into existing health services.