Gender Inequality and the Risk of Schistosomiasis
Krystal Ward, Ingri Garcia-Guerrero & Anonymous
Human Behavior Department
Sociology 101 – 4001
Professor Flora Rudacille
December 7, 2025
Schistosomiasis is not only a neglected tropical disease but also a mirror of global inequities. The scholarship in this text demonstrates how biology, environment, and social structures converge to shape its impact. From neurological complications and pregnancy risks to untreated preschool children and gender vulnerabilities, the research highlights how schistosomiasis disproportionately affects marginalized populations. Climate change, migration, and poverty expand its reach, while limited healthcare access and entrenched inequalities deepen its consequences. Together, these sources provide a foundation for examining schistosomiasis as both a medical condition and a sociological issue, showing how human behavior, systemic barriers, and global health policies intersect in shaping outcomes.
Schistosomiasis is more than a parasitic infection; it is a story of how gender roles, social expectations, and biology intersect to shape health. Both women and men are affected, but the ways they encounter the disease are not the same. In Pakwach District, Uganda, Ssali et al. (2023) reveal how women’s daily routines like collecting water, washing clothes, and caring for families, place them in direct contact with contaminated sources. These tasks, shaped by cultural expectations, make exposure almost unavoidable. Yet when it comes to treatment, women often face barriers such as stigma, reduced autonomy, and limited access to healthcare. Female genital schistosomiasis (FGS) adds another dimension: Sturt et al. (2025) show that FGS lesions 3 increase susceptibility to human papillomavirus (HPV), which can progress to cervical precancer. Despite these risks, FGS remains underdiagnosed, reflecting broader patterns of invisibility in women’s health.
Men’s risks often stem from occupational exposure. Fishing, farming, and other waterbased labor places them in frequent contact with contaminated environments. Ssali et al. (2023) note that men are more likely to access mass drug administration programs, but this advantage is shaped by cultural norms that prioritize men’s participation in public health initiatives. At the same time, expectations of toughness or self-reliance can delay men’s care-seeking, worsening outcomes. Vadukoot et al. (2025) highlights hepatic schistosomiasis in non-endemic regions, where men’s migration for work often increases exposure, though both genders face diagnostic challenges when awareness is low.
Schistosomiasis affects both genders, but in gender-specific ways. Women’s risks are tied to domestic responsibilities and reproductive health, while men’s risks are linked to occupational labor and cultural expectations. Women face consequences such as FGS and its connection to HPV and cervical cancer, while men often experience chronic hepatic complications. Men may access treatment more readily, but women encounter systemic barriers. In non-endemic regions, both genders face diagnostic delays, yet women migrants often experience additional inequities. These comparisons show that schistosomiasis is not simply a medical condition; it reflects how gender shapes health outcomes.
Schistosomiasis is a disease written in the rhythms of daily life, and those rhythms are gendered. Women’s exposure through domestic labor and reproductive health risks, and men’s exposure through occupational labor and cultural norms reveals how the same parasite creates different vulnerabilities. Addressing schistosomiasis requires interventions that see both sides: empowering women to access care, supporting men to overcome cultural barriers, and ensuring that health systems recognize the inequities that shape outcomes. By situating schistosomiasis within gendered frameworks, we gain not only a fuller understanding of the disease but also a clearer picture of the social structures that shape health across communities.
The spread of schistosomiasis is heavily influenced by its geography. Specifically, areas with warm and fresh water are where these parasites thrive, along with places that do not have easy access to healthcare or safe water. Areas with heavily occurring cases of schistosomiasis consist of sub-Saharan Africa, the Middle East, Latin America, and Southeast Asia. These areas 5 house an ideal environment for schistosomiasis to occur (Colley et al., 2014). Additionally, everchanging factors such as climate change can alter global distribution at the hands of temperature changes, rainfall patterns, etc. (Asare et al., 2025). Globally, schistosomiasis is a significantly neglected tropical disease. The transmission of this disease is driven by limited access to healthcare, lack of water sanitation, and lack of control program coverage (Colley et al., 2010). As certain environments interact with constant socioeconomic inequalities, the global burden of schistosomiasis is likely to stay within regions of low public health effort, less environment management, and less control strategies.
In differing environmental and sociological contexts, schistosomiasis can lead to intestinal, urogenital, or even neurological complications (Alanazi et al., 2017). For example, pregnant women and children suffer hardest from this disease. Pre-school children from Lake Victoria, for instance, show higher infection rates due to repetitive contact from domestic responsibilities (Nalugwa et al., 2015). Within pregnant women, urogenital schistosomiasis sometimes leads to factors such as low-birth weight in infants, highlighting possible reproductive and developmental implications (Mombo-Ngoma, et al., 2017). From the Lake Victoria example and studies on pregnant women that suffer from schistosomiasis, we see that the disease not only poses risks from biological sustainability, but also from societal inequities that can lead to varying complications.
Africa’s climate is ideal for the reproduction and spread of snails; it also creates conditions that make schistosomiasis a persistent public-health challenge. A significant challenge Africa faces is poverty, exacerbated by poor economic policies. This disease is most common in areas with inadequate living conditions that promote poor access to clean water, sanitation, and hygiene. The lack of sufficient domestic funding for control programs and inadequate mapping of disease and snail distribution often leads to a decline in the effectiveness of control strategies over time. Healthcare in many African countries faces significant challenges, including limited access to diagnostic and treatment methods, a shortage of healthcare professionals, and underperforming health facilities (Omohwovo et al., 2024). Another major problem is that most people lack sufficient knowledge and understanding of risk factors for transmission and preventive measures.
An estimated 40 million women of childbearing age suffer from schistosomiasis. Pregnant women attending antenatal clinics in Fougamou and Lambaréné, Gabon, were consecutively screened for the presence of schistosoma haematobium eggs in diurnal urine samples (Mombo- 7 Ngoma et al., 2017). Maternal and newborn characteristics assessed at delivery were compared between infected and uninfected mothers. Urogenital schistosomiasis was diagnosed in 103 (9%) of 1115 pregnant women. Low birth weight was more common amongst infants of S. haematobium-infected mothers (Honkpehedji et al., 2017). This association was unaffected by controlling demographic characteristics, gestational age, and Plasmodium falciparum infection status. Other risk factors associated with low-birth-weight delivery were underweight mothers.
Schistosoma haematobium causes significant morbidity and may even lead to lifethreatening complications due to its predilection for the female urogenital tract. Schistosoma haematobium eggs cause granulomatous inflammation and potential obstruction in the urinary bladder, ureter, uterus, fallopian tube, and ovaries (Qunhua et al., 2000). Studies evaluating the association of S. mansoni with pregnancy outcomes have demonstrated an increased risk for anemia, preterm deliveries, and low birth weight infants (Siegrist, Siegrist-Obimpeh, 1992, Ajanga et al., 2006).
The community of people in Lake Albert has been greatly affected by this disease in many ways. People gather their resources from the water, but they cannot use contaminated water. Lake water is used for various domestic purposes, including washing, drinking, and cooking. There have been changes in lake resources and their utilization over time, which are affecting 8 local economies and ways of life. Almost all focus group discussion (FGD) participants across categories from both sites agreed that fish stocks have greatly reduced over time and that it is a critical issue. Overfishing, poor fishing methods, illegal fishing gear, population growth, and climate changes (such as the lack of rain) were given as reasons for the decrease in fish stocks (Anyolitho et al., 2025).
People are also affected by high prices due to inflation. Rising prices have reduced the profitability of snail harvesting and fishing, causing external buyers to stop purchasing these commodities. Participants suggested that minimizing contact with the lake could help address the problem of schistosomiasis in their communities (Neema et al., 2025). There was consensus across communities regarding the need for alternative water sources. The communities proposed that the government should provide alternatives such as boreholes and tap water. This would reduce their reliance on the lake for domestic water needs, thus minimizing contact and potentially solving the problem of schistosomiasis in their communities.
Overall, schistosomiasis is not just a parasitic disease. It reflects socioeconomic intersections of gender, poverty, and inequality. Women and children suffer the hardest due to social roles and systemic neglect, not biological susceptibility. From an outwards perspective, we find that eliminating this disease takes more than just medical practice. It requires resolving inequities within societies. The study of schistosomiasis goes beyond exercise and creates a call to action for global health and gender equality.
References
Alanazi, R. F., Al Karawi, M., Almalki, A., Sufiani, F., & Al Karawi, S. (2023). Schistosomiasis involving the central nervous system: Case report of a rare complication. Case Reports in Surgery, 1–5.
Anyolitho, M. K., Neema, S., Odoi, P., Adriko, M., Vennervald, B. J., Tukahebwa, E. M., Wilson, S., (2025). Community insights into societal causes of and solutions for schistosomiasis transmission in Lake Albert fishing villages: A participatory approach. Health & Place, 95, 48.
Asare, K. K., Mohammed Muhi-Deen Wonwana, A., Aboagye, Y. O., Kathrin, A., & Ritter, M. (2025). Impact of climate change on schistosomiasis transmission and distribution— Scoping review. International Journal of Environmental Research and Public Health, 22(5), 812.
Colley, D. G., Bustinduy, A. L., Secor, W. E., & King, C. H. (2014). Human schistosomiasis. The Lancet, 383(9936), 2253–2264.
Mombo-Ngoma, G., Honkpehedji, J., Basra, A., Mackanga, J. R., Zoleko, R. M., Zinosu, J., … Ramharter, M. (2017). Urogenital schistosomiasis during pregnancy is associated with low birth weight delivery: Analysis of a prospective cohort of pregnant women and their offspring in Gabon. International Journal for Parasitology, 47(1), 69–74.
Nalugwa, A., Olsen, A. K., Tukahebwa, M. E., & Nuwaha, F. (2015). Intestinal schistosomiasis among preschool children along the shores of Lake Victoria in Uganda. Acta Tropica, 142, 115–121.
Omohwovo, E. J., Gabaake, K. P., & Lucero-Prisno, D. P. (2024). Challenges of schistosomiasis control in Africa: The path ahead. ProQuest, 3(1).
Salvador, F., Bocanegra, C., Treviño, B., Sulleiro, E., Sánchez-Montalvá, A., Serre-Delcor, N., … Molina, I. (2024). Imported schistosomiasis in travelers: Experience from a referral tropical medicine unit in Barcelona, Spain. Travel Medicine and Infectious Disease, 60, 102742.
Sanches, R. C. O., Mambelli, F., & Oliveira, S. C. (2022). Neutrophils and schistosomiasis: A missing piece in pathology. Parasite Immunology, 44(6), 1–10.
Ssali, S. N., Morgan, R., Nakiranda, S., Opio, C. K., & Otmani, M. d. B. (2023). Gendered lives, gendered vulnerabilities: An intersectional gender analysis of exposure to and treatment 12 of schistosomiasis in Pakwachdistrict, Uganda. PLoS Neglected Tropical Diseases, 17(11).
Mombo-Ngoma, G., Honkpehedji J., Basra, A., Mackanga, J. R., Zoleko, R. M., Zinosu, J., Dejon Agobe, J. C., Lell, B., Matsiegui, P. B., Gonzales, R., Agnandji, T., Yazdanbakhsh, M., Mendez, C., Kremsner, P. G., Adegnika, A. A., Ramharter, M., (2017). Urogenital schistosomiasis during pregnancy is associated with low birth weight delivery: analysis of a prospective cohort of pregnant women and their offspring in Gabon. International Journal for Parasitology, 47(1), 69-74.
Omohwovo, E. J., Gabaake, K. P., Lucero-Prisno, D. P., (2024). Challenges of schistosomiasis control in Africa: The path ahead. ProQuest 3 (1).
