Epidemiological Mapping of Male Genital Schistosomiasis Coexisting with Human Immunodeficiency Virus Infection in Wajari Community of Gombe State

Background: Male Genital Schistosomiasis (MGS), a chronic complication of Schistosoma haematobium infection, remains largely under-diagnosed despite its potential to facilitate HIV transmission. This study mapped the epidemiological burden of MGS and HIV in the Wajari ward of Gombe State, Nigeria. Methods: A multi-stage cross-sectional study was conducted among 420 adult farmers (294 completed) in Wajari Ward. Data were collected via questionnaires and clinical examinations. Urine samples were analyzed for S. haematobium eggs using filtration and microscopy. MGS and HIV burdens were estimated based on “probable cases” due to none participant consent for semen analysis and HIV screening. Spatial mapping was utilized to correlate urogenital schistosomiasis (UGS) prevalence with clinical MGS and HIV clusters. Results: The overall prevalence of UGS confirmed by urine microscopy was 15.99% (47/294) with Wajari Jodoma recorded the highest intensity of infection (10/35 positive; 28.57%) The prevalence of probable MGS was high, with the highest concentration in Wajari Jodoma (21.97%) and Jauro Bala (17.42%). Probable HIV cases peaked in Botso Botso (20.22%) and Kembuyel (17.42%). Wajari Jodoma emerged as a critical hotspot for co-endemicity (15.17% HIV; 21.97% MGS). Spatial mapping confirmed that areas with the highest UGS burden (16.15% – 18.73%) aligned with high clinical MGS reports, particularly in riverine communities. The mapping revealed distinct geographical clusters correlated with proximity to freshwater bodies and socio-behavioral factors. Conclusion: The coexistence of confirmed UGS and probable MGS/HIV in Wajari Jodoma confirms the presence of a syndemic hotspot. With an overall UGS prevalence of nearly 16%, the community remains at high risk for the chronic reproductive complications of MGS. Mapping the burden has successfully identified that the southern communities require urgent, integrated interventions combining Praziquantel treatment with HIV screening and urological care.