Table 2.

Summary of key knowledge gaps in FGS and research needs to bring FGS out of neglect

Knowledge gaps on FGS	Research needs to bring FGS out of neglect
Measure the global burden of FGS	➔ Conduct burden of disease studies across S. haematobium endemic settings ➔ Develop a framework to accurately estimate the disability weights associated with FGS including associated complications and morbidity.
Explore the pathophysiological and epidemiological associations of FGS with other SRH conditions	➔ Conduct larger longitudinal cohort studies to understand the temporal association between FGS and other SRH conditions, as well as the shared risk factors
Further validate scalable, affordable, accurate and user-friendly diagnostic strategies against a validated gold standard.	➔ Define a reference standard of care for FGS diagnosis that can be used across studies and settings for comparison of diagnostic test results
Understand the impact of praziquantel treatment on FGS clinical outcomes and genital and sexual signs and symptoms	➔ Conduct randomized controlled trials to understand the effect of praziquantel for treating FGS across age groups and endemic settings
Strategies to implement FGS control strategies outside research settings	➔ Conduct further costing studies to understand the affordability of different control strategies. ➔ Evaluate the cost-effectiveness of different FGS control strategies to inform effective implementation by the health system
Evaluate an integrated approach for FGS control within the SRH agenda	➔ Conduct further studies to understand the affordability, cost-effectiveness, coverage and acceptability of integrated control strategies for FGS and SRH conditions.