Bacterial Vaginosis in Female Facility Workers in North-western Tanzania: Prevalence and Risk Factors

Overview

Journal Sex Transm Infect

Specialty Infectious Diseases

Date 2009 May 29

PMID 19473997

Citations 36

Authors

K Baisley

J Changalucha

H A Weiss

K Mugeye

D Everett

I Hambleton

P Hay

D Ross

C Tanton

T Chirwa

R Hayes

D Watson-Jones

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine prevalence of, and risk factors for, bacterial vaginosis (BV) among herpes simplex virus (HSV) 2 seropositive Tanzanian women at enrollment into a randomised, placebo-controlled trial of HSV suppressive treatment.

Methods: 1305 HSV-2 seropositive women aged 16-35 years working in bars, guesthouses and similar facilities were interviewed, examined and tested for HIV, syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, BV, candidiasis and trichomoniasis. Factors associated with BV were analysed using logistic regression to estimate odds ratios and 95% confidence intervals.

Results: BV prevalence was 62.9%; prevalence of Nugent score 9-10 was 16.1%. Independent risk factors for BV were work facility type, fewer dependents, increasing alcohol consumption, sex in the last week (adjusted OR 2.03; 95% CI 1.57 to 2.62), using cloths or cotton wool for menstrual hygiene, HIV (adjusted OR 1.41; 95% CI 1.09 to 1.83) and Trichomonas vaginalis infection. There was no association between BV and the frequency or method of vaginal cleansing. However, BV was less prevalent among women who reported inserting substances to dry the vagina for sex (adjusted OR 0.44; 95% CI 0.25 to 0.75).

Conclusion: BV was extremely prevalent among our study population of HSV-2 positive female facility workers in North-western Tanzania. Although recent sex was associated with increased BV prevalence, vaginal drying was associated with lower BV prevalence. Further studies of the effects of specific practices on vaginal flora are warranted.

Citing Articles

Connecting the dots: Exploring the relationship between menstrual hygiene and bacterial vaginosis in eastern India.

Samantaray S, Parida S, Mohapatra I J Family Med Prim Care. 2024; 13(10):4451-4456.

PMID: 39629382 PMC: 11610884. DOI: 10.4103/jfmpc.jfmpc_431_24.

Effect of metronidazole on concentrations of vaginal bacteria associated with risk of HIV acquisition.

Valint D, Fiedler T, Liu C, Srinivasan S, Fredricks D mBio. 2024; 15(12):e0111024.

PMID: 39570045 PMC: 11633388. DOI: 10.1128/mbio.01110-24.

Efficacy and safety of different drugs for the treatment of bacterial vaginosis: a systematic review and network meta-analysis.

Fan Y, Gu Y, Xian Y, Li Q, He Y, Chen K Front Cell Infect Microbiol. 2024; 14:1402346.

PMID: 39463760 PMC: 11502473. DOI: 10.3389/fcimb.2024.1402346.

Menstrual hygiene management and menstrual problems among adolescent girls in an urban area in north India: A cross-sectional study.

Ahmed S, Nimonkar R, Kalra S, Singh P, Rajiva , Singh S J Family Med Prim Care. 2024; 13(3):1012-1019.

PMID: 38736830 PMC: 11086754. DOI: 10.4103/jfmpc.jfmpc_1329_23.

Self-reported urinary tract infection and bacterial vaginosis symptoms among indigenous adolescents during seasonal periods of water scarcity: A cross-sectional study in Bandarban Hill District of Bangladesh.

Sarkar P, Rifat M, Talukdar I, Saha N, Neufeld N, Miah M Health Sci Rep. 2024; 7(5):e2107.

PMID: 38715721 PMC: 11074625. DOI: 10.1002/hsr2.2107.

References

Bukusi E, Cohen C, Meier A, Waiyaki P, Nguti R, Njeri J . Bacterial vaginosis: risk factors among Kenyan women and their male partners. Sex Transm Dis. 2006; 33(6):361-7. DOI: 10.1097/01.olq.0000200551.07573.df. View

Kapiga S, Sam N, Bang H, Ni Q, Ao T, Kiwelu I . The role of herpes simplex virus type 2 and other genital infections in the acquisition of HIV-1 among high-risk women in northern Tanzania. J Infect Dis. 2007; 195(9):1260-9. DOI: 10.1086/513566. View

Hillier S, Lau R . Vaginal microflora in postmenopausal women who have not received estrogen replacement therapy. Clin Infect Dis. 1997; 25 Suppl 2:S123-6. DOI: 10.1086/516221. View

Sewankambo N, Gray R, Wawer M, Paxton L, McNaim D, Wabwire-Mangen F . HIV-1 infection associated with abnormal vaginal flora morphology and bacterial vaginosis. Lancet. 1997; 350(9077):546-50. DOI: 10.1016/s0140-6736(97)01063-5. View

Ness R, Hillier S, Richter H, Soper D, Stamm C, McGregor J . Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina. Obstet Gynecol. 2002; 100(4):765. DOI: 10.1016/s0029-7844(02)02184-1. View

Watson-Jones D, Weiss H, Rusizoka M, Baisley K, Mugeye K, Changalucha J . Risk factors for herpes simplex virus type 2 and HIV among women at high risk in northwestern Tanzania: preparing for an HSV-2 intervention trial. J Acquir Immune Defic Syndr. 2007; 46(5):631-42. PMC: 2643092. DOI: 10.1097/QAI.0b013e31815b2d9c. View

Koumans E, Sternberg M, Bruce C, McQuillan G, Kendrick J, Sutton M . The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007; 34(11):864-9. DOI: 10.1097/OLQ.0b013e318074e565. View

Cherpes T, Meyn L, Krohn M, Lurie J, Hillier S . Association between acquisition of herpes simplex virus type 2 in women and bacterial vaginosis. Clin Infect Dis. 2003; 37(3):319-25. DOI: 10.1086/375819. View

Nagot N, Ouedraogo A, Defer M, Vallo R, Mayaud P, Van de Perre P . Association between bacterial vaginosis and Herpes simplex virus type-2 infection: implications for HIV acquisition studies. Sex Transm Infect. 2007; 83(5):365-8. PMC: 2659027. DOI: 10.1136/sti.2007.024794. View

10.

Kaul R, Nagelkerke N, Kimani J, Ngugi E, Bwayo J, MacDonald K . Prevalent herpes simplex virus type 2 infection is associated with altered vaginal flora and an increased susceptibility to multiple sexually transmitted infections. J Infect Dis. 2007; 196(11):1692-7. DOI: 10.1086/522006. View

11.

Gray R, Wabwire-Mangen F, Kigozi G, Sewankambo N, Serwadda D, Moulton L . Randomized trial of presumptive sexually transmitted disease therapy during pregnancy in Rakai, Uganda. Am J Obstet Gynecol. 2001; 185(5):1209-17. DOI: 10.1067/mob.2001.118158. View

12.

Myer L, Kuhn L, Stein Z, Wright Jr T, Denny L . Intravaginal practices, bacterial vaginosis, and women's susceptibility to HIV infection: epidemiological evidence and biological mechanisms. Lancet Infect Dis. 2005; 5(12):786-94. DOI: 10.1016/S1473-3099(05)70298-X. View

13.

Myer L, Denny L, Telerant R, De Souza M, Wright Jr T, Kuhn L . Bacterial vaginosis and susceptibility to HIV infection in South African women: a nested case-control study. J Infect Dis. 2005; 192(8):1372-80. DOI: 10.1086/462427. View

14.

Taha T, Hoover D, Dallabetta G, Kumwenda N, MTIMAVALYE L, Yang L . Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS. 1998; 12(13):1699-706. DOI: 10.1097/00002030-199813000-00019. View

15.

Victora C, Huttly S, Fuchs S, Olinto M . The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997; 26(1):224-7. DOI: 10.1093/ije/26.1.224. View

16.

Morison L, Ekpo G, West B, Demba E, Mayaud P, Coleman R . Bacterial vaginosis in relation to menstrual cycle, menstrual protection method, and sexual intercourse in rural Gambian women. Sex Transm Infect. 2005; 81(3):242-7. PMC: 1744975. DOI: 10.1136/sti.2004.011684. View

17.

Fethers K, Fairley C, Hocking J, Gurrin L, Bradshaw C . Sexual risk factors and bacterial vaginosis: a systematic review and meta-analysis. Clin Infect Dis. 2008; 47(11):1426-35. DOI: 10.1086/592974. View

18.

van de Wijgert J, Morrison C, Cornelisse P, Munjoma M, Moncada J, Awio P . Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women. J Acquir Immune Defic Syndr. 2008; 48(2):203-10. DOI: 10.1097/QAI.0b013e3181743936. View

19.

Nugent R, Krohn M, Hillier S . Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991; 29(2):297-301. PMC: 269757. DOI: 10.1128/jcm.29.2.297-301.1991. View

20.

Hassan W, Lavreys L, Chohan V, Richardson B, Mandaliya K, Ndinya-Achola J . Associations between intravaginal practices and bacterial vaginosis in Kenyan female sex workers without symptoms of vaginal infections. Sex Transm Dis. 2006; 34(6):384-8. DOI: 10.1097/01.olq.0000243624.74573.63. View