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Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: a cross-sectional study.
PLoS One. 2014; 9(10):e109670.Plos

Abstract

BACKGROUND

Clinical development of vaginally applied products aimed at reducing the transmission of HIV and other sexually transmitted infections, has highlighted the need for a better characterisation of the vaginal environment. We set out to characterise the vaginal environment in women in different settings in sub-Saharan Africa.

METHODS

A longitudinal study was conducted in Kenya, Rwanda and South-Africa. Women were recruited into pre-defined study groups including adult, non-pregnant, HIV-negative women; pregnant women; adolescent girls; HIV-negative women engaging in vaginal practices; female sex workers; and HIV-positive women. Consenting women were interviewed and underwent a pelvic exam. Samples of vaginal fluid and a blood sample were taken and tested for bacterial vaginosis (BV), HIV and other reproductive tract infections (RTIs). This paper presents the cross-sectional analyses of BV Nugent scores and RTI prevalence and correlates at the screening and the enrolment visit.

RESULTS

At the screening visit 38% of women had BV defined as a Nugent score of 7-10, and 64% had more than one RTI (N. gonorrhoea, C. trachomatis, T. vaginalis, syphilis) and/or Candida. At screening the likelihood of BV was lower in women using progestin-only contraception and higher in women with more than one RTI. At enrolment, BV scores were significantly associated with the presence of prostate specific antigen (PSA) in the vaginal fluid and with being a self-acknowledged sex worker. Further, sex workers were more likely to have incident BV by Nugent score at enrolment.

CONCLUSIONS

Our study confirmed some of the correlates of BV that have been previously reported but the most salient finding was the association between BV and the presence of PSA in the vaginal fluid which is suggestive of recent unprotected sexual intercourse.

Authors+Show Affiliations

Unit of Epidemiology and Control of HIV/STD, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.HIV/STI Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.Clinical Trials Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium.ICRH Kenya, Mombasa, Kenya.ICRH Kenya, Mombasa, Kenya.Rinda Ubuzima, Kigali, Rwanda.Wits Reproductive Health & HIV Institute, University of Witwatersrand, Johannesburg, South Africa.Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.Unit of Epidemiology and Control of HIV/STD, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.Unit of Epidemiology and Control of HIV/STD, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom, and AMC-CPCD, Amsterdam, The Netherlands.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25289640

Citation

Jespers, Vicky, et al. "Prevalence and Correlates of Bacterial Vaginosis in Different Sub-populations of Women in sub-Saharan Africa: a Cross-sectional Study." PloS One, vol. 9, no. 10, 2014, pp. e109670.
Jespers V, Crucitti T, Menten J, et al. Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: a cross-sectional study. PLoS One. 2014;9(10):e109670.
Jespers, V., Crucitti, T., Menten, J., Verhelst, R., Mwaura, M., Mandaliya, K., Ndayisaba, G. F., Delany-Moretlwe, S., Verstraelen, H., Hardy, L., Buvé, A., & van de Wijgert, J. (2014). Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: a cross-sectional study. PloS One, 9(10), e109670. https://doi.org/10.1371/journal.pone.0109670
Jespers V, et al. Prevalence and Correlates of Bacterial Vaginosis in Different Sub-populations of Women in sub-Saharan Africa: a Cross-sectional Study. PLoS One. 2014;9(10):e109670. PubMed PMID: 25289640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: a cross-sectional study. AU - Jespers,Vicky, AU - Crucitti,Tania, AU - Menten,Joris, AU - Verhelst,Rita, AU - Mwaura,Mary, AU - Mandaliya,Kishor, AU - Ndayisaba,Gilles F, AU - Delany-Moretlwe,Sinead, AU - Verstraelen,Hans, AU - Hardy,Liselotte, AU - Buvé,Anne, AU - van de Wijgert,Janneke, AU - ,, Y1 - 2014/10/07/ PY - 2014/05/21/received PY - 2014/09/02/accepted PY - 2014/10/8/entrez PY - 2014/10/8/pubmed PY - 2015/12/23/medline SP - e109670 EP - e109670 JF - PloS one JO - PLoS One VL - 9 IS - 10 N2 - BACKGROUND: Clinical development of vaginally applied products aimed at reducing the transmission of HIV and other sexually transmitted infections, has highlighted the need for a better characterisation of the vaginal environment. We set out to characterise the vaginal environment in women in different settings in sub-Saharan Africa. METHODS: A longitudinal study was conducted in Kenya, Rwanda and South-Africa. Women were recruited into pre-defined study groups including adult, non-pregnant, HIV-negative women; pregnant women; adolescent girls; HIV-negative women engaging in vaginal practices; female sex workers; and HIV-positive women. Consenting women were interviewed and underwent a pelvic exam. Samples of vaginal fluid and a blood sample were taken and tested for bacterial vaginosis (BV), HIV and other reproductive tract infections (RTIs). This paper presents the cross-sectional analyses of BV Nugent scores and RTI prevalence and correlates at the screening and the enrolment visit. RESULTS: At the screening visit 38% of women had BV defined as a Nugent score of 7-10, and 64% had more than one RTI (N. gonorrhoea, C. trachomatis, T. vaginalis, syphilis) and/or Candida. At screening the likelihood of BV was lower in women using progestin-only contraception and higher in women with more than one RTI. At enrolment, BV scores were significantly associated with the presence of prostate specific antigen (PSA) in the vaginal fluid and with being a self-acknowledged sex worker. Further, sex workers were more likely to have incident BV by Nugent score at enrolment. CONCLUSIONS: Our study confirmed some of the correlates of BV that have been previously reported but the most salient finding was the association between BV and the presence of PSA in the vaginal fluid which is suggestive of recent unprotected sexual intercourse. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25289640/Prevalence_and_correlates_of_bacterial_vaginosis_in_different_sub_populations_of_women_in_sub_Saharan_Africa:_a_cross_sectional_study_ L2 - https://dx.plos.org/10.1371/journal.pone.0109670 DB - PRIME DP - Unbound Medicine ER -