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Abstract
Context: Bacterial vaginosis has been prospectively linked to various adverse reproductive and pregnancy related events. Objective: To determine the prevalence of bacteria vaginosis among first time antenatal clinic attendees in Northwest Nigeria. Study design, setting and subjects: A Cross sectional study conducted at the Antenatal clinic of the Ahmadu Bello University Teaching Hospital, Zaria, north-west Nigeria. A total of 228 consecutive booking clients were enrolled from April to June, 2008. Main outcome measures: Presence of at least three of the following: (i) thin, white homogenous discharge, (ii) clue cells on microscopy, (iii) pH of vaginal fluid >4.5 (iv) release of fishy odor on adding alkali (10% potassium hydroxide) or positive whiff test (Amsel’s criteria) and (v) relative proportion of bacteria morphotypes on gram staining (The Nugent score). Results: In all 220 (96.5%) clients concluded the study and were analyzed. Prevalence of bacteria vaginosis (BV) was 14.6% using the Nugent score. Prevalence of asymptomatic BV was 9.6%. Eleven (34.4%) of the clients with BV were symptomatic while 21 (65.6%) were asymptomatic. There was no significant difference in the prevalence of BV between symptomatic and asymptomatic women. Presence of clue cells on microscopy (χ2=10.5, p=0.001), absence of yeast cells (χ2=4.120, p=0.042) and isolation of Gardnerrella vaginalis (χ2=36.480, p=0.000) were significantly associated with BV. BV was more prevalent in the second trimester (81.3%) among parous women with low education, low economic status, in polygamous marriages, who had not used hormonal contraceptives or who were HIV positive. Amsel criteria method had a low sensitivity of 37.5% and a specificity of 70.7%, a positive predictive value of 17.9% and negative predictive value of 86.9%. Conclusion: It is necessary to screen for BV in high risk women with previous untoward events like low birth weight and preterm delivery especially in the second trimester.
Highlights
Study design, setting and subjects: A Cross sectional study conducted at the Antenatal clinic of the Ahmadu Bello University Teaching Hospital, Zaria, north-west Nigeria
Amsel criteria method had a low sensitivity of 37.5% and a specificity of 70.7%, a positive predictive value of 17.9% and negative predictive value of 86.9%
The infection was more prevalent (16, 50.0%) among those aged 25-29 years who were 2.2 times more likely to present with bacteria vaginosis (BV) than any other age group (χ2=4.49, P-value=0.03, OR=2.24, CI: 1.05, 4.79)
Summary
Study design, setting and subjects: A Cross sectional study conducted at the Antenatal clinic of the Ahmadu Bello University Teaching Hospital, Zaria, north-west Nigeria. Main outcome measures: Presence of at least three of the following: (i) thin, white homogenous discharge, (ii) clue cells on microscopy, (iii) pH of vaginal fluid >4.5 (iv) release of fishy odor on adding alkali (10% potassium hydroxide) or positive whiff test (Amsel’s criteria) and (v) relative proportion of bacteria morphotypes on gram staining (The Nugent score). Prevalence of bacteria vaginosis (BV) was 14.6% using the Nugent score. Eleven (34.4%) of the clients with BV were symptomatic while 21 (65.6%) were asymptomatic. There was no significant difference in the prevalence of BV between symptomatic and asymptomatic women. BV was more prevalent in the second trimester (81.3%) among parous women with low education, low economic status, in polygamous marriages, who had not used hormonal contraceptives or who were HIV positive. Amsel criteria method had a low sensitivity of 37.5% and a specificity of 70.7%, a positive predictive value of 17.9% and negative predictive value of 86.9%
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