Abstract
BackgroundThe vaginal microbiota (VMB) are the set of microorganisms residing in the human vagina. During pregnancy, their composition is Lactobacillus-dominant in most Caucasian women. Previous studies suggest that the VMB of women with African ancestry is more likely to be non-Lactobacillus dominant (dysbiotic) compared to other populations, and possibly relate to the high incidence of pregnancy complications, such as preterm birth. This work reviewed the literature on VMB composition in pregnant women from sub-Saharan Africa.MethodsA search was conducted in PubMed and Embase databases following PRISMA guidelines. Observational and intervention studies analysing VMB communities from sub-Saharan African pregnant women using molecular techniques were included.ResultsTen studies performed in seven sub-Saharan African countries were identified. They independently showed that Lactobacillus-dominant VMB (particularly L. iners or L. crispatus) or VMB containing Lactobacilli are the most prevalent, followed by a more diverse anaerobe-dominant VMB, in the studied populations. The majority of pregnant women with a sexually-transmitted infection had a Lactobacillus-dominant VMB, but with a significantly higher presence of anaerobic species.ConclusionIn agreement with studies performed in other populations, Lactobacillus species are the most prevalent VMB species during pregnancy in sub-Saharan African women. The frequency of diverse anaerobe-dominant VMB is high in these populations. In Africa, studies on VMB in pregnancy are scant, heterogeneous in methodology, and knowledge remains limited. More insights on VMB composition and their possible sequalae among these populations is needed.
Highlights
The vaginal microbiota (VMB) are the set of microorganisms residing in the human vagina
There is increasing evidence that VMB dominated by L. crispatus, L. gasseri, or L. jensenii relate to a healthy vaginal state, and that an overgrowth of anaerobes, such as Gardnerella, Atopobium, and Prevotella species contributes to a dysbiotic vaginal state
This review aims to compile available data from original research that characterized the VMB composition among pregnant women living in sub-Saharan Tanzania cluster (Africa)
Summary
The vaginal microbiota (VMB) are the set of microorganisms residing in the human vagina During pregnancy, their composition is Lactobacillus-dominant in most Caucasian women. The number of studies on the microbial communities residing in the human vagina, the vaginal microbiota (VMB), and their role in female reproductive health has increased over the past two decades. L. crispatus has been shown to hinder colonization by anaerobe bacteria such as G. vaginalis, whereas L. iners co-exists with such aerobic microorganisms [11] It is not yet clear whether harboring facultative anaerobic bacteria should always be categorized as an unhealthy vaginal microbiota state, as this microbial composition had been observed in symptoms-free women [11]
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