Epidemiology of bacterial vaginosis in an indigent obstetric population

Abstract

Objective: To compare the prevalence of bacterial vaginosis (BV) to that of other genital tract infections in an indigent, rural prenatal population.Study design: At the time of their first prenatal appointment, patients had a urine culture to screen for asymptomatic bacteriuria (ASB) and were tested for gonorrhea by culture of the endocervix and for chlamydia by polymerase chain reaction. Patients with symptoms of vaginitis were screened at the time of presentation for candidiasis, trichomoniasis, and BV. In addition, all patients were routinely screened for BV at 24–28 weeks. BV was confirmed if the vaginal pH was more than 4.5, the “whiff test” was positive, and microscopic examination showed clue cells.Results: Five hundred women were included in the investigation. One hundred ninety-one (38%) women tested positive for BV. Fifty-nine (11.8%) women had symptomatic candidiasis; patients with BV were not more likely to have candidiasis. Thirty-nine (7.8%) women had either gonorrhea or chlamydia. Patients who were positive for BV were no more likely to be coinfected with gonorrhea or chlamydia than BV-negative patients. Twenty-five (5%) women had symptomatic trichomoniasis. These women were not more likely than uninfected women to have BV. Fifty-three (10.6%) of the women had ASB. Women with BV were not more likely than BV-negative women to have ASB.Conclusions: BV was present in more than one-third of the patients. BV was 3 times more common than candidiasis, 8 times more common than trichomoniasis or chlamydia, and 100 times more common than gonorrhea. Women with BV were not more likely than BV-negative women to be coinfected with other genitourinary tract pathogens.