Prevalence Of Bacterial Vaginosis Research Articles

Using unsupervised machine learning to classify behavioral risk markers of bacterial vaginosis.

This study used an unsupervised machine learning algorithm, sidClustering and random forests, to identify clusters of risk behaviors of Bacterial Vaginosis (BV), the most common cause of abnormal vaginal discharge linked to STI and HIV acquisition. METHODS: Participants were 391 cisgender women in Miami, Florida, with a mean of 30.8 (SD = 7.81) years of age; 41.7% identified as Hispanic; 41.7% as Black and 44.8% as White. Participants completed measures of demographics, risk behaviors [sexual, medical, and reproductive history, substance use, and intravaginal practices (IVP)], and underwent collection of vaginal samples; 135 behavioral variables were analyzed. BV was diagnosed using Nugent criteria. We identified four clusters, and variables were ranked by importance in distinguishing clusters: Cluster 1: nulliparous women who engaged in IVPs to clean themselves and please sexual partners, and used substances frequently [n = 118 (30.2%)]; Cluster 2: primiparous women who engaged in IVPs using vaginal douches to clean themselves (n = 112 (28.6%)]; Cluster 3: primiparous women who did not use IVPs or substances [n = 87 (22.3%)]; and Cluster 4: nulliparous women who did not use IVPs but used substances [n = 74 (18.9%)]. Clusters were related to BV (p < 0.001). Cluster 2, the cluster of women who used vaginal douches as IVPs, had the highest prevalence of BV (52.7%). Machine learning methods may be particularly useful in identifying specific clusters of high-risk behaviors, in developing interventions intended to reduce BV and IVP, and ultimately in reducing the risk of HIV infection among women.

Association between serum carotenoids and bacterial vaginosis infection among American women.

Bacterial vaginosis (BV) is a widely occurring vaginal inflammation in women of childbearing age caused by dysbiosis of the vaginal flora. Few studies have investigated the effect of serum carotenoids on the development and pathogenesis of BV. This study thus aimed to explore the correlation between serum carotenoids and BV in American women. The analysis included 1252 participants with BV from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2004. Multiple logistic regression was conducted to explore the correlation between BV and serum carotenoids, while smooth curve fitting was utilized to examine potential nonlinear correlations. Furthermore, stratified subgroup analyses and sensitivity analyses were conducted. ORs reflected the correlation between BV and serum carotenoids. Results of multiple logistic regression indicated that total serum carotenoids and BV had an inverse correlation. In the fully adjusted model II, the quartile with the highest levels of α-carotene and β-cryptoxanthin had a substantially lower incidence of BV. Smooth curve fitting revealed a significant negative linear correlation between serum carotenoids and the incidence of BV. The negative correlation between serum carotenoids and BV was relatively stable in stratified analyses. Moreover, in sensitivity analyses, the association between serum carotenoids and BV persisted, and β-carotene became significantly negatively correlated with BV. This study found an inverse correlation between serum carotenoids and the prevalence of BV.

Association between body mass index and prevalence of bacterial vaginosis: Results from the NHANES 2001-2004 study.

The impact of bacterial vaginosis on women's health is an increasing concern; however, the effect of the obesity index on bacterial vaginosis is controversial. We investigated the association between body mass index and bacterial vaginosis in women in the United States. This was a cross-sectional study which obtained the data from the National Health and Nutrition Examination Survey from 2001 to 2004, in which weighted multivariate regression and logistic regression analyses were performed to explore the independent relationship between body mass index and bacterial vaginosis. Subgroup analyses and smoothed curve fitting were also performed. A total of 5,428 participants were enrolled, and the findings show that the participants with higher body mass index tended to have a higher incidence of bacterial vaginosis. In the fully adjusted model, a positive association between bacterial vaginosis and body mass index was observed (Odd's ratio = 1.03, 95% Confidence interval, 1.01-1.04). The subgroup analysis showed that this positive association was significant in non-Hispanic White individuals (Odd's ratio = 1.0327, 95% Confidence interval, 1.0163, 1.0493). Increased bacterial vaginosis positivity may be associated with an increased body mass index.

A Cross Sectional Study on Prevalence of Bacterial Vaginosis in Preterm and Term Labor

Background: The aim is to examine bacterial vaginosis (BV) in women with preterm and term labor, explore the link between bacterial vaginosis and preterm labor (PTL), and analyze complications for both mother and baby related to bacterial vaginosis. Design: Hospital based cross sectional study. Materials and Method: We had conducted an observational study at Basaveshwara Medical College and Hospital, involving 100 pregnant patients with preterm and term labor (50 patients in each group). Eligible patients attending the Obstetrics and Gynecology Outpatient Department (OBG OPD) and inpatient department will be included. Bacterial vaginosis will be determined using Amsel's criteria, which include evaluating discharge characteristics, vaginal pH, amine odor with KOH test, and presence of clue cells under microscopic examination. Additionally, vaginal swabs will undergo Gram staining. Results: The percentage of patients meeting Amsel's criteria for diagnosing bacterial vaginosis was significantly higher in the preterm labor group compared to the term labor group, with a statistically significant difference. According to Amsel's criteria, the prevalence of bacterial vaginosis was 30% in the preterm labor group and 2% in the term labor group. Conclusion: Bacterial vaginosis is a significant risk factor for preterm labor. Hence, conducting tests for bacterial vaginosis and promptly treating it can help reduce the risk of preterm labor.

High-risk human papillomavirus prevalence among South African women diagnosed with other STIs and BV.

Human papillomavirus (HPV) infection is a leading cause of cervical cancer. Although this relies on infection and persistence of HPV in epithelial cells, often occurring in the context of other sexually transmitted infections (STIs) and bacterial vaginosis (BV), data on the relationships between these and their relative effects on epithelial barrier integrity in women remain sparse. This study describes the epidemiology of HPV combined with STI and/or BV prevalence and the relative impact on matrix metalloproteinases (MMPs) among South African women. Roche Linear Array was used for HPV genotyping in menstrual cup pellets of 243 HIV-negative women participating in the CAPRISA 083 cohort study. Vulvovaginal swabs were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis using Xpert® CT/NG assay and lateral flow assay, and Gram staining was performed to diagnose BV using Nugent scoring criteria. Concentrations of 5 MMPs were measured in menstrual cup supernatants by multiplexed ELISA. Fisher's exact tests, Mann-Whitney U tests, and multivariable regression models determined associations between HPV infection, STI and/or BV, and MMP concentrations. HPV was prevalent in 34% of women (83/243; median 23 years, interquartile range (IQR) 21-27 years). Low-risk (lr) (71%, 59/83) and high-risk (hr)-HPV infections (54.2%, 45/83) were common. Hr-HPV was frequently detected in STI and/or BV-positive women compared to women without STIs or BV (p = 0.029). In multivariable analysis, BV was associated with increased odds of hr-HPV detection (OR: 2.64, 95%CI: 1.02-6.87, p = 0.046). Furthermore, Gardasil®9 vaccine-type strains were more frequently detected in women diagnosed with STI and/or BV (55.2%, 32/58 vs 24%, 6/25; p = 0.009). Among STI and/or BV-positive women, HPV detection was significantly associated with increased MMP-10 concentrations (b = 0.55, 95% CI 0.79-1.01; p = 0.022). Most women with hr-HPV had another STI and/or BV, emphasizing an urgent need for STI and BV screening and intensive scale-up of cervical cancer screening and HPV vaccination programmes. Furthermore, the study highlights the need for more extensive research to confirm and understand the relationship between HPV infection and barrier integrity.

Bacterial vaginosis due To Gardnerella Species and Risk Factors: A Cross-Sectional Study among Women of Reproductive Age at Mbalmayo District Hospital, Cameroon

Objectives: Bacterial vaginosis is the most prevalent genital infection, characterized by malodorous vaginal discharge, and has arisen as a public health concern due to its link to sexually transmitted illnesses. The purpose of this cross-sectional study was to determine the prevalence of Gardnerella species’ bacterial vaginosis and the risk factors related with this infection in childbearing women at the Hospital of District of Mbalmayo. Methodology: A questionnaire was administered before each vaginal swab sample was obtained. Gardnerella species’ bacterial vaginosis was classified as a Nugent score of 7 to 10, and the presence of clue cells. Results The findings were as follows: 210 women were enrolled in this study. The average age was 29.42±5.15 years, with extremes ranging from 18 to 49 years. The age group with the highest representation (38.67%) was 26-33 years. The prevalence of bacterial vaginosis was 42.85% (90/210), with Gardnerella species present at 90% (81/90) and Mobiluncus species present at 3.33%. The 18-25 age group was more susceptible to Gardnerella species infections (35.80%), although the student group was the most affected (32.09%), and the difference was not statistically significant. With a prevalence of 44.44%, the single group was statistically significantly more exposed to this vaginal infection than the other groups. University-level women had a higher prevalence of Gardnerella species infection (54.32%), followed by secondary-level women (37.03%). Gardnerella species vaginosis was found in both pregnant and non-pregnant women (38.27% and 61.72%, respectively). Conclusion: To avoid future obstetric difficulties, this infection must be effectively managed therapeutically.

A COMPARATIVE OBSERVATIONAL STUDY ON EFFECTIVENESS OF PROBIOTICS AND ANTIBIOTICS IN BACTERIAL VAGINOSIS

Introduction: Bacterial vaginosis is a common vaginal dysbiosis in women of reproductive age. Bacterial vaginosis is a dysbiosis characterized by a reduction of Lactobacillus species, such as L. crispatus, L. gasseri, and L. Jensenii. Anti-microbial resistance of BV pathogens and low long-term cure rates have been increasing in the few years. Aim: Probiotics are proposed as an alternative treatment for BV applying live micro-organisms with the capacity to confer health benefits to the patient. Methods: Patients with white discharge per vagina with or without foul smell, and itching visiting Obstetrics and Gynecology OPD are subjected to Amsel criteria. Those test positive for 3 out of 4 are diagnosed to have bacterial vaginosis and were enrolled in the study. Result: Highest prevalence of bacterial vaginosis was at the age group of 26-30 years (28%), with the lowest prevalence (16%) above 40 years of age. Among group A (probiotics), 68% and 32% of women were in not working and working groups, respectively, when compared with group B (antibiotics), 64% and 36% of women were in not working and working groups. Nulligravida (28% and 32%), Singleton Pregnancy (32% and 16%) in Group A and Group B. We observed that patients treated with both antibiotics (50%) and probiotics (50%) had similar recurrence rates of BV. Conclusion: Hence it would be prudent to prefer probiotics in patients with BV, as they colonize other normal commensals and have similar efficacy as that of antibiotics. The other beneficial factors of probiotics include acceptability to patients and nil side effect profile.

The Prevalence of Bacterial Vaginosis among Infertile Iraqi Women and Subsequent ICSI outcome

The vaginal microbial makeup has a substantial impact on women's health. The typical vaginal microbial profile in healthy women of reproductive age comprises aerobic, facultatively anaerobic, as well as obligately anaerobic organisms. However, the optimal vaginal microbiota is dominated by lactobacilli and is thought to defend against pathogenic microbial colonization and infection by producing lactic acid, antimicrobial metabolites, and lowering immune system activation. Recent research has come up with the term "molecular bacterial vaginosis (BV)" to describe non-optimal vaginal microbiota that is low in Lactobacillus species (spp.) and has a lot of facultative and absolute anaerobic bacteria specifically Gardnerella vaginalis. In the context of IVF, BV has been linked to infertility. The study comprised forty-six women to explore the vaginal and follicular microbiota of asymptomatic infertile Iraqi women starting an ICSI trial. At the time of ova pick-up, a high vaginal swab and follicular fluid were acquired from each instance for DNA extraction to test for the presence of microorganisms by the use of a real-time PCR special commercial kit. In conclusion, molecular technologies have offered a more thorough view into the vaginal microbiota, which may explain why vaginal dysbiosis shifts during the ICSI-ET treatment. Even though the majority of women have no clinically visible infection, the fact is that they have an aberrant vaginal micro-ecology profile. Nevertheless, isolating microorganisms from follicular fluid did not reduce the likelihood of fertilization or the pregnancy rate during ICSI cycles.

Longitudinal assessment of bacterial vaginosis prior to and during incident pregnancy: an observational study in Kenyan adolescent girls and young women

ObjectiveTo determine bacterial vaginosis (BV) status at multiple time points among adolescent girls and young women (AGYW) and assess the impact of pregnancy on their BV status.DesignLongitudinal cohort study.SettingThika, Kenya.ParticipantsAGYW...

Biocenosis of the vagina and modern approaches to the correction of vaginal dysbiosis (Literature review)

In the modern world it is important to understand the interaction of macro- and microorganisms in normal conditions and during illness. It is the biotope of the vagina that plays an extremely important role in a woman’s organism and it reflects the general state of woman’s health. Urogenital endogenous microflora is not static, it is a constantly changing macropopulation. In this population the number of specific types of microorganisms fluctuates within the limits of changes in the conditions of their environment. The microflora of the vagina changes during different periods of a woman’s life, namely during perinatal, late neonatal, prepubertal, pubertal, reproductive and postmenopausal periods, as well as the menstrual cycle, daily and hourly. The ability of commensal microorganisms to protect the region from the invasion of their own microflora from other cavities and the microflora of the sexual partner is unique. Considering the general global trend towards the increase in prevalence, virulence and resistance of microorganisms to traditional methods of antiseptic therapy, as well as the appearance of new types of microorganisms, a steady trend towards an increase in infectious diseases, including sexually transmitted infections, is determined. Dysbiosis is considered qualitative and quantitative violations of the corresponding biotope of the normal flora. According to official statistics, the prevalence of bacterial vaginosis is 10-35% among all patients with pathological vaginal discharge. The variability of the vaginal microbiome is widely studied in the world and depends on many factors, namely the hormonal background of a woman’s organism, her diet, the characteristics of urination and defecation, menstruation, hygienic procedures and infections. One of the key links in the pathogenesis of vaginal infectious diseases is the ability of bacteria to form biofilms, which are microbial associations. Infections caused by film-forming strains of pathogenic and opportunistic microorganisms are characterized by an atypical course, insufficient effectiveness of antibiotic therapy, and often transition to a chronic form or carriage. Therefore, understanding the mechanisms of formation, structure and regulation of vital activities of biofilms helps in solving problems related to human health. The World Health Organization recommends evaluating the vaginal microbiome according to the Hay – Ison criteria. Determining the pH of vaginal secretions also helps to establish the type of vaginal dysbiosis. Clinical therapy includes two main stages of treatment: antiseptic measures and restoration of one’s own vaginal microbiome. Often, these two stages of therapy are carried out simultaneously. Correcting the pH of the vaginal secretion is also important.

Factors Associated with Bacterial Vaginosis in Women of Reproductive Age

The BV is the most prevalent alteration of the vaginal microbiota and constitutes an important public health problem, the prevalence varies by age, ethnicity, socioeconomic factors, and geographic region and the risk factors associated with this condition, are included the number of sexual partners, the use of the intrauterine device, use of vaginal douche, hygiene habits and sexual practices/behaviors. To determine the prevalence and factors associated with bacterial vaginosis in women of reproductive age. Cross-sectional study was developed in Botucatu, Brazil, including 315 women. Data were obtained by applying a questionnaire and gynecological examination, with sample collection for analysis of the vaginal microbiota pattern, according to the Nugent scoring system. The association between independent variables and outcome was performed using a regression model. The variables that most influenced the outcome (p&lt;0.20) were taken to the multiple logistic regression model and those independently associated with the outcome (p&lt;0.05) were identified. The prevalence of bacterial vaginosis was 32% (101/315) and the associated variables were: not living with a partner [1.13(1.02-1.25), p=0.021], use of vaginal douche [1.42(1.22-1.64), p=0.000] and genital hair removal [1.19(1.01-1.42), p=0.042]. Results point to the importance of screening for this vaginal dysbiosis in routine gynecological care and suggest the importance of health professionals conducting guidance on proper intimate hygiene practices for women.

Low prevalence of bacterial vaginosis in Kenyan adolescent girls and rapid incidence after first sex

Bacterial vaginosis (BV) is a risk factor for sexually transmitted infections (STI) including HIV. Adult African women have high prevalence of BV, but it is not known when first BV occurs. We sought to describe BV in younger African women, before and after first sex, and to determine incidence of BV and significant correlates of BV incidence and recurrence. In a prospective observational cohort study enrolling adolescents with limited sexual experience, young women ages 16-21 were recruited in Thika, Kenya. Eligible participants were HIV and HSV-2 seronegative and reported zero or one lifetime sexual partner. Nugent score was determined at quarterly visits from vaginal Gram stains. Trends in BV were described over time; hazard ratios were calculated using Cox regression and relative risk of BV was estimated using generalized estimating equations and Poisson regression. We enrolled 400 participants with a median age of 18.6 years (IQR 16-21). The majority (322, 80.5%) reported no history of sex, while 78 (19.5%) reported sex with 1 partner. At enrollment, BV (Nugent score ≥7) was uncommon (21 of 375, 5.6%). Overall, 144 participants had BV at least once, for an incidence rate of 16.5 cases per 100 person-years. Prior to first sex, BV was present at 2.8% of visits, compared to 13.7% of visits post-first sex. An adjusted model of BV incidence observed that first sex was associated with more than twofold increased BV risk (aHR 2.44, p=0.009, CI 1.25-4.76). Chlamydia diagnosis (aHR 1.73, p=0.02, CI 1.1-2.8) and HSV-2 seropositivity (aHR 2.88, p=0.021, CI 1.17-7.09) were both associated with incident BV. A multivariate GEE model including all episodes of BV demonstrated risk factors including first sex, STIs, urban residence, recent sex and no income; the most important risk factor was first sex (aRR 1.92, p=0.018, CI 1.12-3.31). Probability of BV increased with each subsequent episode; mean Nugent scores increased after each BV episode. Using detailed longitudinal observation, we found that Kenyan adolescents have almost no BV prior to first sex, and that initiation of sexual activity was the strongest risk factor for both prevalent and incident BV.

Prevalence of Bacterial Vaginosis in Preterm Labour and Its Fetal and Maternal Outcome

Introduction: Preterm births accounts for about 11.1 % of births worldwide. Infection accounts for 20% – 40% of these cases and Bacterial vaginosis has been found in 15 % of preterm labor group.&#x0D; Objective: To find the prevalence of Bacterial vaginosis among the cases who presented with preterm labour and to determine its maternal and neonatal outcome.&#x0D; Methodology: A prospective cross- sectional analytical study on 100 preterm labour cases conducted over a year in the obstetric ward in Manipal Teaching Hospital. Three high vaginal swabs from posterior fornix were taken and tested in Microbiology laboratory. The maternal and neonatal outcome of women with preterm labour due to bacterial vaginosis were noted. The data were analyzed using SPSS 21. Chi2 test was used for comparing maternal and neonatal complications positive or negative with Bacterial Vaginosis.&#x0D; Results: In the study period, 584 women had preterm deliveries. The total deliveries during that period was 2,531. The prevalence of Bacterial vaginosis in PTB was found to be 17 %.The accuracy of Gram stain was found to be 90% (sensitivity-57%, specificity-92%, PPV-36%, NPV-96%). The accuracy of wet mount was 90 % (sensitivity-42.85%, specificity-93.5%, PPV-33.3%, NPV95.6%). There were increased cases of chorioamnionitis among women who were BV positive (p-value=0.02). Newborn born to women with BV positive had increased chance of poor Apgar score at 5 minutes (p-value &lt;0.05).&#x0D; Conclusion: Maternal and neonatal complications were more common in women with preterm labour associated with Bacterial Vaginosis. Gram stain and wet mount are fairly accurate and can be used as an adjunct to culture for the diagnosis of Bacterial Vaginosis.

ASYMPTOMATIC URINARY TRACT INFECTION IN PREGNANT WOMEN WITH BACTERIAL VAGINOSIS ATTENDING TERTIARY CARE HOSPITAL, VISAKHAPATNAM

Objective: Determining the prevalence of bacterial vaginosis and asymptomatic bacteriuria in pregnant women who were prenatal outpatients and inpatients at a tertiary care hospital was the goal of the current investigation.&#x0D; Methods: During a one-year period, a total of 234 prenatal women from the OP and IP (GYN and OBG dept.) department representing various age and parity groups and gestational ages attended tertiary care teaching hospital. The samples were subjected to standard microbiological techniques for identification of microorganisms. Amsel's criteria and Nugent scoring system were applied for diagnosis of bacterial vaginosis.&#x0D; Results: Out of 234 study subjects, Increased homogenous vaginal discharge was found in 132 patients (56.4%), whiff’s test positive was seen in 59 patients (25.2%), clue cells were observed in 48 patients (20.5%) and pH greater than 4.5 was seen in 115 patient high vaginal swabs (49.1%). Maximum numbers of cases 109 were reported in the Nugent’s score 7-10 (80.7%) out of 135 cases. Among 234 urine samples subjected to microbiological analysis, 82 urine samples showed microbial growth. The major isolate was E. coli 34 (41.4%) followed by Proteus species 18 (21.9%).&#x0D; Conclusion: In order to avoid pregnancy difficulties, it is advised that antenatal health care institutions examine pregnant women for vaginitis. Moreover, women with BV should get a UTI screening. Antibiotic usage should be promoted responsibly, while misuse of antibiotics should be discouraged. Douching and having several sexual partners are risk factors for BV, hence precautions should be done.

Prevalence, Associated Factors, and Appropriateness of Empirical Treatment of Trichomoniasis, Bacterial Vaginosis, and Vulvovaginal Candidiasis among Women with Vaginitis.

Trichomoniasis (TV), bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC) are the most common causes of vaginitis. This study investigated the prevalence of these diagnoses, their associated factors, and the appropriateness of the empirical treatment. From March 25, 2019, to June 17, 2022, 429 women with symptoms or signs of vaginitis were enrolled in a hospital in northern Taiwan with 438 episodes of vaginitis. Vaginal swabs were collected for Gram's staining, in vitro cultures for Trichomonas vaginalis, bacteria, and yeasts, and multiplex PCR assay for TV, BV, and VVC. Their empirical treatments were recorded. Factors associated with different etiologies of vaginitis were sought in multivariable logistic regression models. The prevalence of TV, BV, and VVC were 2.1%, 22.8%, and 21.7%, respectively, while coinfections of BV and VVC, TV and BV, TV and VVC, and triple infection occurred in 5.0%, 0.2%, 0.2%, and 0.7%, respectively. Multivariable analyses revealed that having multiple sexual partners was associated with TV and BV (adjusted odds ratio [aOR] 9.756 and 3.246, respectively), while menopausal women were less likely to have VVC (aOR 0.184). Moreover, dysuria was associated with TV (aOR 4.981), vaginal itch and pelvic pain with VVC (aOR 3.223 and 0.425, respectively), and discharge pH > 4.5 with BV (aOR 1.767). Other clinical symptoms and pelvic examination features had limited value for differential diagnosis. Among the 78 empirical antifungal and metronidazole prescriptions, 55.2% were ineffective or unnecessary. Our study highlights the importance to integrate appropriate diagnostic tools into the clinical care of women with vaginitis. IMPORTANCE Vaginal complaints are widespread among women and are associated with emotional, physical, and economic burdens with challenges in their diagnosis and management. In this survey, we identified that 40% of vaginitis in Taiwan was caused by either trichomoniasis, bacterial vaginosis, vulvovaginal candidiasis, or a combination of these infections. Our data suggested that typical physical findings appeared infrequently among women with these infections and their empirical treatments were frequently inappropriate. Our findings highlighted the importance of integrating proper diagnostic tools into clinical practice to improve the diagnosis and management of vaginitis, as recommended by national and international guidelines.

Incidence, recurrence, and prevalence of bacterial vaginosis from acute to chronic HIV infection in a prospective cohort of women in South Africa

We investigated the incidence, recurrence, prevalence, and risk factors for bacterial vaginosis (BV) diagnosis starting from acute HIV infection among South African women. The Centre for the AIDS Programme of Research in South Africa 002 study tested and treated women for BV (Nugent score 7-10) once/twice annually from acute to chronic HIV infection (2004-2020). We estimated BV incidence as the number of new cases and recurrence as the number of subsequent diagnoses per 100 person-years (PYs). We fitted Anderson-Gil Cox-proportional-hazard regression models to determine factors associated with BV incidence or recurrence. Of 235 participants, the median age at enrollment was 25 years (Inter Quartile Range [IQR] 22-29). BV prevalence at enrollment was 50.6%. BV incidence was 23.9 cases per 100 PYs, and recurrence was 51.3 cases per 100 PYs. BV incidence/recurrence was associated with younger age (<25 years: adjusted hazard ratio [aHR] 1.70, 95% confidence interval [CI] 1.27-2.27), detectable HIV viral load (aHR 1.54, 95% CI 1.27-1.87) and lower CD4 count (<350 cells/μL: aHR 1.33, 95% CI 1.01-1.76). Our findings underscore the need for early antiretroviral treatment initiation with diagnostic BV and sexually transmitted infection care, especially among younger women.

Analysis of the related factors of atypical squamous cells of undetermined significance (ASC-US) in cervical cytology of post-menopausal women.

Atrophy of the reproductive tract mucosa caused by the decrease of estrogen may increase the detection rate of ASC-US in cervical cytology of post-menopausal women. In addition, other pathogenic infections and inflammation can change the cellular morphology and increase the detection rate of ASC-US. However, further studies are needed to elucidate whether the high detection rate of ASC-US in post-menopausal women leads to the high referral rate of colposcopy. This retrospective study was conducted to document ASC-US in cervical cytology reports at the Department of Cytology at Gynecology and Obstetrics, Tianjin Medical University General Hospital between January 2006 and February 2021. We then analyzed 2,462 reports of women with ASC-US at the Cervical Lesions Department. A total of 499 patients with ASC-US and 151 cytology with NILM participants underwent vaginal microecology tests. The average reporting rate of ASC-US in cytology was 5.7%. The detection rate of ASC-US in women aged > 50 years (7.0%) was significantly higher than that in women aged ≤50 years (5.0%) (P<0.05). The CIN2+ detection rate was significantly lower in the post- (12.6%) than in pre-menopausal (20.5%) patients with ASC-US (P <0.05). The prevalence of abnormal reporting rate of vaginal microecology was significantly lower in the pre-menopausal group (56.2%) than that in the post-menopausal group (82.9%) (P<0.05). The prevalence of bacterial vaginosis (BV) (19.60%) was relatively high in the pre-menopausal group, but the abundance of bacteria-inhibiting flora (40.79%) was mainly an abnormality in the post-menopausal group. The vaginal microecological abnormality rate of the women with HR-HPV (-) of ASC-US was 66.22%, which was significantly higher than that of the HR-HPV (-) and the NILM group (52.32%; P<0.05). The detection rate of ASC-US in women aged > 50 years was higher than that ≤50 years, but the detection rate of CIN2+ was lower in the post-menopausal women with ASC-US. However, vaginal microecological abnormalities may increase the false-positive diagnosis rate of ASC-US. The vaginal microecological abnormalities of the menopausal women with ASC-US are mainly attributed to infectious diseases such as BV, and it mainly occurs in the post-menopausal women was bacteria-inhibiting flora. Therefore, to avoid the high referral rate for colposcopy, more attention should be paid to the detection of vaginal microecology.

Bacterial Vaginosis: Prevalence and Risk Factors among Women in Dakar, Senegal

Introduction: Bacterial vaginosis (BV) is an imbalance of the vaginal flora that most commonly affects women of childbearing age. It is characterised by discomfort due to vaginal discharge and is associated with serious complications in women. We aimed to determine the prevalence of BV and its risk factors.&#x0D; Methodology: We conducted a prospective cross-sectional descriptive study in November 2020 at the Pasteur Institute of Dakar among women who were seen for vaginal sampling. We collected the following parameters: age, parity, history of infection, pregnancy and contraception. VB was diagnosed using the Amsel criteria and the Nugent score. Scoring is based on the presence of different bacterial morphotypes where a score ≥ 7 indicates the presence of BV, 4-6 indicates intermediate flora and 0- 3 normal flora. Analysis was performed using SPSS version 20.0.A statistically significant difference between the occurrence of bacterial vaginosis and a risk factor was retained for a p value &lt; 0.05.&#x0D; Results: A total of 236 patients were included with a median age of 38 years. The prevalence of BV was 20.3%. It was more prevalent in women aged between [30-40 years] (28/101, 27.7%) followed by the age group [20-30 years] (13/51, 25.5%) with a statistically significant difference (p=0.0001).VB was more prevalent in nulliparous or primiparous women (28/118, 23.7%) and in those with no history of vaginal infections (20/83, 24.1%). Pregnant women and women without contraception were more affected with respectively (12/42, 28.6%) and (43/199, 21.6%). No relationship was found between BV and these previous potential risk factors.&#x0D; Conclusion: BV is a very common condition in women of childbearing age. Its complexity motivates numerous researches in order to elucidate its real implication in the occurrence of adverse gynecological conditions.

High Prevalence of Sexually Transmitted and Reproductive Tract Infections (STI/RTIs) among Patients Attending STI/Outpatient Department Clinics in Tanzania.

The patients were consecutively recruited, and the data collection was conducted in eight health care facilities from 2014 to 2016. Genital swabs were collected for the detection of the aetiological pathogens of STI/RTIs. A total of 1243 participants were recruited in the study; the majority (1073, 86%) were women. The overall median age was 27.8. The prevalence of Neisseria gonorrhoeae was 25.7% (319/1243), with proportions of 50.9 and 21.5% for men and women, respectively, of Chlamydia trachomatis 12.9% (160/1241) and Mycoplasma genitalium 4.7% (53/1134). Unmarried men were more often likely to be infected with gonococcal infections as compared to their women counterparts (57.9 vs. 24.1%) p &lt; 0.001. The majority presented with genital discharge syndrome (GDS) 93.6% (1163/1243), genital ulcer disease (GUD) 13.0% (162/1243) and GDS + GUD 9.6% (119/1243). GDS was more common in the health centres, 96.1% (1195/1243), vs. the regional referral hospitals, 92.2% (1146/1243) (p = 0.01), but those reported to the regional referral hospitals were more likely to be infected with N. gonorrhoeae (OR = 2.5) and C. trachomatis (OR = 2.1) than those from the health centres (p &lt; 0.001). The prevalence of bacterial vaginosis (BV) and vaginal candidiasis (VC) was 24.1 and 10.4%, respectively. Interestingly, unmarried and BV-positive women were less likely to be infected with VC (p = 0.03), though VC was strongly inversely associated with an N. gonorrhoeae infection (p &lt; 0.001). High proportions of N. gonorrhoeae (51.1%) and C. trachomatis (23.3%) were found in the Dodoma and Dar es Salaam regions, respectively. M. genitalium (7.6%) was found to be the highest in Mwanza. We reported a high prevalence of STI/RTIs. The findings suggest that these infections are common and prevalent in STI/OPD clinics in six regions of Tanzania. We recommend surveillance to be conducted regularly to elucidate the true burden of emerging and classical STI/RTIs by employing modern and advanced laboratory techniques for the detection and monitoring of STI/RTIs in low- and high-risk populations, including the community settings.

Microbiota unbalance in relation to high-risk human papillomavirus cervical infection

ObjectivesTo assess vaginal dysfunction using basic vaginal states and the presence of lactobacillary microbiota in patients with human papillomavirus (HPV) infection with no squamous intra-epithelial lesions (SIL), with low-grade squamous...