Prevalence Of Vaginal Infections Research Articles

Accuracy of syndromic management in targeting vaginal and cervical infections among symptomatic women of reproductive age attending primary care clinics in Dakar, Senegal.

To assess the effectiveness of the WHO syndromic algorithm in the management of vaginal discharge among women of reproductive age in Dakar. Cross-sectional study of consecutive female patients (aged 18-49 years) presenting with vaginal symptoms at six selected study sites in Dakar; of these, 276 patients were included in the analysis. Vaginal and cervical swab samples were collected and analysed to establish an aetiological diagnosis of any infection. Syndrome-based diagnosis was compared with the laboratory results to evaluate its accuracy based on sensitivity, specificity and positive and negative predictive values. The degree of agreement between the two approaches was assessed using the Cohen's kappa concordance analysis. Overall prevalence of vaginal infections was 56.9% (157/276); 5.4% (15/276) of the patients had cervical infection. Using the syndromic approach, 51% of patients were correctly managed for Trichomonas vaginalis (TV)/Gardnerella vaginalis (GV); 61% for Candida albicans (CA) and 54% for Chlamydia trachomatis (CT)/Neisseria gonorrhoea (NG) infections. Consequently, 31% of patients with TV/GV, 51% with CA and 53% with CT/NG infections would have missed treatment. Further, the kappa value was <0.20, indicating that there was no agreement or only slight agreement between the syndromic approach and laboratory-based diagnosis. This study highlights the limitations of the applicability of the WHO syndromic approach in settings with low prevalence of sexually transmitted infections (STIs) and calls for affordable and accurate rapid tests for STIs.

A novel double-layer mucoadhesive tablet containing probiotic strain for vaginal administration: Design, development and technological evaluation

Vulvovaginal candidosis caused by Candida spp. is the most prevalent vaginal infection in Europe and the second one in EE.UU, so it has become a major female concern. Probiotics bacteria have been proposed as an alternative treatment with the aim of avoiding the adverse effects associated with conventional therapies including antibiotics and other aggressive drugs for the vaginal mucosa and microbiota. The purpose of this work was to design and develop a novel vaginal tablet that contained Lactobacillus spp. bacteria as a treatment against vulvovaginal infections. A total of 21 two-layers vaginal tablets, which contained different polymeric ratios, were proposed. However, formulation F4 (20mg Na-CMC; 50mg Carbopol® 934; 20mg chitosan) was selected as optimal according to its swelling index and dissolution/erosion capability. F4 tablets showed suitable technological properties for vaginal administration as well as mucoadhesion time (24.36±0.88h) and force (0.0941N). Disintegration assay in simulated vaginal fluid (SVF, pH5.5) showed that effervescent layer disappeared in 27.48±0.05s whilst matrix layer was totally gelled in 1h. Two different release profiles were achieved; on the one hand, a promptly release due to the dissolution of both effervescent layer and matrix layer's surface (1.10×108CFU/g), on the second hand, a prolonged released of the remaining bacteria until 24h (5.48×107CFU/g). For stability and storage study, it was found that bacteria viability was constant until 90days in both ways of storage, in a desiccator and at room temperature, with a final dosage of 108CFU/g which was considered appropriate for vaginal therapy (108–1010CFU/g).

Prevalence of Vaginal Infection by Multidrug Resistant Candida Species among Different Ages in Egypt

During 12 months’ the period of study from December 2015 to November 2016, one hundred and sixty women were clinically examined for vaginal yeast infection. Result revealed that 100 cases (62.5%) proved to have vaginal infection. The mean age (±SD) of the participants was 27.70±5.79 years. Most of the positive cases with high count belonged to the age group1 (19-25 year) followed by group 2 (26-30 year) representing 39 and 32 cases respectively (71 % of the total cases). Phenotypic and genotypic characterization of the yeast isolates showed that C. albicans were the predominant Candida species 258 cfu out of 410 cfu represent (62.9%) followed by C. lusitaniae (56 cfu, 13.7%), C. krusei (44 cfu 10.7%), C. glabrata (26 cfu, 6.3%), C. tropicalis (18 cfu, 4.4%) and C. Parapsilosis (8 cfu, 2.0%) respectively. In-vitro sensitivity test showed high resistance to the tested antifungals; whereas 73 isolates out of 128 (57.3%) were resistant to more than one type of tested antifungal agents, including 14 isolates showed resistance to all antifungal agents (Multidrug resistant strains). C. albicans represented by 67 isolates, showed resistance to one or more of the tested antifungal agents such as Fluconazole (61.2 %), Ketoconazole (56.7 %), Amphotericin B (52.2), Itraconazole and Nystatin (43.3 %). In case of non- albicans isolate (61 isolate) the most effective antifungal agent was Nystatin were it susceptible 65 % form C. lusitaniae isolates, 62.5 % from C. tropicalis and 60 % from C. Krusei isolates. The relation between risk factors, such as pregnancy, diabetes mellitus, history of antibiotic uses, and contraceptive methods, was recorded.

Therapeutic activity of a Saccharomyces cerevisiae-based probiotic and inactivated whole yeast on vaginal candidiasis

ABSTRACTVulvovaginal candidiasis is the most prevalent vaginal infection worldwide and Candida albicans is its major agent. Vulvovaginal candidiasis is characterized by disruption of the vaginal microbiota composition, as happens following large spectrum antibiotic usage. Recent studies support the effectiveness of oral and local probiotic treatment for prevention of recurrent vulvovaginal candidiasis. Saccharomyces cerevisiae is a safe yeast used as, or for, the production of ingredients for human nutrition and health. Here, we demonstrate that vaginal administration of probiotic Saccharomyces cerevisiae live yeast (GI) and, in part, inactivated whole yeast Saccharomyces cerevisiae (IY), used as post-challenge therapeutics, was able to positively influence the course of vaginal candidiasis by accelerating the clearance of the fungus. This effect was likely due to multiple interactions of Saccharomyces cerevisiae with Candida albicans. Both live and inactivated yeasts induced coaggregation of Candida and consequently inhibited its adherence to epithelial cells. However, only the probiotic yeast was able to suppress some major virulence factors of Candida albicans such as the ability to switch from yeast to mycelial form and the capacity to express several aspartyl proteases. The effectiveness of live yeast was higher than that of inactivated whole yeast suggesting that the synergy between mechanical effects and biological effects were dominant over purely mechanical effects. The protection of epithelial cells to Candida-induced damage was also observed. Overall, our data show for the first time that Saccharomyces cerevisiae-based ingredients, particularly the living cells, can exert beneficial therapeutic effects on a widespread vaginal mucosal infection.

Evaluation of the Effect of Contraceptives on Prevalence of Candida Species on Vaginal Candidiasis in Dhaka, Bangladesh

This study was designed to find out the relationship between uses of different contraceptives and the prevalence of vaginal candidiasis. High vaginal swabs were obtained from 350 women in the age group of 15-45 years with vaginal discharge attending at Sir Salimullah Medical College Hospital, Dhaka, which comprised of 247 contraceptive users &amp; 103 non-contraceptive users. A detailed clinical history and a thorough examination of all the cases were done. After making the clinical diagnosis, appropriate tests for diagnosing Candidiasis were done by using standard procedures. Of the 247 women of contraceptive users, Candida species was isolated in 140 (56.7%) cases compared to 32 (31.1%) from 103 non-contraceptive users (p value &lt;0.001). Different species of Candida were isolated from 172 (49.1%) cases among 350 women of which C. albicans was found in 125 (72.7%) cases, C. glabrata in 29 (16.9%) cases, C. tropicalis in 13 (7.5%), and C. krusei in 5 (2.9%) cases. Among 173 oral contraceptive users, the isolation rate of Candida species was 120 (69.4%). This was followed by injectables (17, 12.2%) and IUCD (03, 2.1%) cases (p value &lt;0.05). The study revealed a strong association between use of contraceptives and the prevalence of vaginal infection by Candida species of which C. albicans was the most common species (72.7%). Among all contraceptives, use of oral contraceptive pills (OCP) was found as the most common cause of vaginitis, next to which were injectables and IUCDs.Bangladesh J Med Microbiol 2007; 01 (02): 61-64

Prevalencia de vaginosis bacteriana, Actinomyces spp., Candida spp. y Trichomonas vaginalis en usuarias del dispositivo intrauterino (DIU), Medellín, Colombia, 2011-2013

Introducción: el uso del dispositivo intrauterino incrementa el riesgo de algunas infecciones genitales. Objetivo: determinar la prevalencia de vaginosis bacteriana, Actinomyces spp., Candida spp. y Trichomonas vaginalis en usuarias del dispositivo intrauterino. Materiales y métodos: se realizó un estudio transversal en usuarias del dispositivo intrauterino, atendidas en un programa de tamización de cáncer cérvico-uterino en Medellín, Colombia, entre 2011 y 2013. Se empleó una fuente de información secundaria basada en los registros citológicos del laboratorio clínico, se calculó la prevalencia global de las cuatro infecciones y las prevalencias específicas según grupo etario y sector de residencia, con un intervalo de confianza del 95%. La exploración de asociaciones se hizo con la prueba chi cuadrado de Pearson. Resultados: Se registraron 12.541 usuarias del dispositivo intrauterino de 10 comunas de Medellín. La edad promedio fue 34,0±9,8 años; el 50% de los valores centrales estuvo entre 26 y 41 años. Las prevalencias de infecciones vaginales fueron: vaginosis bacteriana 25,6%, Actinomyces spp. 8,9%, Candida spp. 5,1% y Trichomonas vaginalis 1,2%. La prevalencia de vaginosis bacteriana y Candida spp. fue estadísticamente mayor en adolescentes y jóvenes. La prevalencia de las cuatro infecciones fue estadísticamente diferente según el sector de residencia. Conclusión: en usuarias del dispositivo intrauterino las principales infecciones genitales son vaginosis bacteriana y Actinomyces spp., las adolescentes y jóvenes son los grupos de mayor riesgo para vaginosis bacteriana y Candida spp. y la ocurrencia de infecciones varía entre los sectores de la ciudad; información relevante para la planeación de programas de prevención y atención.

Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial.

Background & objectives:Bacterial vaginosis (BV) is the most prevalent vaginal infection in women of reproductive age group which has been found to be associated with vitamin D deficiency. The purpose of this study was to investigate the effectiveness of the administration of 2000 IU/day edible vitamin D for 15 wk to eliminate asymptomatic BV among reproductive age women with vitamin D deficiency.Methods:A total of 208 women with asymptomatic BV, who were found to be eligible after interviews and laboratory tests, were randomly assigned to a control group (n=106) or an intervention group (n=105). They used vitamin D drops daily for 105 days. Vaginal and blood samples were taken before and after the second intervention using identical methods (Nugent score for BV diagnosis, serum 25-hydroxyvitamin D for vitamin D determination).Results:The cure rate of asymptomatic BV was 63.5 per cent in the intervention and 19.2 per cent in the control group (P <0.001). The results showed that being unmarried (P=0.02), being passive smoker (P<0.001), and being in the luteal phase of a menstrual cycle during sampling (P=0.01) were significantly associated with post-intervention BV positive results. After these elements were controlled, the odds of BV positive results in the control group was 10.8 times more than in the intervention group (P<0.001).Interpretation & conclusions:Among women in reproductive age group with vitamin D deficiency, the administration of 2000 IU/day edible vitamin D was effective in eliminating asymptomatic BV. This treatment could be useful in preventing the symptoms and side effects of BV.

Prevalence of vaginal infections and associated lifestyles of students in the university of Cape Coast, Ghana

ObjectiveTo determine the prevalence of vaginal infections and associated lifestyles of students visiting the University of Cape Coast Hospital. MethodsFifty female students presenting with clinical symptoms of vaginitis were sampled. One hundred samples made up of 50 urine and 50 higher vaginal swabs (HVS) were obtained from patients and questionnaire administered. Samples were wet prepared, examined microscopically, and cultured on blood and chocolate agars for 24 h at (35±2) °C. Colonial morphology, Gram reactions and biochemical tests were used for the identification of isolates. ResultsThere were high percentages of pus cells (64%), epithelial cells (62%) and yeast cells (56%) in all urine samples. Bacterial isolates included Staphylococcus aureus (28%) and (22%), Klebsiella spp. (6%) and (4%) in urine and HVS samples respectively; Escherichia coli in urine (18%) and Candida in HVS (16%). The overall prevalence of vaginitis was 66%, including bacterial vaginosis 28%, Candida infection 22% and co-infection of bacterial and Candida 16%. Lifestyle data showed all sampled students were sexually active, 48% used contraceptives, 54% used antimicrobial agents, and 92% prefered wearing of trousers and shorts. ConclusionsThe present study indicates prevalence of vaginal infection among female students, which strongly correlates with student lifestyle. Education on lifestyle modifications will go a long way in reducing the prevalence of vaginitis.

Clinical Study of Bacillus coagulans Unique IS-2 (ATCC PTA-11748) in the Treatment of Patients with Bacterial Vaginosis

Bacterial vaginosis (BV) is the most prevalent vaginal infection worldwide and is characterized by reduction of native lactobacilli. Antimicrobial therapy used to cure the disease is often found to be ineffective. We postulate that Bacillus coagulans Unique IS-2 (Unique Biotech Limited, India) might provide an appendage to antimicrobial treatment and improve curing rate. In the present study 40 Indian women diagnosed with BV by the presence of symptoms including white discharge, pH greater than 4.7, burning micturation, itching, soreness and redness at vulva. The subjects were divided in 2 groups probiotic (n=20) and control (n=20) based on age (control group, 33±3years and probiotic group, 32.5±3years), history of previous vaginosis (control group, 75% or 15/20 and probiotic group, 75% or 15/20) and severity of current vaginosis infection (burning micturation and itching, 35% in each group). Probiotic group subjects were assigned to receive a dose of antibiotic therapy [Ofloxacin-Ornidazole with strength of 200-500mg per capsule/day for 5days along with vaginal peccaries (co-kimaxazol) for 3days] simultaneously with two probiotic capsules (10(9)CFUs of Bacillus coagulans Unique IS-2 per capsule). The control group received only antibiotic therapy. At the end of the treatment the 80% of probiotic group subjects showed significant positive response as revealed by reduction of vaginosis symptoms compared to the control group which exhibited reduction in 45% subjects only. Thus, the results of present study indicate that strain Bacillus coagulans Unique IS-2 can provide benefits to women being treated with antibiotics to cure an infectious condition.

Trichomonas vaginalis is Highly Prevalent in Adolescent Girls, Pregnant Women, and Commercial Sex Workers in Ndola, Zambia

The aim of the study was to assess the prevalence of Trichomonas sp. infection among adolescent girls, pregnant women, and commercial sex workers in Ndola, Zambia. A cross-sectional study was conducted among 460 girls attending school, 307 pregnant women, and 197 commercial sex workers. Self-collected specimens from the vagina, rectum, and mouth were tested by polymerase chain amplification assays for the presence of Trichomonas vaginalis, Pentatrichomonas hominis, and Trichomonas tenax. Genotyping was performed on specimens that tested positive for T. vaginalis. The prevalence of vaginal infection with T. vaginalis was 24.6% among the adolescents, 32.2% among the pregnant women, and 33.2% among the commercial sex workers. Trichomonads other than T. vaginalis were rarely found in the vagina, rectum, and mouth. The presence of T. vaginalis in the rectum was associated with T. vaginalis in the vagina. T. tenax was also detected in the vagina. A total of 9 actin genotypes of T. vaginalis were identified. The distribution of the actin genotypes of T. vaginalis was similar in the 3 study groups. We detected high prevalence rates of trichomoniasis among women in Ndola, Zambia. Prevalence among adolescent girls was lower than among pregnant women and commercial sex workers but was still high. We were not able to detect differences in T. vaginalis actin genotypes among the 3 study groups.

Maternal Vitamin D Deficiency Is Associated with Bacterial Vaginosis in the First Trimester of Pregnancy

Bacterial vaginosis (BV) is a highly prevalent vaginal infection that is associated with adverse pregnancy outcomes. Vitamin D exerts an influence on the immune system and may play a role in BV. The objective of this study was to examine the association between maternal vitamin D status and the prevalence of BV in early pregnancy. Women (n = 469) enrolled in a pregnancy cohort study at <16 wk underwent a pelvic examination and provided a blood sample for determination of serum 25-hydroxyvitamin D [25(OH)D]. BV was diagnosed using Gram-stained vaginal smears interpreted using the method of Nugent. Approximately 41% of women had BV (Nugent score 7-10) and 52% had a serum 25(OH)D concentration <37.5 nmol/L. The mean unadjusted serum 25(OH)D concentration was lower among BV cases (29.5 nmol/L; 95% CI: 27.1, 32.0) compared with women with normal vaginal flora (40.1 nmol/L; 95% CI: 37.0, 43.5; P < 0.001). BV prevalence decreased as vitamin D status improved (P < 0.001). Approximately 57% of the women with a serum 25(OH)D concentration <20 nmol/L had BV compared with 23% of women with a serum 25(OH)D concentration >80 nmol/L. There was a dose-response association between 25(OH)D and the prevalence of BV. The prevalence declined as 25(OH)D increased to 80 nmol/L, then reached a plateau. Compared with a serum 25(OH)D concentration of 75 nmol/L, there were 1.65-fold (95% CI: 1.01, 2.69) and 1.26-fold (1.01, 1.57) increases in the prevalence of BV associated with a serum 25(OH)D concentration of 20 and 50 nmol/L, respectively, after adjustment for race and sexually transmitted diseases. Vitamin D deficiency is associated with BV and may contribute to the strong racial disparity in the prevalence of BV.

Improved cure of bacterial vaginosis with single dose of tinidazole (2 g),Lactobacillus rhamnosusGR-1, andLactobacillus reuteriRC-14: a randomized, double-blind, placebo-controlled trial

Bacterial vaginosis (BV) is the most prevalent vaginal infection worldwide and is characterized by depletion of the indigenous lactobacilli. Antimicrobial therapy is often ineffective. We hypothesized that probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 might provide an adjunct to antimicrobial treatment and improve cure rates. Sixty-four Brazilian women diagnosed with BV were randomly assigned to receive a single dose of tinidazole (2 g) supplemented with either 2 placebo capsules or 2 capsules containing L. rhamnosus GR-1 and L. reuteri RC-14 every morning for the following 4 weeks. At the end of treatment (day 28), the probiotic group had a significantly higher cure rate of BV (87.5%) than the placebo group (50.0%) (p = 0.001). In addition, according to the Gram-stain Nugent score, more women were assessed with "normal" vaginal microbiota in the probiotic group (75.0% vs. 34.4% in the placebo group; p = 0.011). This study shows that probiotic lactobacilli can provide benefits to women being treated with antibiotics for an infectious condition.

PREVALENCIA Y DETERMINANTES DE LAS INFECCIONES VAGINALES EN LAS MUJERES RECLUIDAS EN UNA CÁRCEL COLOMBIANA

valence ratios (PR), 95% confidence intervals (CI95%), and p-values. The likelihood ratio test was used to assess the overall significance of the model. Results: The global prevalence of vaginal infections was 28.2%. The factors associated with a higher risk of vaginal infection at the time of the study were: a. smoking (PR: 1.71; 95%CI: 1.08-2.71); b. age over 35 (PR: 1.41; 95%CI: 1.01-1.97); c. the antecedent symptom of bad-smelling vaginal discharge (PR: 2.22; 95%CI: 1.423.47) and d. vaginal douches (PR: 1.71; 95%CI: 1.08-2.71). Conclusion: Those women imprisoned in penitentiaries may have a higher frequency of risk factors of vaginal infections. In this group, it is recommendable to create an awareness and early-detection program for these entities as a regular prevention activity.

A Persistent(ly) Enigmatic Ecological Mystery: Bacterial Vaginosis

Considering the vagina's central role in women's susceptibility to acquiring sexually transmitted infections (STIs), including HIV, we have a remarkably limited understanding of its microflora and mucosal immunology. We have known for >2 decades that the normal vagina is dominated by hydrogen peroxide-producing Lactobacillus species, particularly L. crispatus and L. jensenii [1]. Quantitative declines in numbers of these vaginal lactobacilli have been associated with an increased risk of the acquisition of bacterial vaginosis (BV) [2], gonorrhea [3], and HIV infection [3] and with cervicitis [4]. BV itself, in which the relative lack of lactobacilli is accompanied by a profound increase in the quantity of vaginal anaerobic bacteria, has been associated with an increased risk of some STIs [5] and HIV infection [6, 7]. BV is the most prevalent vaginal infection in women of reproductive age-it affects 8%-23% of women and is the most common cause of vaginal symptoms prompting women to seek medical care. Despite this, our collective

Lactobacilli, Hydrogen Peroxide, and Vaginal Health

Bacterial vaginosis, the most prevalent vaginal infection among reproductive-age women, is associated with increased risk for acquiring sexually

The susceptibility of organisms associated with bacterial vaginosis to spermicidal compounds, in vitro.

Bacterial vaginosis (BV) is a prevalent vaginal infection that is now regarded as a risk factor in more serious pelvic and obstetric complications. Spermicides are known to have antimicrobial activity against other sexually transmitted diseases and the aim of this study was to test whether the causative organisms of BV were also susceptible to spermicides, in vitro. Minimal Inhibitory Concentrations of five spermicidal compounds were determined for the organisms associated with BV, in an agar dilution technique. The Department of Experimental and Clinical Microbiology, University of Sheffield Medical School, UK. SPERMICIDES AND ORGANISMS: Nonoxynol-9, Nonoxynol-11, Docusate sodium, Benzalkonium chloride and Menfegol were tested against 20 strains each of Gardnerella vaginalis, Bacteroides and Mobiluncus organisms, isolated from patients with BV who attended the Department of Genitourinary Medicine, the Royal Hallamshire Hospital, Sheffield. The susceptibility of BV-associated organisms to spermicidal compounds, in vitro. G vaginalis, Mobiluncus spp, Bacteroides bivius and Bacteroides disiens were all susceptible to the five spermicides tested, with MICs ranging between less than or equal to 19 and 5000 mg/l (0.0019%-0.5%). The concentrations of spermicides incorporated in contraceptive preparations are usually between 3% and 8%, which are far in excess of the MICs found for BV organisms. Their usage could exert a significant antimicrobial effect and be a useful prophylactic in preventing the infection.