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Mujuzi H, Siya A, Wambi R. Infectious vaginitis among women seeking reproductive health services at a sexual and reproductive health facility in Kampala, Uganda. BMC Womens Health 2023; 23:677. [PMID: 38114988 PMCID: PMC10729507 DOI: 10.1186/s12905-023-02835-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Infectious vaginitis is one of the most prevalent conditions affecting women of reproductive age with significant clinical consequences. Bacterial vaginosis (BV), vulvo-vaginal candidiasis (VVC), and trichomoniasis (TV) are the main etiologies. Unfortunately, there is limited data on the prevalence and associated risk factors, especially in sub-saharan Africa. This study, thus, determined the prevalence and risk factors of infectious vaginitis among women seeking reproductive health services at a Marie-stopes health facility in urban areas of Kampala, Uganda. METHODS A cross-sectional study with 361 participants was conducted from July to October 2021. Data on risk factors and infection were collected via a structured questionnaire and laboratory analysis of vaginal swabs, respectively, with data analysis performed using Stata version 14.0 college station, Texas 77,845 US. RESULTS The ages of participants ranged from 18 to 49 years, with a mean age of 29.53 years. Overall, 58.45% were infected, of whom 33.24% had VVC, 24.93% had BV, and 0.28% had TV. Bivariate analysis revealed that women with pruritus (COR: 3.057, 95% CI: 1.940-4.819), pregnancy (COR: 4.914, 95% CI: 1.248-19.36), antibiotic use (COR: 1.592, 95% CI: 1.016-2.494), douching (COR: 1.719, 95% CI: 1.079-2.740), and multiple partners (COR: 1.844, 95% CI: 1.079-2.904) were more likely to have VVC, whereas having higher education status (University; Vocational) (COR: 0.325, 95% CI: 0.134-0.890; COR: 0.345, 95% CI: 0.116-0.905) reduced the risk. On the other hand, women with a smelly discharge (COR: 1.796, 95% CI: 1.036-3.110), IUD use (COR: 1.868, 95% CI: 1.039-3.358), and antibiotic use (COR: 1.731, 95% CI: 1.066-2.811) were more likely to have BV. Multivariable analysis identified pruritus (AOR: 2.861, 95% CI: 1.684-4.863) as the only independent predictor for VVC. CONCLUSION Results indicate a high prevalence of infection among these women; therefore regular screening and treatment is recommended to curb the high rate of infection. More studies on risk factors of infection are recommended.
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Affiliation(s)
- Huzaima Mujuzi
- Department of Microbiology, UMC Victoria Hospital, Kampala, Uganda.
- Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, P.O.Box 7060, Kampala, Uganda.
| | - Aggrey Siya
- Department of Zoology, Entomology and Fisheries Sciences, Makerere University, P.O. Box 7060, Kampala, Uganda
| | - Rogers Wambi
- Department of Clinical Laboratories, Mulago National Referral Hospital, Kampala, Uganda
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Govender V, Moodley D, Naidoo M, Connoly C, Ngcapu S, Abdool Karim Q. High incidence of asymptomatic genital tract infections in pregnancy in adolescent girls and young women: need for repeat aetiological screening. Sex Transm Infect 2023; 99:482-488. [PMID: 37208192 DOI: 10.1136/sextrans-2022-055658] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/10/2023] [Indexed: 05/21/2023] Open
Abstract
INTRODUCTION Sexually transmitted infection (STI) prevalence and incidence estimates for pregnant adolescents are under-reported. We estimated prevalence and incidence of STIs in pregnant adolescents (15-19 years) in comparison with pregnant women 20-24 and >25 years. METHODS Pregnant women registering at primary care clinics in Umlazi, a periurban subdistrict in KwaZulu-Natal, South Africa, were enrolled in an HIV incidence cohort study during February 2017-March 2018. Women were examined for abnormal vaginal discharge, received empirical treatment, tested for HIV-1 and had vaginal swabs taken at their first and a subsequent visit in the third trimester. Vaginal swabs were stored for STI testing at completion of study and tested for Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium using PCR. RESULTS A total of 752 HIV-negative pregnant women were enrolled at a median gestational age of 17 weeks: 180 (23.9%), 291 (38.7%) and 281 (37.4%) in the 15-19, 20-24 and >25 years age groups. Pregnant adolescents had an STI prevalence of 26.7% at baseline, not significantly lower than the 20-24 (34.7%, OR 1.4; 95% CI 1.0 to 2.1, p=0.09) and >25 years (33.8%, OR 1.4; 95% CI 0.9 to 2.1, p=0.12) age groups. T. vaginalis (11.1%), C. trachomatis (7.8%) and N. gonorrhoeae (4.4%) were most prevalent in adolescents, a trend similar to the other age groups. Overall, 43.4% were symptomatic and treated at baseline. Overall, 40.7% (118 of 290) of women who tested negative for an STI at baseline tested positive at the repeat visit (incidence 19.5/100 person years). STI incidence in pregnant adolescents was 23.9/100 person years and comparable with older age groups (20.5/100 person years and 16.2/100 person years). At the repeat visit, 19.0% of all women with an STI were symptomatic and treated. Performance of syndromic management was poor at baseline (negative predictive value (NPV) 68.6%, positive predictive value (PPV) 34.0%) and at repeat visit (NPV 58.4%, PPV 34.3%). CONCLUSIONS Prevalence of asymptomatic curable STIs in pregnant adolescents is high and comparable with women >20 years old. Adolescents remain at substantial risk of asymptomatic incident STIs during pregnancy.
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Affiliation(s)
- Vani Govender
- Centre for the AIDS Program of Research in South Africa, CAPRISA, Durban, KwaZulu-Natal, South Africa
- Obstetrics and Gynaecology, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
| | - Dhayendre Moodley
- Centre for the AIDS Program of Research in South Africa, CAPRISA, Durban, KwaZulu-Natal, South Africa
- Obstetrics and Gynaecology, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
| | - Megeshinee Naidoo
- Centre for the AIDS Program of Research in South Africa, CAPRISA, Durban, KwaZulu-Natal, South Africa
| | - Cathy Connoly
- Department of Biostatistics, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Sinaye Ngcapu
- Centre for the AIDS Program of Research in South Africa, CAPRISA, Durban, KwaZulu-Natal, South Africa
- Department of Medical Microbiology, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
| | - Quarraisha Abdool Karim
- Centre for the AIDS Program of Research in South Africa, CAPRISA, Durban, KwaZulu-Natal, South Africa
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Majhi J, Mohapatra D, Chayani N. The prevalence of Mycoplasma hominis in Outpatients at a Tertiary Care Hospital in East India. Cureus 2022; 14:e31110. [DOI: 10.7759/cureus.31110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/07/2022] Open
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Ahmed M, Admassu Ayana D, Abate D. Bacterial Vaginosis and Associated Factors Among Pregnant Women Attending Antenatal Care in Harar City, Eastern Ethiopia. Infect Drug Resist 2022; 15:3077-3086. [PMID: 35754781 PMCID: PMC9215287 DOI: 10.2147/idr.s364229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 06/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Bacterial vaginosis is one of the most common causes of abnormal vaginal discharge in women of reproductive age, especially pregnant women. It is characterized by the decrement of lactobacilli and increasing proliferation of diverse anaerobic bacteria. The prevalence of bacterial vaginosis and contributing factors vary between countries, within the same country, and among different populations. Objective The purpose of this study was to determine the prevalence of bacterial vaginosis and associated factors among pregnant women attending antenatal care from May 5-July 15, 2021 in health-care facilities found in Harar town, eastern Ethiopia. Methods and Materials An institutional-based cross-sectional study was conducted among 248 pregnant women attending antenatal care through systematic random sampling. Data were collected using a structured questionnaire and two vaginal swabs were collected using sterile swabs and transported to the microbiology laboratory. Samples were analyzed using Amsel's criteria or using Nugent scoring criteria and culture. Data were entered into EpiData version 3.1 and transferred to SPSS version 25 for analysis. Binary logistic regression was used to identify variables associated with bacterial vaginosis. P-value <0.05 was considered statistically significant. Results Altogether 248 pregnant women were included in the study. Overall, 21.4% (95% CI: 16, 27) of study participants had bacterial vaginosis. History of sexually transmitted infection (AOR = 6.0, 95% CI: 1.94, 19.07; P = 0.002), history of spontaneous abortion (AOR = 5.8, 95% CI: 1.55, 22.02; P = 0.009), multiple sex partners (AOR = 8.6, 95% CI: 2.93, 25.79; P = 0.000) and having vaginal discharge (AOR = 5.5, 95% CI: 2.48, 12.41; P = 0.000) were significantly associated with bacterial vaginosis. Conclusion The prevalence of bacterial vaginosis is higher among symptomatic pregnant women and associated with a history of sexually transmitted infection, vaginal discharge, multiple sexual partners and spontaneous abortion.
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Affiliation(s)
- Mohammed Ahmed
- Department of Medical Laboratory Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Desalegn Admassu Ayana
- Department of Medical Laboratory Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Degu Abate
- Department of Medical Laboratory Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Prevalence of bacterial vaginosis and aerobic vaginitis and their associated risk factors among pregnant women from northern Ethiopia: A cross-sectional study. PLoS One 2022; 17:e0262692. [PMID: 35213556 PMCID: PMC8880645 DOI: 10.1371/journal.pone.0262692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/03/2022] [Indexed: 01/10/2023] Open
Abstract
This study aimed to determine the prevalence of bacterial vaginosis (BV) and aerobic vaginitis (AV) and their associated risk factors among pregnant women from Ethiopia. Also, this study investigated the bacterial pathogens and their antibiotic resistance in AV cases. A total of 422 pregnant women from northern Ethiopia were participated in this study. Socio-demographic and clinical data were recorded. Vaginal swabs were collected and used for wet mount and Gram stain methods to evaluate the AV and BV scores according to the Nugent’s and Donder’s criteria, respectively. In AV cases the bacterial pathogens and their antibiotic resistance were determined using standard methods. The possible risk factors for AV and BV in pregnant women were investigated. The prevalence rates of BV and AV were 20.1% (85/422) and 8.1% (34/422), respectively. BV was more common in symptomatic vs. asymptomatic people (P < 0.001), and in second trimester vs. first trimester samples (P = 0.042). However, AV was more common in secondary school vs. primary and those who were unable to read and write (P = 0.021) and in housewife women vs. employee (P = 0.013). A total of 44 bacterial strains were isolated from AV cases, of which the coagulase-negative staphylococci (CoNS) (38.6%) and Staphylococcus aureus (29.5%) were the most predominant bacteria, respectively. The highest resistance rate was observed against penicillin (100.0%) in staphylococci, while 86.7% of them were sensitive to ciprofloxacin. The resistance rate of Enterobacteriaceae ranged from 0.0% for ciprofloxacin and chloramphenicol to 100.0% against amoxicillin/clavulanate. The prevalence of BV was higher than AV in pregnant women. This higher prevalence of BV suggests that measures should be taken to reduce the undesired consequences related to BV in the pregnancy. The circulation of drug-resistant bacteria in vaginal infections requires a global surveillance to reduce the risks to pregnant mothers and infants.
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Characterizations of Bacterial Vaginosis among HIV-Positive and HIV-Negative Women in Rural Eastern Cape Province, South Africa. Int J Microbiol 2021; 2021:9913878. [PMID: 34335783 PMCID: PMC8321757 DOI: 10.1155/2021/9913878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/25/2021] [Accepted: 06/27/2021] [Indexed: 12/02/2022] Open
Abstract
Bacterial vaginosis (BV) is extremely common among the African population and is associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection. The objective of this study was to determine the prevalence and characteristics of BV among HIV-infected and -uninfected women in rural Eastern Cape province of South Africa. A descriptive cross-sectional study was conducted between September 2017 and March 2018 on women aged 18 years and above (n = 100), attending Nelson Mandela Academic Hospital and Ngangelizwe Community Health Centre with signs and symptoms suggestive of vaginal infection. High vaginal swabs were collected, and BV was diagnosed using Nugent's score. The prevalence rate of BV was 70% irrespective of HIV status. Of the 61 HIV-infected patients, 49 (80.3%) and 12 (19.7%) were BV positive and BV negative, respectively; whilst of the 39 HIV-uninfected women, 21 (53.8%) and 18 (46.2%) were BV positive and BV negative, respectively (OR = 3.5; CI: 1.4–8.5; p=0.005). Women aged above 35 years were highly likely to develop BV (p=0.049). The presence of Mobiluncus species (>25 per high microscopic field) was significantly associated with BV among HIV-infected patients (p=0.030). A recent history of antibiotic use (≤3 months) was significantly associated with BV among HIV-negative patients (p=0.044). This study shows that BV is more prevalent among HIV-positive women than their HIV-negative counterparts, and its occurrence is higher among those aged above 35 years. The predominance of Mobiluncus species in the vagina microbiota of HIV-infected women might play a significant role in the development of BV. These findings suggest that the treatment of BV could restore normal flora and reduce susceptibility to and transmission of HIV.
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High Global Burden and Costs of Bacterial Vaginosis: A Systematic Review and Meta-Analysis. Sex Transm Dis 2020; 46:304-311. [PMID: 30624309 DOI: 10.1097/olq.0000000000000972] [Citation(s) in RCA: 209] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Bacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age and is associated with important adverse health outcomes. Estimates of the burden of BV and associated costs are needed to inform research priorities. METHODS We conducted a systematic review and meta-analysis of global BV prevalence among reproductive-aged women in the general population. We searched PubMed and Embase and used random effects models to estimate BV prevalence by global regions. We estimated the direct medical costs of treating symptomatic BV. Assuming a causal relationship, we also estimated the potential costs of BV-associated preterm births and human immunodeficiency virus cases in the United States. RESULTS General population prevalence of BV is high globally, ranging from 23% to 29% across regions (Europe and Central Asia, 23%; East Asia and Pacific, 24%; Latin America and Caribbean, 24%; Middle East and North Africa, 25%; sub-Saharan Africa, 25%; North America, 27%; South Asia, 29%). Within North America, black and Hispanic women have significantly higher (33% and 31%, respectively) prevalence compared with other racial groups (white, 23%; Asian, 11%; P < 0.01). The estimated annual global economic burden of treating symptomatic BV is US $4.8 (95% confidence interval, $3.7-$6.1) billion. The US economic burden of BV is nearly tripled when including costs of BV-associated preterm births and human immunodeficiency virus cases. CONCLUSIONS The BV prevalence is high globally, with a concomitant high economic burden and marked racial disparities in prevalence. Research to determine the etiology of BV and corresponding prevention and sustainable treatment strategies are urgently needed to reduce the burden of BV among women. Additionally, the exceptionally high cost of BV-associated sequelae highlights the need for research to understand potential causal linkages between BV and adverse health outcomes.
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Tine RC, Dia L, Sylla K, Sow D, Lelo S, Ndour CT. Trichomonas vaginalis and Mycoplasma infections among women with vaginal discharge at Fann teaching hospital in Senegal. Trop Parasitol 2019; 9:45-53. [PMID: 31161092 PMCID: PMC6542312 DOI: 10.4103/tp.tp_50_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 12/25/2022] Open
Abstract
Background: Trichomonas vaginalis and genital Mycoplasmas are two synergistic pathogens, but in many settings, limited data on the co-infection by Trichomonas and Mycoplasma are available. Objective: This study aimed at assessing Mycoplasma prevalence and its association with Trichomonas vaginalis among women with vaginal discharge. Materials and Methods: A retrospective analysis of laboratory records (2012 and 2013) from patients referred at the Fann teaching hospital in Dakar Senegal for vaginal discharge was carried out. Detection of genital mycoplasmas was based on the commercial Kit Mycoplasma Duo Bio-Rad™ using endo-cervical swabs. Vaginal swabs were collected and examined using optic microscopy with 40x magnification to detect T. vaginalis. Results: Overall, data from 1257 women were analysed. Prevalence of Mycoplasma hominis represented 57.4%, 95%CI(54.6-60.1), versus 54.9%, 95%CI(52.1-57.5) for Ureaplasma urealyticum. Trichomonas vaginalis infection was observed with a frequency of 3%. Out of the 50 patients with trichomoniasis, 76% of them were co-infected by Mycoplasma hominis and patients with Trichomonas vaginalis had an increased risk of acquiring Mycoplasma infection (adjusted OR:2.5, 95%CI(1.2-5.2);p=0.02)). Conclusion: Trichomonas vaginalis and Mycoplasmas are two closely associated pathogens in the urogenital tract of women. This clinically significant symbiotic action may require systematic screening of Mycoplasma among patients with trichomoniasis for optimal management of sexually transmitted infections.
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Affiliation(s)
- Roger C Tine
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal.,Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Lamine Dia
- Centre for Diagnostic and Medical Imagery, Laboratory of Bacteriology and Virology, Fann Teaching Hospital, Dakar, Senegal
| | - Khadime Sylla
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal.,Centre for Diagnostic and Medical Imagery, Laboratory of Parasitology and Mycology, Fann Teaching Hospital, Dakar, Senegal
| | - Doudou Sow
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal.,Centre for Diagnostic and Medical Imagery, Laboratory of Parasitology and Mycology, Fann Teaching Hospital, Dakar, Senegal
| | - Souleye Lelo
- Centre for Diagnostic and Medical Imagery, Laboratory of Parasitology and Mycology, Fann Teaching Hospital, Dakar, Senegal
| | - Cheikh T Ndour
- Department of Infectious and Tropical Diseases, Fann Teaching Hospital, Dakar, Senegal.,Division for AIDS and Sexually Transmitted Infections Control, Ministry of Health, Senegal
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Abdel Rahman SM, Hassan RA, Sakna NA. Antimicrobial susceptibility pattern of genital Mycoplasmas among a group of pregnant women. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2015.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Safaa M. Abdel Rahman
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rania A. Hassan
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Noha A. Sakna
- Department of Gynaecology and Obstetrics, Ain Shams University, Cairo, Egypt
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Melgaço ACC, Blohem Pessoa WF, Freire HP, Evangelista de Almeida M, Santos Barbosa M, Passos Rezende R, Timenetsky J, Miranda Marques L, Romano CC. Potential of Maintaining a Healthy Vaginal Environment by Two Lactobacillus Strains Isolated from Cocoa Fermentation. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7571954. [PMID: 30364031 PMCID: PMC6186379 DOI: 10.1155/2018/7571954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 08/28/2018] [Accepted: 09/12/2018] [Indexed: 11/25/2022]
Abstract
Bacteria in the genera Mycoplasma and Ureaplasma do not have cell walls and therefore interact with host cells through lipid-associated membrane proteins (LAMP). These lipoproteins are important for both surface adhesion and modulation of host immune responses. Mycoplasma and Ureaplasma have been implicated in cases of bacterial vaginosis (BV), which can cause infertility, abortion, and premature delivery. In contrast, bacteria of the genus Lactobacillus, which are present in the vaginal microbiota of healthy women, are thought to inhibit local colonization by pathogenic microorganisms. The aim of the present study was to evaluate the in vitro interactions between lipoproteins of Mycoplasma and Ureaplasma species and vaginal lineage (HMVII) cells and to study the effect of Lactobacillus isolates from cocoa fermentation on these interactions. The tested Lactobacillus strains showed some important probiotic characteristics, with autoaggregation percentages of 28.55% and 31.82% for L. fermentum FA4 and L. plantarum PA3 strains, respectively, and percent adhesion values of 31.66 and 41.65%, respectively. The two strains were hydrophobic, with moderate to high hydrophobicity values, 65.33% and 71.12% for L. fermentum FA4 and L. plantarum PA3 in toluene. Both strains secreted acids into the culture medium with pH=4.32 and pH=4.33, respectively, and showed antibiotics susceptibility profiles similar to those of other lactobacilli. The strains were also able to inhibit the death of vaginal epithelial cells after incubation with U. parvum LAMP from 41.03% to 2.43% (L. fermentum FA4) and 0.43% (L. plantarum PA3) and also managed to significantly decrease the rate of cell death caused by the interaction with LAMP of M. hominis from 34.29% to 14.06% (L. fermentum FA4) and 14.61% (L. plantarum PA3), thus demonstrating their potential for maintaining a healthy vaginal environment.
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Affiliation(s)
- Ana Clara Correia Melgaço
- Departamento de Ciências Biológicas, Laboratório de Imunologia, Centro de Biotecnologia e Genética, Universidade Estadual de Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, 45662-900 Ilhéus, BA, Brazil
| | - Wallace Felipe Blohem Pessoa
- Departamento de Ciências Biológicas, Laboratório de Imunologia, Centro de Biotecnologia e Genética, Universidade Estadual de Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, 45662-900 Ilhéus, BA, Brazil
| | - Herbert Pina Freire
- Departamento de Ciências Biológicas, Laboratório de Imunologia, Centro de Biotecnologia e Genética, Universidade Estadual de Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, 45662-900 Ilhéus, BA, Brazil
| | - Milena Evangelista de Almeida
- Departamento de Ciências Biológicas, Laboratório de Imunologia, Centro de Biotecnologia e Genética, Universidade Estadual de Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, 45662-900 Ilhéus, BA, Brazil
| | - Maysa Santos Barbosa
- Instituto de Ciências Biomédicas, Departamento de Microbiologia, Laboratório de Micoplasmas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Rachel Passos Rezende
- Departamento de Ciências Biológicas, Laboratório de Biotecnologia Microbiana, Centro de Biotecnologia e Genética, Universidade Estadual de Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, 45662-900 Ilhéus, BA, Brazil
| | - Jorge Timenetsky
- Instituto de Ciências Biomédicas, Departamento de Microbiologia, Laboratório de Micoplasmas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Lucas Miranda Marques
- Instituto de Ciências Biomédicas, Departamento de Microbiologia, Laboratório de Micoplasmas, Universidade de São Paulo (USP), São Paulo, Brazil
- Instituto Multidisciplinar em Saúde/Campus Anísio Teixeira, Universidade Federal da Bahia, IMS/CAT-UFBA, Vitória da Conquista, Brazil
| | - Carla Cristina Romano
- Departamento de Ciências Biológicas, Laboratório de Imunologia, Centro de Biotecnologia e Genética, Universidade Estadual de Santa Cruz (UESC), Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, 45662-900 Ilhéus, BA, Brazil
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Lagier JC, Diagne N, Fenollar F, Tamalet C, Sokhna C, Raoult D. Vaginal self-sampling as a diagnosis tool in low-income countries and potential applications for exploring the infectious causes of miscarriage. Future Microbiol 2017; 12:609-620. [PMID: 28604063 DOI: 10.2217/fmb-2016-0179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Gynecological health is a challenge in low-income countries. Personal opposition to perineal examination has been overcome by the use of vaginal self-sampling. Here, we review the use of this procedure notably in low-income countries and the main infectious causes of miscarriage. Vaginal self-sampling was mainly used for human papillomavirus detection but also to detect microorganisms causing sexually transmitted infections or bacterial vaginosis. 58 studies have been performed in low-resource countries, mainly studies performed to detect human papillomavirus in urban and peri-urban areas and demonstrating excellent acceptability. Several infectious causes of miscarriage could be tested using self-vaginal samples. In the future, such strategies coupled with a rapid-identification point-of-care method could allow the development of screening and treatment programs in rural areas in low-resource countries.
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Affiliation(s)
- Jean-Christophe Lagier
- Aix-Marseille Université, URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, Inserm U1095, Campus International UCAD-IRD, BP 1386, CP 18524, Dakar, Senegal
| | - Nafissatou Diagne
- Aix-Marseille Université, URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, Inserm U1095, Campus International UCAD-IRD, BP 1386, CP 18524, Dakar, Senegal
| | - Florence Fenollar
- Aix-Marseille Université URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, INSERM 1095, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Catherine Tamalet
- Aix-Marseille Université URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, INSERM 1095, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Cheikh Sokhna
- Aix-Marseille Université, URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, Inserm U1095, Campus International UCAD-IRD, BP 1386, CP 18524, Dakar, Senegal
| | - Didier Raoult
- Aix-Marseille Université URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, INSERM 1095, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
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Redelinghuys MJ, Ehlers MM, Bezuidenhoudt JE, Becker PJ, Kock MM. Assessment of Atopobium vaginae and Gardnerella vaginalis concentrations in a cohort of pregnant South African women. Sex Transm Infect 2017; 93:410-415. [PMID: 28143901 DOI: 10.1136/sextrans-2016-052883] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/26/2016] [Accepted: 01/14/2017] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The purpose of this cross-sectional study was to assess Atopobium vaginae and Gardnerella vaginalis concentrations in pregnant women of different age groups, gestational age groups, vaginal flora categories and HIV status, and also to determine which DNA concentrations best discriminated between bacterial vaginosis (BV)-positive and non-BV categories. METHODS Self-collected vaginal swabs were obtained from 220 pregnant women attending an antenatal clinic in Pretoria, Gauteng, South Africa, from July 2012 to December 2012. BV was detected with the Nugent scoring system, and A. vaginae and G. vaginalis DNA was quantified with a multiplex quantitative real-time PCR assay. RESULTS Median concentrations of A. vaginae and G. vaginalis were not significantly different among various age groups (A. vaginae p=0.98 and G. vaginalis p=0.18) or different trimesters (A. vaginae p=0.31 and G. vaginalis p=0.19), but differed significantly among the vaginal flora categories (A. vaginae p<0.001 and G. vaginalis p<0.001) and HIV status (A. vaginae p<0.001 and G. vaginalis p=0.004). The presence of A. vaginae (OR=5.8; 95% CI 1.34 to 25.21 and p value=0.02) but not that of G. vaginalis (OR=1.90; 95% CI 0.81 to 4.43 and p value=0.14) was associated with HIV infection. An A. vaginae DNA concentration of ≥107 copies/mL together with a positive G. vaginalis result (≥100 copies/mL) best discriminated between BV-positive (39/220) and non-BV categories (181/220) with a sensitivity of 85% (95% CI 0.70 to 0.94) and a specificity of 82% (95% CI 0.76 to 0.88). CONCLUSIONS A. vaginae and G. vaginalis were present in high numbers and concentrations in this pregnant cohort. Threshold concentrations should be established for specific populations to ensure sensitive molecular assays for BV detection.
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Affiliation(s)
- M J Redelinghuys
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
| | - M M Ehlers
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.,Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa
| | | | - P J Becker
- Biostatistics Unit, University of Pretoria, Pretoria, South Africa
| | - M M Kock
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.,Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa
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