Prevalence of bacterial vaginosis in pregnant women attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria using the complete Amsel's diagnostic criteria

Background: Bacterial vaginosis (BV) in pregnant women remains a cause for clinical concern among clinicians and health care professionals. BV has been linked to prenatal, antenatal and postnatal challenges in pregnant women. Information on prevalence of BV across trimesters of pregnancy is expected to give better clinical insight into the pathophysiology of this polymicrobial disorder. This study was conducted to determine the prevalence of BV in pregnant women attending the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. Methodology: This was a cross-sectional study of 120 pregnant women (40 in each trimester of pregnancy) who had symptoms suggestive of BV, selected by systematic random sampling from among the women attending the Obstetrics and Gynaecology (O & G) clinic of NAUTH, Nnewi. Each subject participant was examined by the attending clinician, and high vaginal swab (HVS) sample was collected for diagnostic analysis of BV using with complete Amsel's clinical criteria, which consists of three of the four criteria; (i) adherent and homogenous vaginal discharge, (ii) vaginal pH > 4.5, (iii) detection of clue cells on saline wet mount, and (iv) amine odor after the addition of potassium hydroxide (positive Whiff test). Results: The mean age of the 120 selected participants was 27.25±6.09 years. The age groups 25-29 (36.7%) and 20-24 years (33.3%) constituted the largest proportion, while age groups <20 (5.0%) and 40-45 years (5.0%) constituted the least. Of the 120 participants, 26 (21.7%) were positive for BV by the Amsel's criteria. Pregnant women in age group <20 years had the highest prevalence of BV (100%, 6/6), followed by those in the age groups 20-24 (27.5%), 40-45 (16.7%), 25-29 (15.9%), 30-34 (9.1%) and 35-39 years (0%) (X 2=28.063, p=0.0001). Prevalence of BV was significantly higher in single (unmarried) pregnant women (45.5%, X 2=4.038, p=0.045), women with primary school education level (66.7%, X 2=14.530, p=0.001), unemployed women (36.1%, X 2=13.278, p=0.0013), and nulliparous women [36.4%, X 2 (for trend) = 4.805, p=0.0274), while there was no significant difference in the prevalence of BV with relation to trimester of pregnancy (X 2=2.750, p=0.253). Conclusion: This study reveals a relatively high prevalence of BV and significant association with factors such as age group, education and occupational status among pregnant women attending NAUTH Nnewi. Regular screening of women for BV prenatally may enable appropriate interventions to prevent adverse pregnancy outcomes

Prevalence of bacterial vaginosis among sexually active women attending the cdc central clinic tiko, south west region, Cameroon

Background: Bacterial vaginosis (BV) is a polymicrobial; superficial vaginal infection involving a reduction in the amount of hydrogen peroxide-producing Lactobacillus and overgrowth of anaerobic bacteria. Common symptoms include increased fishy smelling vaginal discharge which is usually white or gray in color. Burning with urination may occur and itching is uncommon. Risk factors include douching; new or multiple sex partners; antibiotics; and use of intrauterine device among others. Materials and Methods: This cross-sectional study assessed the prevalence of bacterial vaginosis among sexually active women aged 15-45 years. Vaginal swabs were obtained with the use of sterile swab sticks which were later smeared on clean glass slides and then Gram stained. The stained smears were observed for bacterial morphotypes with the X100 oil immersion objective and the Nugent scoring system was used to determine BV. Data were analyzed using the Statistical Package for Social Scientists (SPSS) version 17.0 and were considered significant at p = 0.05. Results: A total of 100 women participated in the study with the overall prevalence of BV rated 38%. The prevalence of BV with respect to associated factors was also investigated and it was observed that BV was more prevalent in the age groups 20-25 (48.1%) and 25-29 (44.4%); those who had attained only primary education (60.5%); married women; (68.4%); pregnant women (71.0%); and women who practiced vaginal douching; (97.4%). However; no statistical significant difference was observed in the prevalence between these parameters (P 0.05). Conclusions: Conclusively; the prevalence of bacterial vaginosis in our study population is 38% and highest among women aged between 25 and 34 years; pregnant women; married women; less educated women and women who practiced poor vaginal hygiene

Prevalence of bacterial vaginosis in women with vaginal symptoms in South Province, Rwanda

This is a prospective study of 297 Consecutive High Vaginal Swab (HVS) specimen from patients with vaginal symptoms at the laboratory of Butare University Teaching Hospital; South Province; Rwanda. The aim of the study was to evaluate the prevalence of bacterial vaginosis and the role of some micro-organisms and laboratory indices associated with it. The age range was 16-57 years with a mean of 30.8 years. The overall prevalence of bacterial vaginosis was 17.8and the highest percentage of 52.8(28) found in the age group of 21-30 years compared with the lowest percentage of 1.9(1) in the age group less than 20 years. Almost half of patients with trichomoniasis were found to have bacterial vaginosis (P0.05). The demonstration Clue cells in wet mount was found in significantly higher numbers (90.5) in women with bacterial vaginosis (P0.001; positive predictive value 90.4) while low sensitivity and positive predictive value were seen for vaginal discharge for detecting infection with bacterial vaginosis ( p 0.05; positive predictive value 26.0). Bacterial vaginosis is common among women with vaginal symptoms in Rwanda as showed by gram stain examination. Further research into this pathology in other Rwandan women populations is needed

Organisms associated with bacterial vaginosis in Nigerian women as determined by PCR-DGGE and 16S rRNA Gene Sequence

Background: Bacterial vaginosis (BV) is a condition with diverse etiology.This condition predisposes women to increased susceptibility to sexually transmitted diseases; including human immunodeficiency virus (HIV) infections and preterm birth. The diagnostic methods currently adopted in the evaluation of patient samples for BV are arguably Amsel criteria; and Nugent score that require microscopy and expert interpretation.These two methods are still subjective. Objective: The objective of this study was to determine the organisms present in the vagina of 34 HIV negative Nigerian women diagnosed as having bacterial vaginosis by using molecular techniques. Methods:The vaginal samples were subjected to DNA extraction; and amplified with eubacterial primers via PCR.The PCR products were separated using denaturing gradient gel electrophoresis (DGGE). Bands were excised; re-amplified; purified and sequenced. Sequence identification was performed using the BLAST algorithm and Genbank data base. Results: Mycoplasma hominis (12/34; 35) was the most common isolate and 9 (26) contained one of two clones of an unusual Rainbow Trout intestinal bacterium; while unculturable Streptococcus sp; and other bacteria made up the remaining isolates. Con-clusions:The findings indicate further diversity in the etiological agents associated with BV; and raise the question as to whether diagnosis and management of this condition needs to be re-evaluated in countries like Nigeria.There is some controversy over the clinical importance of BV; as it was once regarded as a disease caused by Gardnerella and presenting as an odourous discharge condition; but is now diagnosed without necessarily the presence of these organisms or signs. With the incidence of BV aligned to an increased risk of HIV in a country ravaged by this virus; the effective eradication of BV can only be achieved if appropriate therapies are delivered

Caracterisation de la flore vaginale a Abidjan : Identification et role des lacto bacillus

Dans le but de caracteriser la flore genitale de la femme a Abidjan; les secretions genitales de 512 patientes consultant a l'Institut Pasteur de Cote d'ivoire pour le diagnostic etiologique d'un ecoulement vaginal ont ete analysees de Novembre 1999 a Janvier 2000. L'ecosysteme vaginal a ete caracterise a l'examen direct (coloration de Gram). Les Lactobacillus ont ete recherches a l'examen direct puis apres culture sur gelose MRS et leur capacite a produire du h2o2; peroxyde d'hydrogene a ete recherchee sur gelose MRS au tetramethyl-benzidine ou TMB. Au plan epidemiologique et clinique; les patientes analysees avaient une moyenne d'age de 28ans avec des extremes d'age de 25 a 70 ans. L'ecoulement vaginal etait un signe frequent chez les patientes analysees; il etait peu abondant. Les methodes contraceptives etaient peu utilisees; ce qui n'etait pas le cas de la douche vaginale qui etait tres pratiquee dans la population etudiee. Au plan microbiologique; la flore de type IV; c'est a dire celle depourvu de Lactobacilus etait la plus frequente chez nos patientes. 200 souches de Laclobacillus ont pu etre isoler sur la gelose MRS. Les Lactobacillus du sous genre Thermobacterium actuellement appele Lactobacillus du groupe acidophilus etait le plus frequemment rencontre. Aucune souche protectrice de h2o2 n'a ete retrouvee. La premiere etiologie des ecoulements vaginaux etait representee par la vaginose bacterienne; qui etait en rapport avec la pauvrete de la flore vaginale en Lactobacillus. En conclusion l'absence de Lactobacillus au niveau de la flore favorise le developpement des agents pathogenes; et pourrait egalement constituer un facteur favorisant a la transmission l'infection a VIH