Prevalence of bacterial vaginosis in Thai women attending the family planning clinic, Siriraj Hospital.

OBJECTIVES: To investigate the prevalence of bacterial vaginosis (BV) among Thai women attending a family planning clinic and to evaluate the association of BV with potential risk factors. MATERIAL AND METHOD: A cross sectional prevalence study was conducted among 800 women attending the family planning clinic, Siriraj Hospital, between August and December 2003. BV was diagnosed according to Amsel's criteria. Prevalence and risk factor models were compiled and statistically analyzed RESULTS: Among the low risk population acquiring sexually transmitted diseases, the prevalence of BV was 14.6% (117 of 800). Asymptomatic disease was recognized in up to 47.9% (56 of 117). BV was significantly more prevalent among those who used douching inside the vagina [OR = 3.98 (1.85-8.33), p < 0.01] and high a prevalence among IUD users [OR = 1.84 (1.22-2.79), p < 0.01]. Although not statistically significant, BV tended to be more prevalent among women with a lower age at first intercourse, higher numbers of lifetime partners, higher frequency of sexual intercourse and current smokers. CONCLUSION: BV is a relatively high prevalent condition. The two potential risk factors, douching inside the vagina and IUD use, can be demonstrated, adding to be more concerned about the inappropriate practice of douching and more consideration in IUD users. The other potential risk factors, the impact to adverse reproductive outcomes and the prevention of BV need further studies, particularly in various Thai populations.

Prevalence of actinomyces in cervico-vaginal smears of intrauterine device users.

A total of 300 Papanicolaou smears from current intrauterine device (IUD) users who attended the Family Planning Clinic of Siriraj Hospital from 2 November 1996 to 10 March 1997 were screened for actinomyces. The overall prevalence rate of actinomyces was 14 percent. Insert IUDs produced a significantly higher infection rate compared with metallic IUDs. The infection rate was also found to increase in direct relation to the duration of IUD use. Findings such as other infectious agents and symptoms are also discussed. The treatment of actinomyces with serious complications poses a management problem for the clinician when actinomyces is reported in a routine smear. Our findings lead us to question the practicality of earlier recommendations of IUD removal and/or antibiotic therapy.