High rate of bacterial vaginosis among women with intrauterine devices in Manado, Indonesia.

Recent research reported that bacterial vaginosis (BV) might enhance the acquisition and transmission of HIV. BV is also associated with an increased risk of pelvic inflammatory disease, a disease also associated with intrauterine device (IUD) insertion. To measure the magnitude of this problem, we conducted a prevalence survey of BV and sexually transmitted diseases (STDs; defined as current infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and/or Trichomonas vaginalis) among all patients attending a family planning clinic in Manado from May to July 1999. BV was diagnosed by Gram stain using Nugent's criteria and vaginal trichomoniasis by wet mount or culture. Cervical infections with C. trachomatis and N. gonorrhoeae were diagnosed by DNA probe. Of 357 patients, 116 (32.5%) had BV, 83 (23.3%) had trichomoniasis, 9 (2.5%) had chlamydia, and 8 (2.2%) had gonorrhea. The prevalence of STD was similar among users of all types of contraception. However, BV was more common among IUD users (47.2%) than among non-IUD users (29.9%). This association persisted after controlling for age, education, ever had douching, and any STD (odds ratio 2.0, 95% CI 1.1-3.8). BV was also associated with STD (41.3% in women with STD vs. 29.4% in women without). This association remained significant after adjusting for age, education, ever had douching, and IUD use (odds ratio 1.7, 95% CI 1.1-2.9). Because we found that BV was associated with IUDs and that other studies reported that both BV and IUDs were associated with pelvic inflammatory disease, a Gram stain evaluation of BV may be considered prior to IUD insertion

Intestinal parasitic infections in Likupang, North Sulawesi, Indonesia.

A parasitological survey was conducted on the inhabitants of 6 villages of Likupang, Minahasa Peninsula, North Sulawesi, Indonesia, in August 1991. A total of 419 fecal samples were examined by using direct smear, flotation, formalin ether concentration, Harada-Mori culture and agar-plate culture techniques. Five nematode and 7 protozoan parasites were detected, while trematode and cestode infection was not observed. Soil-transmitted nematode infections were predominant. Among the younger inhabitants aged less than 15, positive rates of Ascaris, Trichuris and hookworm infections were almost same, namely 45.7, 45.3 and 47.7%, respectively. Among the elder people aged 15 or more, positive rate of hookworm infection (89.4%) was much higher than Ascaris and Trichuris infections (19.3 and 26.1%, respectively). Village to village differences in parasite prevalence, probably due to socio-economic and sanitary-environmental differences were observed. Both Necator americanus and Ancylostoma duodenale were detected. The agar-plate culture was proved to be an efficient method for detection of hookworm as well as Strongyloides stercoralis.