Bacterial Vaginosis Prevalence and Its Associated Risk Factors among Women at Kiambu Level-5 Hospital, Kenya
Published: 2023-11-17
Page: 245-252
Issue: 2023 - Volume 6 [Issue 1]
Susan Akinyi Omwono *
Department of Medical Laboratory Sciences, School of Health Sciences, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya.
Arodi Washingtone
Department of Medical Laboratory Sciences, School of Health Sciences, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya.
Molly Maundu
Department of Cytology, Kiambu Level-5 Hospital, P.O. Box 2344-00900, Kiambu, Kenya.
Josephine Nyabeta Rioki
Department of Human Pathology, Faculty of Health Sciences, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
Onesmus Muia Mutuku
Department of Medical Laboratory Sciences, School of Health Sciences, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Background: Bacterial vaginosis (BV) is a commonly experienced vaginal disorder in women. It occurs when the beneficial lactobacillus species are replaced by anaerobic and facultative bacteria, leading to a foul-smelling vaginal discharge. Its diagnosis remains a big challenge in developing countries such as Kenya. Gram stain and Nugent scoring of the bacterial morphotypes is the recommended method of diagnosis, but is tedious to undertake and require highly skilled microscopists. The objective of this study was to determine the prevalence of BV among women at Kiambu Level-5 Hospital and to establish the risk factors associated with it.
Methodology: The Cross-sectional study was carried out at Kiambu Level-5 hospital, department of Pathology between April 2023 and June 2023. We included 196 women between the ages 18-55 who were enrolled by convenience sampling and screened for bacterial vaginosis using Gram staining and microscopy for bacterial morphotypes.
Results: Out of the 196 participants 46 were positive for BV (23.0%) while 150 (77.0%) were negative. Yeast cells (candidiasis) was found in 23 participants (11.7%) while 1 participant (0.5%) had gonococci. Out of the risk factors analyzed, only age had a significant association with BV (P=0.03)
Conclusion: The relatively high prevalence of bacterial vaginosis attained in this study shows that it is a health concern among women in Kiambu, Kenya particularly those aged between 41-45 years. There is need to educate women on how to avoid BV and to empower them to recognize the signs and symptoms, in order to seek treatment.
Keywords: Bacterial vaginosis, prevalence, risk factors
How to Cite
References
Javed Ayesha, Fahed Parvaiz, Sobia Manzoor. Bacterial vaginosis: An insight into the prevalence, alternative treatments regimen and its associated resistance patterns. Microbial pathogenesis. 2019;127:21-30.
Russo R, Karadja E, De Seta F. Evidence-based mixture containing Lactobacillus strains and lactoferrin to prevent recurrent bacterial vaginosis: A double blind, placebo controlled, randomised clinical trial. Beneficial microbes. 2019;10(1):19-26.
Yusuf MA, Chowdhury M, Islam KS, Eva EO, Sharif AR, Rahman MK, Begum SA. Common microbial aetiology of abnormal vaginal discharge among sexually active women in Dhaka, Bangladesh. South East Asia Journal of Public Health. 2013;1(1):35-39.
Demba Edward, et al. Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa. BMC infectious diseases. 2005;5(1):1-12.
Jespers V, Crucitti T, Menten J, Verhelst R, Mwaura M, Mandaliya K. Vaginal biomarkers study group. Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: A cross-sectional study. PloS one. 2014;9(10):e109670.
Woodman Zenda. Can one size fit all? Approach to bacterial vaginosis in sub-Saharan Africa. Annals of clinical microbiology and antimicrobials. 2016;15(1):1-7.
Muia Mutuku Onesmus, et al. Prevalence of bacterial vaginosis among HIV-positive women in Machakos County Hospital, Kenya. Asian Research Journal of Gynaecology and Obstetrics. 2021;5(1):28-34.
Musyoki Helgar, et al. Prevalence of HIV, sexually transmitted infections, and risk behaviours among female sex workers in Nairobi, Kenya: Results of a respondent driven sampling study. AIDS and Behavior. 2015;19:46-58.
Nzomo J, Waiyaki P, Waihenya R. Bacterial vaginosis and correlates in women of reproductive age in Thika, Kenya; 2013.
Sobel JD. Gynecologic infections in human immunodeficiency virus infected women. Clinical infectious diseases. 2000;31(5):1225-1233.
Coughlin Gabrielle, Mimi Secor. Bacterial vaginosis: update on evidence-based care. Advance for nurse practitioners. 2010;18(1):41-4.
Workowski Kimberly A, Laura H Bachmann. Centers for disease control and prevention’s sexually transmitted diseases infection guidelines. Clinical infectious diseases. 2022;74 (Supplement_2):S89-S94.
Verstraelen Hans, et al. The epidemiology of bacterial vaginosis in relation to sexual behaviour. BMC infectious diseases. 2010;10(1):1-11.
Mengistie Zemenu, et al. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. BMC research notes. 2014;7:1-5.
Bhujel Rajshree, et al. Comparative study of Amsel’s criteria and Nugent scoring for diagnosis of bacterial vaginosis in a tertiary care hospital, Nepal. BMC Infectious Diseases. 2021;21(1):1-6.
Muzny Christina A, Jane R Schwebke. Pathogenesis of bacterial vaginosis: Discussion of current hypotheses. The Journal of infectious diseases. 2016; 214(suppl_1):S1-S5.
Muzny Christina A, et al. Host–vaginal microbiota interactions in the pathogenesis of bacterial vaginosis. Current opinion in infectious diseases. 2020;33(1):59-65.
Nayar Ritu, David C Wilbur. The bethesda system for reporting cervical cytology: A historical perspective. Acta cytological. 2017;61(4-5):359-372.
Nugent Robert P, Marijane A Krohn, Sharon L Hillier. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. Journal of clinical microbiology. 1991;29(2):297-301.
Huang Sung-Hsi, et al. Prevalence, associated factors, and appropriateness of empirical treatment of trichomoniasis, bacterial vaginosis, and vulvovaginal candidiasis among women with vaginitis. Microbiology Spectrum. 2023:e00161-23.
Ndiaye Babacar, et al. Bacterial vaginosis: Prevalence and risk factors among women in dakar, senegal. Asian Journal of Research in Infectious Diseases. 2023; 12(1):33-40.
Mengistie Zemenu, et al. Comparison of clinical and gram stain diagnosis methods of bacterial vaginosis among pregnant women in Ethiopia. Journal of Clinical and Diagnostic Research: JCDR. 2013;7(12): 2701.
Ambike Abhijit S, et al. Prevalence of asymptomatic and symptomatic bacterial vaginosis in pregnant women attending antenatal clinic in a tertiary care rural hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020;9(9):3673.
Lokken Erica M, et al. Nugent score, amsel's criteria, and a point-of-care rapid test for diagnosis of bacterial vaginosis: Performance in a cohort of kenyan women. Sexually Transmitted Diseases. 2022; 49(1):e22-e25.
Majigo Mtebe V, Paschal Kashindye, Zachariah Mtulo. Bacterial vaginosis, the leading cause of genital discharge among women presenting with vaginal infection in Dar es Salaam, Tanzania. African Health Sciences. 2021;21;(2):531-537.
Oparaugo Chinedum Taahie, et al. Identification and antibiotic resistance profile of uropathogenic bacteria from sexually active women with bacterial vaginosis. Journal of Biosciences and Medicines. 2021;9(11):52-67.
Cherpes Thomas L, et al. A delicate balance: risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology. Sexually transmitted diseases. 2008;78-83.
Fethers Katherine A, et al. Early sexual experiences and risk factors for bacterial vaginosis. The Journal of Infectious Diseases. 2009;200(11):1662-1670.
Vaca M, Guadalupe I, Erazo S, Tinizaray K, Chico ME, Cooper PJ, et al. High prevalence of bacterial vaginosis in adolescent girls in a tropical area of Ecuador. BJOG: An International Journal of Obstetrics & Gynaecology. 2010;117: 225-228.
Ibrahim SM, Bukar M, Galadima GB, Audu BM, Ibrahim HA. Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North-Eastern Nigeria. Nigerian Journal of Clinical Practice. 2014;17:154-158
Bitew Adane, et al. Prevalence of bacterial vaginosis and associated risk factors among women complaining of genital tract infection. International Journal of Microbiology. 2017;(2017).
Yalew Gebrehiwet Tesfay, et al. 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(2):e0262692.
Donders Gilbert. Diagnosis and management of bacterial vaginosis and other types of abnormal vaginal bacterial flora: A review. Obstetrical & Gynecological survey. 2010;65;7:462-473.
Bonneton Marion, et al. Bacterial vaginosis and other infections in pregnant women in Senegal. BMC Infectious Diseases. 2021; 21(1):1090.
Achilles Sharon L, et al. Impact of contraceptive initiation on vaginal microbiota. American Journal of Obstetrics and Gynecology. 2018;218(6):622-e1.
Gallo Maria F, et al. Accuracy of clinical diagnosis of bacterial vaginosis by human immunodeficiency virus infection status. Sexually Transmitted Diseases. 2011;270-274.
Guédou Fernand A, et al. Behavioural and medical predictors of bacterial vaginosis recurrence among female sex workers: Longitudinal analysis from a randomized controlled trial. BMC Infectious Diseases. 2013;13:1-11.