Prevalent bacterial vaginosis infection – a risk factor for incident sexually transmitted infections in women in Durban, South Africa

Abstract

The association between bacterial vaginosis (BV) and incident sexually transmitted infections (STIs) in a cohort of high-risk women from Durban, South Africa was investigated in this study. We undertook a secondary analysis of the Methods for Improving Reproductive Health in Africa trial that assessed effectiveness of the latex diaphragm and lubricant gel on HIV prevention among women. During study visits, urine specimens were collected for testing for Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis The presence of BV was based on vaginal pH and wet mount test assessments. The association between BV and the risk for incident STIs was determined using the Cox proportional hazards model. Prevalence of BV was 31% in a cohort of 435 women tested at baseline. Among these women, BV was significantly associated with incident Trichomonas vaginalis (14.6 per 100 PY, p = 0.03) and Chlamydia trachomatis infections (15.8 per 100 PY, p = 0.04). BV remained a significant predictor for Trichomonas vaginalis infections even after adjusting for potential confounders such as age and marital status (HR: 1.60, 95% CI: 1.00, 2.57, p = 0.04). Our study showed an association between baseline BV infections and incident Trichomonas vaginalis and Chlamydia trachomatis infections. Women with BV infections should be counselled on the use of condoms and the risk of new STIs.

High prevalence of curable sexually transmitted infections among pregnant women in a rural county hospital in Kilifi, Kenya

“…Women with BV had an almost 3-fold higher risk of infection with a curable STIs than women without BV, comparable to other studies [4, 33]. It might be advisable to better document the presence of BV.…”

“…trachomatis and N . gonorrhoeae [3, 4], is highly prevalent [5]. These curable STIs and BV have been associated with a number of adverse pregnancy outcomes such as spontaneous abortion, ectopic pregnancy, preterm delivery, low birth weight, stillbirth, postpartum sepsis, and congenital infection [6].…”

Asymptomatic Bacterial Vaginosis in Pregnancy and Missed Opportunities for Treatment: A Cross-Sectional Observational Study

“…BV in pregnancy is clinically significant because of its association with pre-term labor and delivery, pre-mature, pre-labor rupture of membranes, spontaneous miscarriage, and infections post-delivery [3][4][5][6]. BV may also pose a risk for the acquisition of sexually transmitted infections (STIs) such as HIV, N. gonorrhoeae, C. trachomatis, and HSV-2 that are independently associated with preterm delivery if untreated [7][8][9][10][11][12].…”

Impact of antiseptics on Chlamydia trachomatis growth

“…; Abbai et al . ). The connection between bacterial vaginosis and chlamydia infection is not clear, but one of the possibilities is the increased indole production of the bacterial vaginosis‐related bacteria (Aiyar et al .…”

“…Bacterial vaginosis is a state where the normal lactobacillus flora of the vagina is disappearing and is replaced by a polybacterial flora. Several studies showed that bacterial vaginosis is a significant risk factor of acquiring STIs including chlamydial STIs with a relative risk of 2Á0-3Á4 (Wiesenfeld et al 2003;Aghaizu et al 2014;Abbai et al 2015). The connection between bacterial vaginosis and chlamydia infection is not clear, but one of the possibilities is the increased indole production of the bacterial vaginosis-related bacteria (Aiyar et al 2014).…”