Bacterial Vaginosis and Associated Factors Among Pregnant Women Attending Antenatal Care in Harar City, Eastern Ethiopia

Ahmed, Mohammed; Ayana, Desalegn Admassu; Abate, Degu

doi:10.2147/idr.s364229

Cited by 5 publications

(5 citation statements)

References 68 publications

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“…С еред вагінальних інфекцій особливе місце посідає бактеріальний вагіноз (БВ) -незапальне ураження піхви, що характеризується дисбіозом піхвової мікрофлори з переважанням росту облігатно-анаеробних бактерій. Згідно з літературними джерелами, поширеність БВ серед вагітних становить 10-30% [1,7]. Проте у половини жінок БВ перебігає безсимптомно, тому дійсну поширеність процесу визначити практично неможливо.…”

Section: а к у ш е р с т в оunclassified

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

Beniuk,

Hychka,

Kovaliuk

et al. 2024

RHW

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Pregnancy with bacterial vaginosis (BV) is accompanied by a high risk of various obstetric and perinatal complications, including miscarriage, preterm birth, placental dysfunction, premature rupture of membranes, chorionamnionitis, polyhydramnios, etc. Screening for BV is carried out in the first half of pregnancy during the registration of a woman, however, taking into account the gestational age, many drugs with antimicrobial and antiseptic effects are categorically contraindicated, as they have an embryo- and fetotoxic effect.Timely detection and correction of microbiocenosis disorders of the birth canal is an extremely important element to prevent a number of obstetric and perinatal complications. A balanced approach in the treatment of vaginal dysbiosis consists in the use of modern combined antiseptic preparations for local treatment, which do not contain antibacterial components and are safe for use during pregnancy.The objective: to determine the effectiveness of the treatment of BV in primigravida women in the first half of pregnancy.Materials and methods. 126 primigravida women aged 18–35 years in the first half of pregnancy were examined during pregnancy registration. The participants were selected randomly.The main group included 36 primigravida women with a gestation period of up to 20 weeks with a diagnosis of BV according to the Amsel and Hay–Ison criteria, who were treated with a combined antiseptic drug (chlorhexidine and chlorophyllipt) – suppository vaginally twice a day, the course of treatment – 5 days. The control group included 30 primigravida women with a gestational age of up to 20 weeks with vaginal normocenosis.For all women the pH of vaginal secretions was determined, followed by microscopy of a native smear, stained according to Gram, and a cultural study was performed. Adherence to the Amsel criteria was also determined, followed by evaluation by the Hay–Ison criteria. The clinical effect was evaluated according to clinical examination data before and on the 6th day of treatment with a combined antiseptic drug (chlorhexidine and chlorophyllipt) using bacterioscopic and bacteriological methods.Results. A normal pH was observed only in every fifth part of examined pregnant woman (28 women – 22.2%), while in the rest patients the acidity of the vaginal environment was not normal. Normocenosis was observed only among 1/3 of primigravida women (37 women – 29.4%). A third of the patients were diagnosed with BV (36 women - 28.6%), every fifth pregnant woman – vulvovaginal candidiasis (28 women - 22.2%).In healthy pregnant women (control group, n=30), the main component of the microbiocenosis was Lactobacillus spp. with a small content of facultatively anaerobic microorganisms. In the main group Atopobium vaginae (38.9%), Gardnerella vaginalis (33.3%), Prevotella bivia (27.8%), Candida spp. (22.2%), as well as Lactobacillus spp. in low titers were dominated. Before the treatment all 36 pregnant women of the main group corresponded to the 3rd type according to the Hay–Ison criteria with the dominance of Gardnerella vaginalis and/or Mobiluncus morphotypes and a small number or complete absence of lactobacilli, which served as the basis for establishing the diagnosis of BV. After treatment type 1 (94.4%) was found in 34 pregnant women, and type 2 (5.6%) – in 2 pregnant women.The results of the microbiological study indicate the normalization of the content of the biotope with the predominance of Lactobacillus spp. in women of the main group, in whom the indicators were similar to the control group.Conclusions. Since pregnancy with BV is accompanied by a high risk of obstetric and perinatal complications, the premorbid background of which is laid already in the first half of pregnancy, there is an urgent need to carry out the birth canal sanitation. The drugs of choice for the BV in the first half of pregnancy are local combined agents of a wide spectrum of action.A universal antiseptic with an anti-inflammatory effect, which includes two components – chlorhexidine and chlorophyllipt, fully meets the recommendations for efficiency and safety and can be used for the BV in the first half of pregnancy.

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Section: а к у ш е р с т в оunclassified

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

Beniuk,

Hychka,

Kovaliuk

et al. 2024

RHW

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“…As already known, there is a close relationship between the quantitative and qualitative composition of the vaginal and intestinal microbiota and immune system dysfunction [9,10]. Representatives of the microbiota of the lower genital tract in healthy women, which are mainly represented by L. crispatus, L. jensenii, and L. iners, metabolize glycogen secreted by the vaginal epithelium and produce lactic acid, which is largely responsible for the vagina pHwhen it exhibits virucidal activity against pathogens [6,[15][16][17]. Th e cervix secretions contain factors of innate immunity: complement, defensins, and immunoglobulins (Igs) in high concentrations, which are the fi rst line of defense against pathogens (Kozlowski et al, 1999).…”

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“…Sialidase, which is more commonly produced by G. vaginalis, can cause immunosuppression and promote the recurrence of BV. Other hydrolytic enzymes, such as vaginolysin, also suppress IgA production [6,15,17]. At the same time, high levels of IgA against G. vaginalis hemolysin prevent adverse outcomes in BV development, especially during pregnancy [16] as the innate immunity of the vaginal mucosa is closely related to the adaptive immunity development.…”

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confidence: 99%

“…Th e mechanisms of immune response development in BV remain insuffi ciently studied, and the recurrence of this disease is a serious burden on healthcare worldwide [16]. Many studies have confi rmed that BV can increase the risk of gonorrhea, chlamydia, HIV, herpes virus, and papillomavirus infections, and thus, cervical cancer [3,4,17]. To eff ectively treat patients with BV, probiotics with a defi ned multifactorial mechanism of action (antimicrobial, anti-infl ammatory, and immunomodulatory) are used alone or in combination with etiotropic or pathogenetic therapy, which can normalize the vaginal microbiota, the state of the immune system, and infl ammation [5,10,11,15].…”

mentioning

confidence: 99%

“…Note that disruption of vaginal microbiota caused by BV creates a more favorable environment for HIV infection and increases the risk of genital herpes virus (HSV-2) transmission by 2.3 times [17]. Literature sources confi rm that the reduction of colonization resistance of indigenous vaginal microbiota and its colonization by opportunistic microorganisms (enterococci, staphylococci, etc.…”

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Effect of Probiotic Therapy on the Vagina Microbiota and the Humoral Link of Immunity in Bacterial Vaginosis

et al. 2023

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The aim of the research is to determine the effect of the probiotic preparation «Dialak» (dietary supplement), which includes the strain Lactobacillus casei IMV B-7280, on the vaginal microbiota and humoral immunity in women with bacterial vaginosis (BV). Methods. 40 female patients aged 20—45 years with disturbed vaginal microbiota and 10 healthy individuals were examined. The verification of 3 types of vaginal biocenosis states, namely normocenosis, intermediate type, and vaginal dysbiosis, was carried out on the basis of the Recommendations for the Treatment of Sexually Transmitted Infections Weekly Morbidity and Mortality Report (2021) and laboratory diagnostic methods according to the well-known criteria proposed by R. Amsel. Female patients with an intermediate type of BV (group 1) received suppositories and capsules of the probiotic (once daily) for 10 days. Women with vaginal dysbiosis (group 2) received metronidazole in a dosage of 500 mg twice a day for 7 days during the first stage, and then 1 suppository at night and oral capsules of the probiotic in the morning for 10 days during the second stage. The studied vaginal secretion was stained by the Gram method in the Kopeloff modification and also sown on nutrient media to determine facultatively anaerobic and obligately anaerobic microorganisms. Microorganism identification was carried out on the basis of morphological, cultural, biochemical, and antigenic properties according to the classification of D. H. Bergey (2009). The activity of humoral immunity was determined by evaluating the number of B-lymphocytes in the peripheral blood of patients using flow cytometry, as well as the levels of serum Ig A, M, and G before treatment and aft er 1 month using the immunoturbidimetric method and the Cobas 6000 test system from Roche Diagnostics (Switzerland). Results. When analyzing the vaginal microbiota in two groups of patients before treatment, a decrease in the number of Lactobacillus spp. and Bifidobacterium spp. and a significant increase in the number of obligate anaerobic microorganisms, including Gardnerella vaginalis, were found compared to the control group. Before treatment, the number of Lactobacillus spp. in women of group 2 was lower compared to group 1. In patients with vaginal dysbiosis before treatment, the number of obligate anaerobic microorganisms was higher than in patients with bacterial vaginosis, except for Eubacterium spp. At the same time, in women in both comparison groups, the indicators of the humoral immune response were partially disrupted, as evidenced by a decrease in the level of IgG and IgA (in women of group 2) in the serum against the normal level of B lymphocytes (CD19+ cells). However, these patients showed an increase in the IgM level in the serum, which may be due to the development of anaerobic microflora. After treatment, the number of Lactobacillus spp. and Bifidobacterium spp. in the vagina of women in both comparison groups increased compared to the indicators before treatment. However, the number of these bacteria in the vagina of patients with dysbiosis remained lower compared to patients with BV. In both groups, normalization of the number of obligate anaerobic microorganisms, including G. vaginalis, except for Veillonella spp., was also observed. After treatment, the humoral immune response indicators were normalized as well: the level of serum IgG and IgA increased, and the content of serum IgM decreased. Conclusions. In BV patients, the probiotic «Dialak» normalizes the vaginal microbiota, which was confirmed by increasing the number of Lactobacillus spp. and Bifidobacterium spp. along with decreasing the number of anaerobic microorganisms, including G. vaginalis, against the background of the dynamic disappearance of clinical signs of the disease, as well as restoration to the normal level of indicators of the immunity humoral link. The obtained data indicate the effective therapeutic effect of the probiotic «Dialak» on BV.

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Prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics at public hospitals in West Shoa Zone, Oromia, Ethiopia

Regassa,

Kumsa,

Wondimu

et al. 2024

Sci Rep

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Bacterial vaginosis is a polymicrobial syndrome characterized by the decrease of Lactobacilli and an overgrowth of facultative and anaerobic bacteria in vaginal fluid. Though it has received little attention, it has been associated with poor pregnancy outcomes, such as pre-term labor and delivery, premature rupture of membranes, low birth weight, spontaneous abortion, and postpartum infections. This study aimed to determine the prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics from September 15 to December 14, 2021, at public hospitals in West Shoa Zone, Oromia, Ethiopia. An institutional-based cross-sectional study was conducted on 260 pregnant women, and systematic random sampling was employed to recruit the study participants. Data were collected through a structured questionnaire and the vaginal swab was collected using a sterile cotton swab. The gram staining result was interpreted using the Nugent scoring system. Data was entered into an Excel spreadsheet and exported to STATA-14 for analysis. Data were presented using tables and graphs. Binary and multivariable logistic regressions were performed. Variables with a P value ≤ 0.25 at the binary logistic regression were entered into the multivariable logistic regression. Finally, variables with a P value ≤ 0.05 were considered predictors of bacterial vaginosis and interpreted using adjusted Odds Ratios (AOR) with a 95% confidence interval (CI). A total of 260 pregnant women attending antenatal care were included in the study. The prevalence of bacterial vaginosis according to the Nugent scoring system was 22.3% (95% CI 17.4 to 27.9%). Pregnant women with other marital status were at reduced risk of bacterial vaginosis as compared with married pregnant women (AOR = 0.260, 95% CI 0.068 to 0.9995; P = 0.05). Rural residence (AOR = 2.1, 95% CI 1.05 to 4.24; P = 0.036), use of one pant per week (AOR = 2.7, 95% CI 1.04 to 7.2; P = 0.041), and use of two or more pants per week (AOR = 4.96, 95% CI 1.49 to 16.57; P = 0.009) were significantly associated with bacterial vaginosis. In the current study, a high magnitude of bacterial vaginosis was reported. Residence, marital status, and number of pants used per week were found significantly associated among pregnant women. Hence, screening for the disease should be integrated into the recommended basic laboratory investigations during antenatal visits.

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Bacterial Vaginosis and Associated Factors Among Pregnant Women Attending Antenatal Care in Harar City, Eastern Ethiopia

Cited by 5 publications

References 68 publications

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

Effect of Probiotic Therapy on the Vagina Microbiota and the Humoral Link of Immunity in Bacterial Vaginosis

Prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics at public hospitals in West Shoa Zone, Oromia, Ethiopia

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