Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon

Abstract

Background Bacterial vaginosis (BV) is a common reproductive tract disorder in women of child bearing age, accounting for one third of vaginal infections. It is characterized by an increase in vaginal pH, decreased Lactobacilli, and overgrowth of facultative and anaerobic bacteria. Studies have consistently shown BV to be a risk factor for adverse obstetric and gynecological outcomes. BV is believed to play a critical role in the transmission of sexually transmitted infections. Its aetiology and risk factors are poorly understood. This study determined the prevalence and risk factors for BV among pregnant women in Kumba Health District (KHD) Cameroon to generate findings that could guide the design of interventions for prevention of infection and associated poor pregnancy outcomes. Methods A structured questionnaire was administered to 309 women seeking antenatal care (ANC) in three health facilities in KHD between May to July 2016, to capture data on demographic, gynecological and obstetric characteristics, and hygiene behavior. High vaginal swabs (HVS) collected from these women were gram stained, examined under a microscope and BV evaluated by Nugent scoring. Chi square (χ 2 ) test was used to determine the relationship between BV and factors investigated. Statistical significance was set at p < 0.05. Results The prevalence of BV was 26.2%. Nine point 1 % of participants had a mixed infection with Candida . BV was higher (29.5%) in participants from the rural area (χ 2 = 8.609. P = 0.014), those who did not use antibiotics (31.9%) prior to the study (χ 2 = 12.893, P = 0.002) and women with no history of a genital tract infection (χ 2 = 18.154, P = 0.001). There was a significant difference in prevalence with respect to gestation age (χ 2 = 13.959, P = 0.007) with the highest occurring in women in the second trimester (31.7%). Women who practiced douching (χ 2 = 23.935, P = 0.000) and those who did not wash pants with disinfectant (χ 2 = 7.253, P = 0.027) had a high prevalence. Conclusion BV could be a health concern among pregnant women in study area. BV prevalence was affected by some hygiene behaviors, socio-demographic and clinical factors. Screening and treatment of positive cases during antenatal visits to prevent adverse outcomes, as well as education of women on vaginal hygiene is highly recommended.

Risk Factors Associated with Prevalence ofCandida albicans,Gardnerella vaginalis, andTrichomonas vaginalisamong Women at the District Hospital of Dschang, West Region, Cameroon

“…Higher prevalence of vaginal infection in all the age groups could be due to the fact that women are more sexually active and some of them have many sexual partners, whether they are married or not, in addition to the poor hygiene conditions. ese results are in accordance with those of Kamga et al [7] and Achondou et al [8] in Cameroon. e high prevalence of these infections could be due to the anatomy of the female vaginal organ which favours penetration and the installation of the infection and poor personal hygiene.…”

“…12.02% of the symptomatic patients presented recurrent symptoms of nonspecific vaginitis. e prevalence of multiple infections was lower in this study than that reported by others [7,8]. However, G. vaginalis was frequently associated with C. albicans (9.49%).…”

Prevalence and factors associated with Trichomonas vaginalis infection in indigenous Brazilian women

“…Concomitant infection between TV and G. vaginalis and TV and C. albicans were found in 3 women, respectively. The concomitant infection is commonly found in cases where TV makes the vaginal environment susceptible to infection by C. albicans, and other microorganisms, such as G. vaginalis joins leading to the development of bacterial vaginosis (BV) [24][25][26][27][28][29][30]. The presence of atypical squamous cells of unknown significance was observed in 10 of the sample population, and HPV characteristic lesions were observed in 14 women, and among them, 5/24 of women who show lesion on the pap smear, were infected concomitantly with TV.…”

Morbidities and mortality among infants of HIV-1-infected mothers with bacterial vaginosis in Kenya

“…For example, Alcendor (12) investigated health disparities in BV and its implications for HIV-1 acquisition in African-American women and reported prevalence rates of 52% and 32% among Black and Mexican American women respectively. Kamga et al (13) reported a prevalence rate of 26% among pregnant women in Cameroon. In comparison, Nduati et al (14) reported a prevalence rate of 47% in a cohort of HIV-positive pregnant women receiving care in Kenya.…”

“…However, the actual mechanisms underlying BV and the associated risk factors are still poorly understood (16). It is crucial to note that BV could a ict non-pregnant and pregnant women (13,16) and can also occur in both sexually-active and -inactive young women (17), and in young and older women. Still, it is more pronounced among younger women (18).…”