Risk and protective factors associated with BV chronicity among women in Rakai, Uganda

Abstract

ObjectivesTo assess risk and protective factors associated with bacterial vaginosis (BV) chronicity ascertained by Nugent score criteria.MethodsA longitudinal cohort study included 255 sexually experienced, postmenarcheal women who provided weekly self-collected vaginal swabs for up to 2 years. Vaginal swabs were scored using Nugent criteria and classified as normal (≤3), intermediate (4–6) and Nugent-BV (≥7). Detailed behavioural/health information were assessed every 6 months. A per-woman longitudinal summary measure of BV chronicity was defined as the percentage of each woman’s weekly vaginal assessments scored as Nugent-BV over a 6-month interval. Risk and protective factors associated with BV chronicity were assessed using multiple linear regression with generalised estimating equations.ResultsAverage BV chronicity was 39% across all follow-up periods. After adjustment, factors associated with BV chronicity included baseline Nugent-BV (β=35.3, 95% CI 28.6 to 42.0) compared with normal baseline Nugent scores and use of unprotected water for bathing (ie, rainwater, pond, lake/stream) (β=12.0, 95% CI 3.4 to 20.5) compared with protected water sources (ie, well, tap, borehole). Women had fewer BV occurrences if they were currently pregnant (β=−6.6, 95% CI −12.1 to 1.1), reported consistent condom use (β=−7.7, 95% CI −14.2 to 1.3) or their partner was circumcised (β=−5.8, 95% CI −11.3 to 0.3).ConclusionsFactors associated with higher and lower values of BV chronicity were multifactorial. Notably, higher values of BV chronicity were associated with potentially contaminated bathing water. Future studies should examine the role of waterborne microbial agents in the pathogenesis of BV.

Analysis of characteristics of vulvo-vaginal infections in 14- to 18-year-old girls in late puberty

“…27 Studies have shown that BV infection is caused by various factors, mainly including microbial diversity of the host vagina, the environment, genetics, and the route of infection. 28,29 In our study, the incidence of BV in the 17-year-old group was the highest among the age groups, which may have been due to vaginal microbial diversity of girls at this age. Additionally, 17-year-old girls in China have a stressful life because of preparation for the College Entrance Examination, with tremendous academic pressure and a lack of exercises.…”

Self‐reported urinary tract infection and bacterial vaginosis symptoms among indigenous adolescents during seasonal periods of water scarcity: A cross‐sectional study in Bandarban Hill District of Bangladesh

“…Surface and spring water are exposed to the environment and may be contaminated by human and animal excreta and other environmental pathogens 36 . Hence, these water sources can be reservoirs of disease‐causing agents resulting in higher likelihood to contribute to infection among users 4–6 . For example, evidence has also shown seasonal outbreaks of waterborne diseases, such as diarrhea, in Bandarban.…”

“…36 Hence, these water sources can be reservoirs of disease‐causing agents resulting in higher likelihood to contribute to infection among users. 4 , 5 , 6 For example, evidence has also shown seasonal outbreaks of waterborne diseases, such as diarrhea, in Bandarban. Low level of perceived water quality was negatively associated with any symptom of infection.…”

“…Urinary tract infection (UTI) and bacterial vaginosis (BV) are caused by bacterial presence in the urinary tract and the vagina. 1 , 2 Factors, including water accessibility, 3 water quality, 4 , 5 , 6 and poor menstrual hygiene practices can contribute to the increased susceptibility to UTI and BV. 7 , 8 , 9 BV is one of the most prevalent infections among women of reproductive age worldwide.…”