TY - JOUR
T1 - Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa
T2 - A cross-sectional study
AU - Vaginal Biomarkers Study Group
AU - Jespers, Vicky
AU - Crucitti, Tania
AU - Menten, Joris
AU - Verhelst, Rita
AU - Mwaura, Mary
AU - Mandaliya, Kishor
AU - Ndayisaba, Gilles F.
AU - Delany-Moretlwe, Sinead
AU - Verstraelen, Hans
AU - Hardy, Liselotte
AU - Buvé, Anne
AU - Van De Wijgert, Janneke
AU - Dierick, Lou
AU - Jaoko, Walter
AU - Irungu, Eunice
AU - Katingima, Christine
AU - Maina, Mercy
AU - Mazera, Jane Wanjiru
AU - Gichuru, Josephine
AU - Onuki, Grace Aketch
AU - Kiambi, Mary
AU - Thiong'o, Mary
AU - Wanjiku, Salome
AU - Nduku, Patricia
AU - Njeru, Carol
AU - Mbogho, Bernard
AU - Wambua, Sammy
AU - Baya, Rachel Sidi
AU - Onduko, Emmanuel Moffat
AU - Kombo, Patrick Katana
AU - Masha, Simon Chengo
AU - John, Mary Ndinda
AU - Odeyo, Kevin
AU - Ngala, Dora
AU - Odero, Collins
AU - Edward, Vinodh Aroon
AU - Reddy, Krishnaveni
AU - Von Knorring, Nina
AU - Mahabeer, Ishania
AU - Mashilo, Johannah Nkoleleng
AU - Mnyandu, Ntombifuthi
AU - Mokoatle, Keneuoe
AU - Nani, Siyabulela
AU - Tshabalala, Gugu
AU - Mngwevu, Thembisile Hope
AU - Mtabane, Noxolo
AU - Masalesa, Puseletso Maria
AU - Kumase, Zodidi
AU - Mohale, Sefora Dipolelo
AU - Temmerman, Marleen
N1 - Publisher Copyright:
© 2014 Jespers et al.
PY - 2014/10/7
Y1 - 2014/10/7
N2 - Background: Clinical development of vaginally applied products aimed at reducing the transmission of HIV and other sexually transmitted infections, has highlighted the need for a better characterisation of the vaginal environment. We set out to characterise the vaginal environment in women in different settings in sub-Saharan Africa.Methods: A longitudinal study was conducted in Kenya, Rwanda and South-Africa. Women were recruited into pre-defined study groups including adult, non-pregnant, HIV-negative women; pregnant women; adolescent girls; HIV-negative women engaging in vaginal practices; female sex workers; and HIV-positive women. Consenting women were interviewed and underwent a pelvic exam. Samples of vaginal fluid and a blood sample were taken and tested for bacterial vaginosis (BV), HIV and other reproductive tract infections (RTIs). This paper presents the cross-sectional analyses of BV Nugent scores and RTI prevalence and correlates at the screening and the enrolment visit.Results: At the screening visit 38% of women had BV defined as a Nugent score of 7-10, and 64% had more than one RTI (N. gonorrhoea, C. trachomatis, T. vaginalis, syphilis) and/or Candida. At screening the likelihood of BV was lower in women using progestin-only contraception and higher in women with more than one RTI. At enrolment, BV scores were significantly associated with the presence of prostate specific antigen (PSA) in the vaginal fluid and with being a self-acknowledged sex worker. Further, sex workers were more likely to have incident BV by Nugent score at enrolment.Conclusions: Our study confirmed some of the correlates of BV that have been previously reported but the most salient finding was the association between BV and the presence of PSA in the vaginal fluid which is suggestive of recent unprotected sexual intercourse.
AB - Background: Clinical development of vaginally applied products aimed at reducing the transmission of HIV and other sexually transmitted infections, has highlighted the need for a better characterisation of the vaginal environment. We set out to characterise the vaginal environment in women in different settings in sub-Saharan Africa.Methods: A longitudinal study was conducted in Kenya, Rwanda and South-Africa. Women were recruited into pre-defined study groups including adult, non-pregnant, HIV-negative women; pregnant women; adolescent girls; HIV-negative women engaging in vaginal practices; female sex workers; and HIV-positive women. Consenting women were interviewed and underwent a pelvic exam. Samples of vaginal fluid and a blood sample were taken and tested for bacterial vaginosis (BV), HIV and other reproductive tract infections (RTIs). This paper presents the cross-sectional analyses of BV Nugent scores and RTI prevalence and correlates at the screening and the enrolment visit.Results: At the screening visit 38% of women had BV defined as a Nugent score of 7-10, and 64% had more than one RTI (N. gonorrhoea, C. trachomatis, T. vaginalis, syphilis) and/or Candida. At screening the likelihood of BV was lower in women using progestin-only contraception and higher in women with more than one RTI. At enrolment, BV scores were significantly associated with the presence of prostate specific antigen (PSA) in the vaginal fluid and with being a self-acknowledged sex worker. Further, sex workers were more likely to have incident BV by Nugent score at enrolment.Conclusions: Our study confirmed some of the correlates of BV that have been previously reported but the most salient finding was the association between BV and the presence of PSA in the vaginal fluid which is suggestive of recent unprotected sexual intercourse.
UR - http://www.scopus.com/inward/record.url?scp=84907853618&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0109670
DO - 10.1371/journal.pone.0109670
M3 - Article
C2 - 25289640
AN - SCOPUS:84907853618
SN - 1932-6203
VL - 9
JO - PLoS ONE
JF - PLoS ONE
IS - 10
M1 - e109670
ER -