Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2015

Open Access 01-12-2015 | Research article

Intravaginal practices and lactobacilli colonization among women in Accra, Ghana

Authors: Francisca Nana-Aba McCarthy, Nicholas Israel Nii-Trebi, Billal Obeng Musah, Richard Harry Asmah

Published in: BMC Women's Health | Issue 1/2015

Login to get access

Abstract

Background

Intravaginal practices may affect the colonization of vaginal flora and lead to vaginal infections due to the potential effects on the vaginal environment. This study investigated the vaginal practices and their possible effects on vaginal lactobacilli flora colonization in women in Accra.

Methods

A cross-sectional, descriptive single-site study was carried out on 141 women assessing medical care at the Obstetrics and Gynaecology Department of the Korle-Bu Teaching Hospital (KBTH) in Accra. Study-relevant information on participants was obtained by means of questionnaire. Vaginal swab samples were collected and processed for laboratory analyses.

Results

All the participants (141/141, 100.0 %) indicated they performed intravaginal practices using various methods. Almost half (46.1 %) of these women were between the ages of 25–34 years and 65.0 % were married. Internal douching (82.3 %; p > 0.05) was the commonest practice reported. Other practices such as insertion and wiping with hands and objects, as well as use of locally prepared concoctions and certain commercial products were also reported. The reason most commonly given was for hygienic purpose (83.0 %); a few (10.6 %) did it for sexual satisfaction, while others indicated vaginal tightness (5.7 %) and wound healing (0.7 %) as reasons for their practice. No Lactobacillus sp. was detected in as many as 78.7 % of the sample. Association tests by the Pearson correlation analysis showed strong significant negative correlation (r = −0.954, p < 0.05) between use of traditional herbs/concoction and vaginal lactobacilli colonization; and douching being the least negatively (r = −0.601, p > 0.05) correlated practice.

Conclusions

Vaginal practices were common among the women studied. A more elaborate prospective, case–control study into intravaginal practices and their impact on the health of women in Ghana should be explored.
Appendix
Available only for authorised users
Literature
1.
2.
Liliana MP, Marı´a BD, Cristina P, Lucila BT. Lactobacillus species isolated from the vagina: identification, hydrogen peroxide production and nonoxynol-9 resistance. Contraception. 2006;73:78–81.CrossRef
3.
Antonio MA, Hawes SE, Hillier SL. The identification of vaginal Lactobacillus species and the demographic and microbiologic characteristics of women colonized by these species. J Infect Dis. 1999;180:1950–6.CrossRefPubMed
4.
5.
Fredricks DN, Fiedler TL, Marrazzo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med. 2005;353:1899–911.CrossRefPubMed
6.
Spear GT, Gilbert D, Landay AL, Zariffard R, French AL, Patel P, et al. Pyrosequencing of the Genital Microbiotas of HIV-Seropositive and HIV-Seronegative Women Reveals Lactobacillus iners as the Predominant Lactobacillus species. Appl Environ Microbiol. 2011;77:378–81.CrossRefPubMed
7.
8.
Boris S, Barbés C. Role played by lactobacilli in controlling the population of vaginal pathogens. Microbes Infect. 2000;2:543–6.CrossRefPubMed
9.
Hilber AM, Hull TH, Preston-Whyte E, Bagnol B, Smit J, Wacharasin C, et al. A cross cultural study of vaginal practices and sexuality: implications for sexual health. Soc Sci Med. 2010;70:392–400.CrossRef
10.
Reid G. Lactobacillus in the Vagina: Why, How, Which Ones and What Do They Do? In Lactobacillus Molecular Microbiology: From Genomics to Probiotics. Edited by: Ljungh A, Wadström T. Norfolk: Caister Academic Press; 2009.
11.
12.
Martin HL, Richardson BA, Nyange PM, Lavreys L, Hillier SL, Chohan B, et al. Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. JInfect Dis. 1999;180:1863–8.CrossRef
13.
Wiesenfeld HC, Hillier SL, Krohn MA, Landers DV, Sweet RL. Bacterial vaginosis is a strong predictor of Neisseria gonorrhoeae and Chlamydia trachomatis infection. Clin Infect Dis. 2003;36:663–8.CrossRefPubMed
14.
Torok MR, Miller WC, Hobbs MM, Macdonald PD, Leone PA, Schwebke JR, et al. The association between Trichomonas vaginalis infection and level of vaginal lactobacilli in non-pregnant women. J Infect Dis. 2007;196:1102–7.CrossRefPubMed
15.
McLean NW, Rosenstein IJ. Characterisation and selection of Lactobacillus species to recolonise the vagina of women with recurrent bacterial vaginosis. J Med Microbiol. 2000;49:543–52.CrossRefPubMed
16.
17.
Pavlova SI, Kilic AO, Kilic SS, So JS, Nader-Macias ME, Simoes JA, et al. Genetic diversity of vaginal lactobacilli from women in different countries based on 16S rRNA gene sequences. J Appl Microbiol. 2002;92:451–9.CrossRefPubMed
18.
Zhou X, Brown CJ, Abdo Z, Davis CC, Hansmann MA, Joyce P, et al. Differences in the composition of vaginal microbial communities found in healthy Caucasian and black women. ISME J. 2007;1:121–33.CrossRefPubMed
19.
Vera DM, Slobodanka VD, Nataša ZO, Milan KD, Lazar TR. Hydrogen peroxide producing lactobacilli in women with vaginal infections. Europ J Obst Gyn Rep Biol. 2006;129:69–76.CrossRef
20.
Hillier SL, Krohn MA, Rabe LK, Klebanoff SJ, Eschenbach DA. The normal vaginal flora, H2O2-producing lactobacilli, and bacterial vaginosis in pregnant women. Clin Infect Dis. 1993;16:273–81.CrossRef
21.
Hawes SE, Hillier SL, Benedetti J, Stevens CE, Koutsky LA, Welncr-Hanssen P, et al. Hydrogen Peroxide-Producing Lactobacilli and Acquisition of Vaginal Infections. J Infect Dis. 1996;174:1058–63.CrossRefPubMed
22.
Verstraelen H, Verhelst R, Claeys G, De Backer E, Temmerman M, Vaneechoutte M. Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora. BMC Microbiol. 2009;9:116.CrossRefPubMedPubMedCentral
23.
Zhou X, Brown CJ, Abdo Z, Davis CC, Hansmann MA, Joyce P, et al. Differences in the composition of vaginal microbial communities found in healthy Caucasian and black women. ISME J. 2007;1:121–33.CrossRefPubMed
24.
Vallor AC, Antonio MA, Hawes SE, Hillier SL. Factors associated with acquisition of persistent colonization by vaginal lactobacilli: Role of hydrogen peroxide production. J Infect Dis. 2001;184:1431–6.CrossRefPubMed
25.
Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, et al. Defense factors of vaginal lactobacilli. Am J Obstet Gynecol. 2001;185:375–9.CrossRefPubMed
26.
Taha TE, Hoover DR, Dallabetta GA, Kumwenda NI, Mtimavalye LA, Yang LP, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS. 1998;12:1699–706.CrossRefPubMed
27.
Low N, Chersich MF, Schmidlin K, Egger M, Francis SC, van de Wijgert JHHM, et al. Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis. PLoS Med. 2011;8:e1000416.CrossRefPubMedPubMedCentral
28.
Hull T, Hilber AM, Chersich MF, Bagnol B, Prohmmo A, Smit JA, et al. Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia: findings from a multicountry household survey. J Womens Health (Larchmt). 2011;20:1097–109.CrossRef
29.
Brown JE, Brown RC. Traditional intravaginal practices and the heterosexual transmission of disease: a review. Sex Transm Dis. 2000;27:183–7.CrossRefPubMed
30.
Van de Wijgert JH, Mason PR, Gwanzura l, Mbizvo MT, Chirenje ZM, Iliff V, et al. Intravaginal practices, vaginal flora disturbances, and acquisition of sexually transmitted diseases in Zimbabwean women. J Infect Dis. 2000;181:587–94.CrossRef
31.
Imade G, Sagay A, Egah D, Onwuliri V, Grigg M, Egbodo C, et al. Prevalence of HIV and other sexually transmissible infections in relation to lemon or lime juice douching among female sex workers in Jos, Nigeria. Sexual Health. 2008;5:55–60.CrossRefPubMed
32.
Van de Wijgert JH, Mbizvo M, Dube S, Mwale M, Nyamapfeni P, Padian N. Intravaginal Practices In Zimbabwe: which women engage in them and why? Cult Health Sex. 2001;3:133–48.CrossRef
33.
Scorgie F, Kunene B, Smit JA, Manzini NF, Chersich M, Preston-Whyte EM. In search of sexual pleasure and fidelity: vaginal practices in KwaZulu-Natal, South Africa”. Cult Health Sex. 2009;11:267–83.CrossRefPubMed
34.
Cheesbrough M. District Laboratory Practice in Tropical Countries. 2nd ed. UK: Cambridge University press; 2006.CrossRef
35.
36.
Myer L, Denny L, De Souza M, Barone MA, Wright Jr TC, Kuhn L. Intravaginal practices, HIV and other sexually transmitted diseases among South African women. Sex Trans Dis. 2004;31:174–9.CrossRef
37.
Anderson RM , May RM , Boily MC. , Garnett GP , Rowley JT, May RM: The spread of HIV-1 in Africa: sexual contact patterns and the predicted demographic impact of AIDS. Nature 1991;352:581–589.
38.
Hilber AM, Francis SC, Chersich M, Scott P, Redmond S, Bender N, et al. Intravaginal practices, vaginal infections and HIV acquisition: systematic review and meta-analysis. PLoS ONE. 2010;5:e9119.CrossRefPubMedPubMedCentral
39.
Fethers KA, Fairley CK, Hocking JS, Gurrin LC, Bradshaw CS. Sexual risk factors and bacterial vaginosis: a systematic review and meta-analysis. Clin Infect Dis. 2008;47:1426–35.CrossRefPubMed
40.
Mbizvo ME, Musya SE, Stray-Pedersen B, Chirenje Z, Hussain A. Bacterial vaginosis and intravaginal practices: association with HIV. Cent Afr J Med. 2004;50:41–6.PubMed
Metadata
Title
Intravaginal practices and lactobacilli colonization among women in Accra, Ghana
Authors
Francisca Nana-Aba McCarthy
Nicholas Israel Nii-Trebi
Billal Obeng Musah
Richard Harry Asmah
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2015
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-015-0205-2

Other articles of this Issue 1/2015

BMC Women's Health 1/2015 Go to the issue

Research article

Symptomatic presentation with cervical cancer in Uganda: a qualitative study assessing the pathways to diagnosis in a low-income country

Research article

Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial

Research article

Emotional suppression and depressive symptoms in women newly diagnosed with early breast cancer

Research article

Validation of a risk prediction tool for coronary heart disease in middle-aged women

Research article

Communicating under medical patriarchy: gendered doctor-patient communication between female patients with overactive bladder and male urologists in Hong Kong

Research article

Common causes of vaginal infections and antibiotic susceptibility of aerobic bacterial isolates in women of reproductive age attending at Felegehiwot referral Hospital, Ethiopia: a cross sectional study