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Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Sexually Transmitted Infection | Research article

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

Authors: Yiewou Marguerithe Kamga, John Palle Ngunde, Jane-Francis K. T. Akoachere

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

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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 (χ2) 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 (χ2 = 8.609. P = 0.014), those who did not use antibiotics (31.9%) prior to the study (χ2 = 12.893, P = 0.002) and women with no history of a genital tract infection (χ2 = 18.154, P = 0.001). There was a significant difference in prevalence with respect to gestation age (χ2 = 13.959, P = 0.007) with the highest occurring in women in the second trimester (31.7%). Women who practiced douching (χ2 = 23.935, P = 0.000) and those who did not wash pants with disinfectant (χ2 = 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.
Literature
2.
go back to reference Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. Am J Obstet Gynecol. 2013;209:505–23.CrossRef Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. Am J Obstet Gynecol. 2013;209:505–23.CrossRef
3.
go back to reference Alcendor DJ. Evaluation of health disparity in bacterial vaginosis and the implications for HIV-1 Acquisition in African American Women. Am J Reprod Immunol. 2016;76(2):99–107.CrossRef Alcendor DJ. Evaluation of health disparity in bacterial vaginosis and the implications for HIV-1 Acquisition in African American Women. Am J Reprod Immunol. 2016;76(2):99–107.CrossRef
4.
go back to reference Machado D, Castro J, Martinez-de-Oliveira J, Nogueira-Silva C, Cerca N. Prevalence of bacterial vaginosis in Portuguese pregnant women and vaginal colonization by Gardnerella vaginalis. PeerJ. 2017;5:e3750.CrossRef Machado D, Castro J, Martinez-de-Oliveira J, Nogueira-Silva C, Cerca N. Prevalence of bacterial vaginosis in Portuguese pregnant women and vaginal colonization by Gardnerella vaginalis. PeerJ. 2017;5:e3750.CrossRef
5.
go back to reference Hyman RW, Fukushima M, Diamond L, Kumm J, Giudice LC, Davis RW. Microbes on the human vaginal epithelium. PNAS. 2005;102(22):7952–7.CrossRef Hyman RW, Fukushima M, Diamond L, Kumm J, Giudice LC, Davis RW. Microbes on the human vaginal epithelium. PNAS. 2005;102(22):7952–7.CrossRef
6.
go back to reference Achondou AE, Fumoloh FF, Aseneck AC, Awah AR, Utokoro AM. Prevalence of bacterial vaginosis among sexually active women attending the CDC central clinic Tiko, south west region, Cameroon. Afr J Infect Dis. 2016;10(2):96–101.PubMedPubMedCentral Achondou AE, Fumoloh FF, Aseneck AC, Awah AR, Utokoro AM. Prevalence of bacterial vaginosis among sexually active women attending the CDC central clinic Tiko, south west region, Cameroon. Afr J Infect Dis. 2016;10(2):96–101.PubMedPubMedCentral
7.
go back to reference Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of bacterial vaginosis and associated risk factors among women complaining of genital tract infection. Int J Microbiol 2017; 2017: 4919404. Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of bacterial vaginosis and associated risk factors among women complaining of genital tract infection. Int J Microbiol 2017; 2017: 4919404.
8.
go back to reference Afolabi BB, Olusanjo EM, Oyinlola OO. Bacterial vaginosis and pregnancy outcome in Lagos, Nigeria. Open Forum Infect Dis. 2016;3(1):ofw030.CrossRef Afolabi BB, Olusanjo EM, Oyinlola OO. Bacterial vaginosis and pregnancy outcome in Lagos, Nigeria. Open Forum Infect Dis. 2016;3(1):ofw030.CrossRef
9.
go back to reference Li XD, Tong F, Zhang XJ, Pan WJ, Chen ML, Wang CC, Li X, Gao GP, Sun L, Sun YH. Incidence and risk factors of bacterial vaginosis among pregnant women: a prospective study in Maanshan city, Anhui Province, China. J Obstet Gynaecol Res. 2015;41(8):1214–22.CrossRef Li XD, Tong F, Zhang XJ, Pan WJ, Chen ML, Wang CC, Li X, Gao GP, Sun L, Sun YH. Incidence and risk factors of bacterial vaginosis among pregnant women: a prospective study in Maanshan city, Anhui Province, China. J Obstet Gynaecol Res. 2015;41(8):1214–22.CrossRef
10.
go back to reference Desseauve D, Chantrel J, Fruchart A, Khoshnood B, Brabant G, Ancel PY, Subtil D. Prevalence and risk factors of bacterial vaginosis during the first trimester of pregnancy in a large French population-based study. Eur J Obstet Gynecol Reprod Biol. 2012;163(1):30–4.CrossRef Desseauve D, Chantrel J, Fruchart A, Khoshnood B, Brabant G, Ancel PY, Subtil D. Prevalence and risk factors of bacterial vaginosis during the first trimester of pregnancy in a large French population-based study. Eur J Obstet Gynecol Reprod Biol. 2012;163(1):30–4.CrossRef
11.
go back to reference Shayo PA, Kihunrwa A, Massinde AN, Mirambo A, Rumanyika R, Ngwalida N, Gumodoka B, Kidola J, Magoma M. Prevalence of bacterial vaginosis and associated factors among pregnant women attending at Bugando medical Centre, Mwanza, Tanzania. Tanzania J Health Res. 2012;14(3):1–10. Shayo PA, Kihunrwa A, Massinde AN, Mirambo A, Rumanyika R, Ngwalida N, Gumodoka B, Kidola J, Magoma M. Prevalence of bacterial vaginosis and associated factors among pregnant women attending at Bugando medical Centre, Mwanza, Tanzania. Tanzania J Health Res. 2012;14(3):1–10.
12.
go back to reference Verstraelen H, Verhelst R, Vaneechoutte M, Temmerman M. The epidemiology of bacterial vaginosis in relation to sexual behaviour. BMC Infect Dis. 2010;10:81.CrossRef Verstraelen H, Verhelst R, Vaneechoutte M, Temmerman M. The epidemiology of bacterial vaginosis in relation to sexual behaviour. BMC Infect Dis. 2010;10:81.CrossRef
13.
go back to reference 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.CrossRef 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.CrossRef
14.
go back to reference Mengistie Z, Woldeamanuel Y, Asrat D, Adera A. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University hospital, Addis Ababa, Ethiopia. BMC Res Notes. 2014;7:822.CrossRef Mengistie Z, Woldeamanuel Y, Asrat D, Adera A. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University hospital, Addis Ababa, Ethiopia. BMC Res Notes. 2014;7:822.CrossRef
15.
go back to reference Yzeiraj-Kalemaj L, Shpata V, Vyshka G, Manaj A. Bacterial vaginosis, educational level of pregnant women, and preterm birth: a case-control study. ISRN Infect Dis 2013; 2013, Article ID 980537. Yzeiraj-Kalemaj L, Shpata V, Vyshka G, Manaj A. Bacterial vaginosis, educational level of pregnant women, and preterm birth: a case-control study. ISRN Infect Dis 2013; 2013, Article ID 980537.
16.
go back to reference Das TR, Fatema K, Chowdhury S, Noor F, Ara R, Chakma B, Parveen M, Ali MJB. Association of Bacterial Vaginosis with preterm delivery. J Bangladesh Col Physic Surg. 2017;34(4):188–92.CrossRef Das TR, Fatema K, Chowdhury S, Noor F, Ara R, Chakma B, Parveen M, Ali MJB. Association of Bacterial Vaginosis with preterm delivery. J Bangladesh Col Physic Surg. 2017;34(4):188–92.CrossRef
17.
go back to reference Kiran CK, Kandati J, Ponugoti M. Prevalence of bacterial vaginosis in preterm and termlabour: a one year study. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2292–6.CrossRef Kiran CK, Kandati J, Ponugoti M. Prevalence of bacterial vaginosis in preterm and termlabour: a one year study. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2292–6.CrossRef
18.
go back to reference Işik G, Demirezen S, Dönmez GH, Beksaç SM. Bacterial vaginosis in association with spontaneous abortion and recurrent pregnancy losses. J Cytol. 2016;33(3):135–40.CrossRef Işik G, Demirezen S, Dönmez GH, Beksaç SM. Bacterial vaginosis in association with spontaneous abortion and recurrent pregnancy losses. J Cytol. 2016;33(3):135–40.CrossRef
19.
go back to reference Haggerty CL, Hillier SL, Bass DC, Ness RB. Bacterial vaginosis and anaerobic bacteria are associated with endometritis. Clin Infect Dis. 2004;39(7):990–5.CrossRef Haggerty CL, Hillier SL, Bass DC, Ness RB. Bacterial vaginosis and anaerobic bacteria are associated with endometritis. Clin Infect Dis. 2004;39(7):990–5.CrossRef
20.
go back to reference Mullick S, Watson-Jones D, Beksinska M, Mabey D. Sexually transmitted infections in pregnancy: prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. Sex Transm Infect. 2005;81:294–302.CrossRef Mullick S, Watson-Jones D, Beksinska M, Mabey D. Sexually transmitted infections in pregnancy: prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. Sex Transm Infect. 2005;81:294–302.CrossRef
21.
go back to reference Forcey DS, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, Bradshaw CS. Factors associated with bacterial vaginosis among women who have sex with women: a systematic review. PLoS One. 2015;10(12):e0141905.CrossRef Forcey DS, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, Bradshaw CS. Factors associated with bacterial vaginosis among women who have sex with women: a systematic review. PLoS One. 2015;10(12):e0141905.CrossRef
22.
go back to reference Bautista CT, Wurapa E, Sateren WB, Morris S, Hollingsworth B, Sanchez JL. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res. 2016;3:4.CrossRef Bautista CT, Wurapa E, Sateren WB, Morris S, Hollingsworth B, Sanchez JL. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res. 2016;3:4.CrossRef
23.
go back to reference Atashili J, Poole C, Ndumbe PM, Adimora AA, Smith JS. Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS. 2008;22(12):1493–501.CrossRef Atashili J, Poole C, Ndumbe PM, Adimora AA, Smith JS. Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS. 2008;22(12):1493–501.CrossRef
24.
go back to reference Mirmonsef P, Krass L, Landay A, Spea GT. The role of bacterial vaginosis and Trichomonas in HIV transmission across the female genital tract. Curr HIV Res. 2012;10(3):202–10.CrossRef Mirmonsef P, Krass L, Landay A, Spea GT. The role of bacterial vaginosis and Trichomonas in HIV transmission across the female genital tract. Curr HIV Res. 2012;10(3):202–10.CrossRef
25.
go back to reference Nsagha DS, Zofou D, Assob JCN, Njunda AL, Nchang CD, MvoNgum N, Weledji EP, NgoweNgowe M. The epidemiology of Trichomonas vaginalis, Gardnerella vaginalis and Candida albicans co-infections in women attending the Yaounde University teaching hospital. Am J Epidemiol Infect Dis. 2015;3(2):28–31. Nsagha DS, Zofou D, Assob JCN, Njunda AL, Nchang CD, MvoNgum N, Weledji EP, NgoweNgowe M. The epidemiology of Trichomonas vaginalis, Gardnerella vaginalis and Candida albicans co-infections in women attending the Yaounde University teaching hospital. Am J Epidemiol Infect Dis. 2015;3(2):28–31.
26.
go back to reference Kesah FNC, Payne VK, Asakizi A. Prevalence and etiology of sexually transmitted infections in a gynecologic unit of a developing country. Ann Trop Med Pub Health. 2013;6(5):526–31.CrossRef Kesah FNC, Payne VK, Asakizi A. Prevalence and etiology of sexually transmitted infections in a gynecologic unit of a developing country. Ann Trop Med Pub Health. 2013;6(5):526–31.CrossRef
27.
go back to reference Mbu ER, Kongnyuy EJ, Mbopi-Keou FX, Tonye RN, Nana PN, Leke RJI. Gynaecological morbidity among HIV positive pregnant women in Cameroon. Reprod Health. 2008;5:3.CrossRef Mbu ER, Kongnyuy EJ, Mbopi-Keou FX, Tonye RN, Nana PN, Leke RJI. Gynaecological morbidity among HIV positive pregnant women in Cameroon. Reprod Health. 2008;5:3.CrossRef
28.
go back to reference Daniel WW. Biostatistics: A Foundation for analysis in the health sciences. 7th ed. New York: John Wiley & Sons; 1999. Daniel WW. Biostatistics: A Foundation for analysis in the health sciences. 7th ed. New York: John Wiley & Sons; 1999.
29.
go back to reference Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by standardized method of gram stain interpretation. J Clin Microbiol. 1991;29:297–301.PubMedPubMedCentral Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by standardized method of gram stain interpretation. J Clin Microbiol. 1991;29:297–301.PubMedPubMedCentral
30.
go back to reference Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Non-specific vaginitis: diagnostic criteria and microbial and epidemiologic associations. AJM. 1983;74:14–22.CrossRef Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Non-specific vaginitis: diagnostic criteria and microbial and epidemiologic associations. AJM. 1983;74:14–22.CrossRef
31.
go back to reference Nergis TAJ, Alam MSU, Sarah, Bajwa Z, Waheed A, Ullah E. Bacterial vaginosis in pregnant women and its diagnosis using Amsel’s Clinical Criteria and Nugent’s method. P J M H S. 2014;8(1):133. Nergis TAJ, Alam MSU, Sarah, Bajwa Z, Waheed A, Ullah E. Bacterial vaginosis in pregnant women and its diagnosis using Amsel’s Clinical Criteria and Nugent’s method. P J M H S. 2014;8(1):133.
33.
go back to reference Abdelaziz ZA, Ibrahim ME, Bilal NE, Hamid ME. Vaginal infections among pregnant women at Omdurma maternity Hospital in Khartoum, Sudan. J Infect Dev Ctries. 2014;8(4):490–7.CrossRef Abdelaziz ZA, Ibrahim ME, Bilal NE, Hamid ME. Vaginal infections among pregnant women at Omdurma maternity Hospital in Khartoum, Sudan. J Infect Dev Ctries. 2014;8(4):490–7.CrossRef
34.
go back to reference Awoniyi AO, Komolafe OI, Bifarin O, Olaniran O. Bacterial vaginosis among pregnant women attending a primary health care center in lle-Ife, Nigeria. Glo Adv Res J Med Med Sci. 2015;4:057–60. Awoniyi AO, Komolafe OI, Bifarin O, Olaniran O. Bacterial vaginosis among pregnant women attending a primary health care center in lle-Ife, Nigeria. Glo Adv Res J Med Med Sci. 2015;4:057–60.
35.
go back to reference Ajani G, Oduyebo O, Haruna M, Elikw C. Nugent scores for pregnant women in a tertiary institution in Nigeria. AdvMicrobiol. 2012;2:531–6. Ajani G, Oduyebo O, Haruna M, Elikw C. Nugent scores for pregnant women in a tertiary institution in Nigeria. AdvMicrobiol. 2012;2:531–6.
36.
37.
go back to reference Sobel JD, Subramanian C, Foxman B, Fairfax M, Gygax SE. Mixed vaginitis-more than coinfection and with therapeutic implications. Curr Infect Dis Rep. 2013;15(2):104–8.CrossRef Sobel JD, Subramanian C, Foxman B, Fairfax M, Gygax SE. Mixed vaginitis-more than coinfection and with therapeutic implications. Curr Infect Dis Rep. 2013;15(2):104–8.CrossRef
38.
go back to reference Ibrahim SM, Bukar M, Galadima GB, Audu BM, Ibrahim HA. Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North-Eastern Nigeria. Niger J Clin Pract. 2014;17:154–8.CrossRef Ibrahim SM, Bukar M, Galadima GB, Audu BM, Ibrahim HA. Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North-Eastern Nigeria. Niger J Clin Pract. 2014;17:154–8.CrossRef
39.
go back to reference Nwadioha SI, Egah DZ, Banwat EB, Aloa OO. Microbial agents of abnormal vaginal discharge in mothers attending PHC centres of Jos, Nigeria. J Clin Med Res. 2010;2:007–11. Nwadioha SI, Egah DZ, Banwat EB, Aloa OO. Microbial agents of abnormal vaginal discharge in mothers attending PHC centres of Jos, Nigeria. J Clin Med Res. 2010;2:007–11.
40.
go back to reference Mitchell C, Moreira C, Fredricks D, Paul K, Caliendo AM, Kurpewski J, Ingersoll J, Cu-Uvin S. Detection of fastidious vaginal bacteria in women with HIV infection and bacterial vaginosis. Infect Dis Obstet Gyneco. 2009;236919. Mitchell C, Moreira C, Fredricks D, Paul K, Caliendo AM, Kurpewski J, Ingersoll J, Cu-Uvin S. Detection of fastidious vaginal bacteria in women with HIV infection and bacterial vaginosis. Infect Dis Obstet Gyneco. 2009;236919.
41.
go back to reference Schellenberg JJ, Card CM, Ball TB, Mungai JN, Irungu E, Kimani J, Jaoko W, Wachihi C, Fowkes KR, Plummer FA. Bacterial vaginosis, HIV serostatus and T-cell subset distribution in a cohort of East African commercial sex workers: retrospective analysis. AIDS. 2012;26:387–93.CrossRef Schellenberg JJ, Card CM, Ball TB, Mungai JN, Irungu E, Kimani J, Jaoko W, Wachihi C, Fowkes KR, Plummer FA. Bacterial vaginosis, HIV serostatus and T-cell subset distribution in a cohort of East African commercial sex workers: retrospective analysis. AIDS. 2012;26:387–93.CrossRef
42.
go back to reference Amin AA. Rural Poverty and Agricultural Development in Cameroon. Paper presented at a Colloqium organized by Unesco, Universite Montesquieu-Bordeau IV – Unesco Paris. 22 & 23 November 2001. Amin AA. Rural Poverty and Agricultural Development in Cameroon. Paper presented at a Colloqium organized by Unesco, Universite Montesquieu-Bordeau IV – Unesco Paris. 22 & 23 November 2001.
Metadata
Title
Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon
Authors
Yiewou Marguerithe Kamga
John Palle Ngunde
Jane-Francis K. T. Akoachere
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2312-9

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