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Bacterial vaginosis in female facility workers in north-western Tanzania: prevalence and risk factors
  1. Kathy Baisley (kathy.baisley{at}lshtm.ac.uk)
  1. London School of Hygiene and Tropical Medicine, United Kingdom
    1. John Changalucha
    1. National Institute of Medical Research, Tanzania, United Republic of
      1. Helen Weiss
      1. London School of Hygiene and Tropical Medicine, United Kingdom
        1. Kokugonza Mugeye
        1. African Medical and Research Foundation (AMREF), Tanzania, United Republic of
          1. Dean Everett
          1. London School of Hygiene and Tropical Medicine, United Kingdom
            1. Ian Hambleton
            1. London School of Hygiene and Tropical Medicine, United Kingdom
              1. Phillip Hay
              1. St George's Hospital, United Kingdom
                1. David Ross
                1. London School of Hygiene and Tropical Medicine, United Kingdom
                  1. Clare Tanton
                  1. London School of Hygiene and Tropical Medicine, United Kingdom
                    1. Tobias Chirwa
                    1. London School of Hygiene and Tropical Medicine, United Kingdom
                      1. Richard Hayes
                      1. London School of Hygiene and Tropical Medicine, United Kingdom
                        1. Deborah Watson-Jones (deborah.watson-jones{at}lshtm.ac.uk)
                        1. London School of Hygiene and Tropical Medicine, United Kingdom

                          Abstract

                          Objectives: To determine prevalence of, and risk factors for, bacterial vaginosis (BV) among HSV-2 seropositive Tanzanian women at enrolment into a randomised, placebo-controlled trial of HSV suppressive therapy.

                          Methods: 1305 HSV-2 seropositive women aged 16-35 years working in bars, guesthouses and similar facilities were interviewed, examined and tested for HIV, syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, BV, candidiasis and trichomoniasis. Factors associated with BV were analysed using logistic regression to estimate odds ratios and 95% confidence intervals.

                          Results: BV prevalence was 62.9%; prevalence of Nugent score 9-10 was 16.1%. Independent risk factors for BV were work facility type, fewer dependents, increasing alcohol consumption, sex in the last week (adjusted OR=2.03, 95% CI=1.57-2.62), using cloths or cotton wool for menstrual hygiene, HIV (adjusted OR=1.41, 95% CI=1.09-1.83) and T vaginalis infection. There was no association between BV and the frequency or method of vaginal cleansing. However, BV was less prevalent among women who reported inserting substances to dry the vagina for sex (adjusted OR=0.44, 95% CI=0.25-0.75).

                          Conclusion: BV was extremely prevalent among our study population of HSV-2 positive female facility workers in northwestern Tanzania. Although recent sex was associated with increased BV prevalence, vaginal drying was associated with lower BV prevalence. Further studies of the effects of specific practices on vaginal flora are warranted (Current Controlled Trials Number ISRCTN35385041).

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