Systematic reviews
General gynecology
The global epidemiology of bacterial vaginosis: a systematic review

https://doi.org/10.1016/j.ajog.2013.05.006Get rights and content

Bacterial vaginosis (BV) enhances the acquisition and transmission of a range of sexually transmitted infections including human immunodeficiency virus. This has made it more important to uncover the reasons why some populations have very high BV prevalences and others not. This systematic review describes the global epidemiology of BV. It summarizes data from peer-reviewed publications detailing the population prevalence of BV as diagnosed by a standardized and reproducible methodology–Nugent scoring system. BV variations between countries, and between ethnic groups within countries, are described. We evaluated 1692 English- and non-English-language articles describing the prevalence of BV using MEDLINE and the Web of Science databases. A total of 86 articles met our inclusion criteria. BV prevalences were found to vary considerably between ethnic groups in North America, South America, Europe, the Middle East, and Asia. Although BV prevalence is, in general, highest in parts of Africa and lowest in much of Asia and Europe, some populations in Africa have very low BV prevalences and some in Asia and Europe have high rates.

Section snippets

Methods

A search was conducted in the PubMed/MEDLINE and Web of Science databases in April 2012. Search terms included “bacterial vaginosis,” “bacterial vaginitis,” “bacterial vaginoses,” “epidemiology,” “incidence,” and “prevalence.” This resulted in the retrieval of 1692 articles. Cited references were also assessed for inclusion. Articles in English, French, Spanish, and Polish were considered for inclusion. No date restrictions were applied. Studies were then selected according to a 3-step process.

Results

Comparisons of the prevalence of BV by geographic area or country are hampered by a number of factors including differences in how the samples were selected and differences in the type of population surveyed–such as age composition and pregnancy. Despite these difficulties, certain trends are apparent.

Comment

This study represents an attempt at describing the geographic and ethnic patterning of BV globally. The advent of a standardized diagnostic process in the form of NSS has made this possible. There are, however, a number of limitations with the study. Firstly, this study described large gaps in the literature. There are large populations in the world, such as China, where the prevalence of BV has not been evaluated by the NSS. In other parts of the world, there are no published reports on BV

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    The authors report no conflict of interest.

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