scholarly journals Transkingdom Analysis of the Female Reproductive Tract Reveals Bacteriophages Form Communities

2021 ◽  
Author(s):  
Ferralita S Madere ◽  
Michael Sohn ◽  
Angelina Winbush ◽  
Breona Barr ◽  
Alex Grier ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
South African ◽  
Reproductive Tract ◽  
Alpha Diversity ◽  
Female Reproductive Tract ◽  
African Women ◽  
Complex Interactions ◽  
Vaginal Health ◽  
South African Women ◽  
Community Clustering

The female reproductive tract (FRT) microbiome plays an important role in maintaining vaginal health. Viruses play a key role in regulating other microbial ecosystems, but little is known about how the FRT viruses (virome), particularly bacteriophages, impacts FRT health and dysbiosis. We hypothesize that bacterial vaginosis is associated with alterations in the FRT virome, and these changes correlate with bacteriome shifts. We conducted a retrospective, longitudinal analysis of vaginal swabs collected from 54 bacterial vaginosis (BV)-positive and 46 BV-negative South African women. Bacteriome analysis revealed samples clustered into five distinct bacterial community groups (CG). Bacterial alpha diversity was significantly associated with BV. Virome analysis on a subset of baseline samples showed FRT bacteriophages clustering into novel viral state types (VSTs), a viral community clustering system based on virome composition and abundance. Distinct BV bacteriophage signatures included increased alpha diversity along with Bacillus, Burkholderia and Escherichia bacteriophages. Discriminate bacteriophage-bacteria transkingdom associations were also identified between Bacillus and Burkholderia viruses and BV-associated bacteria, providing key insight for future studies elucidating transkingdom interactions driving BV-associated microbiome perturbations. In this cohort, bacteriophage-bacterial associations suggest complex interactions which may play a role in the establishment and maintenance of BV.

scholarly journals Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis

2020 ◽  
Vol 16 (6) ◽  
pp. e1008559 ◽  
Author(s):  
Anna-Ursula Happel ◽  
Brian Kullin ◽  
Hoyam Gamieldien ◽  
Nicole Wentzel ◽  
Chambrez Z. Zauchenberger ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
South African ◽  
African Women ◽  
Vaginal Lactobacillus ◽  
South African Women

scholarly journals Bacterial Vaginosis and Susceptibility to HIV Infection in South African Women: A Nested Case‐Control Study

2005 ◽  
Vol 192 (8) ◽  
pp. 1372-1380 ◽  
Author(s):  
Landon Myer ◽  
Lynette Denny ◽  
Robin Telerant ◽  
Michelle de Souza ◽  
Thomas C. Wright, Jr. ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Bacterial Vaginosis ◽  
South African ◽  
Case Control Study ◽  
Case Control ◽  
African Women ◽  
South African Women ◽  
Nested Case Control ◽  
Control Study

scholarly journals Finding a Balance in the Vaginal Microbiome: How Do We Treat and Prevent the Occurrence of Bacterial Vaginosis?

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 719
Author(s):  
Rebecca Jane Joseph ◽  
Hooi-Leng Ser ◽  
Yi-He Kuai ◽  
Loh Teng-Hern Tan ◽  
Valliammai Jayanthi Thirunavuk Arasoo ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Reproductive Tract ◽  
Vaginal Microbiota ◽  
Female Reproductive Tract ◽  
Gardnerella Vaginalis ◽  
Vaginal Microbiome ◽  
Health Issues ◽  
Healthy State ◽  
Vaginal Health ◽  
Pathogenic Microbes

Bacterial vaginosis (BV) has been reported in one-third of women worldwide at different life stages, due to the complex balance in the ecology of the vaginal microbiota. It is a common cause of abnormal vaginal discharge and is associated with other health issues. Since the first description of anaerobic microbes associated with BV like Gardnerella vaginalis in the 1950s, researchers have stepped up the game by incorporating advanced molecular tools to monitor and evaluate the extent of dysbiosis within the vaginal microbiome, particularly on how specific microbial population changes compared to a healthy state. Moreover, treatment failure and BV recurrence rate remain high despite the standard antibiotic treatment. Consequently, researchers have been probing into alternative or adjunct treatments, including probiotics or even vaginal microbiota transplants, to ensure successful treatment outcomes and reduce the colonization by pathogenic microbes of the female reproductive tract. The current review summarizes the latest findings in probiotics use for BV and explores the potential of vaginal microbiota transplants in restoring vaginal health.

scholarly journals Results from the first South African Health Products Regulatory Authority-approved randomised trial evaluating supplementation of standard antibiotic therapy with a commercially available probiotic in South African women with bacterial vaginosis

2020 ◽  
Author(s):  
Anna-Ursula Happel ◽  
Ravesh Singh ◽  
Nireshni Mitchev ◽  
Koleka Mlisana ◽  
Heather B. Jaspan ◽  
...  
Keyword(s):  
South African ◽  
Randomised Trial ◽  
African Women ◽  
The South ◽  
African Health ◽  
Health Products ◽  
Vaginal Health ◽  
South African Women ◽  
Cure Rates ◽  
South African Health

AbstractBackgroundBacterial vaginosis (BV) increases HIV risk and adverse reproductive outcomes in women. The standard-of-care (SOC) for BV is antibiotic treatment; however, cure rates are low and recurrence frequent. In South Africa, no trial comparing probiotics to SOC for BV has been approved by the South African Health Products regulatory Authority (SAHPRA). We aimed to explore the South African regulatory and ethics environment to evaluate adjunctive probiotics for improvement of BV treatment in a randomized single-blinded trial of a locally sourced oral-vaginal-combination probiotic for vaginal health.MethodsSouth African women with symptomatic vaginal discharge were screened for BV and sexually transmitted infections (STIs) including Trichomonas vaginalis, Mycoplasma genitalium, Neisseria gonorrhoae and Chlamydia trachomatis. BV positive (by Nugent Scoring) STI negative women were randomized to Metrogel™ alone (n=12) or Metrogel™ followed by a commercially available South African oral/vaginal probiotic (Vagiforte PLUS® Combo Pack; n=18). BV cure at one month was the primary endpoint. Secondary endpoints were recurrence, symptoms, vaginal microbiota and genital inflammation over five months post-treatment, and acceptability of the administered probiotic.ResultsSAHPRA reviewed and acknowledged this trial. Overall, 44.8% of women cleared BV one month post-treatment. Despite confirmed viability of probiotic species contained in the commercial oral/vaginal probiotic, they did not appear to colonize the female genital tract of most women in the intervention group. No significant differences in BV cure rates, vaginal pH, microbiota nor IL-1α concentrations were found between SOC and intervention groups, although we were underpowered to detect small differences. Acceptability and adherence to the probiotic product was high.ConclusionNavigation of the SAHPRA registration process for evaluating a commercial probiotic in a randomised trial has laid the path for future trials of improved probiotic products for vaginal health in South Africa with adequate sample sizes. Acceptability of vaginally applied probiotics was high in South African women. Improvements in both the content and delivery of commercially available probiotic products for vaginal health should be considered.Trial registrationThis trial was registered on 17 October 2017 with the South African National Clinical Trial Register of the Department of Health (DOH-27-1117-5579).

scholarly journals Temporal Changes in Vaginal Microbiota and Genital Tract Cytokines Among South African Women Treated for Bacterial Vaginosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Andile Mtshali ◽  
James Emmanuel San ◽  
Farzana Osman ◽  
Nigel Garrett ◽  
Christina Balle ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
South African ◽  
Relative Abundance ◽  
Genital Tract ◽  
Vaginal Microbiota ◽  
African Women ◽  
Response To Treatment ◽  
Rrna Gene ◽  
Short Term ◽  
South African Women

The standard treatment for bacterial vaginosis (BV) with oral metronidazole is often ineffective, and recurrence rates are high among African women. BV-associated anaerobes are closely associated with genital inflammation and HIV risk, which underscores the importance of understanding the interplay between vaginal microbiota and genital inflammation in response to treatment. In this cohort study, we therefore investigated the effects of metronidazole treatment on the vaginal microbiota and genital cytokines among symptomatic South African women with BV [defined as Nugent score (NS) ≥4] using 16S rRNA gene sequencing and multiplex bead arrays. Among 56 BV-positive women, we observed short-term BV clearance (NS <4) in a proportion of women six weeks after metronidazole treatment, with more than half of these experiencing recurrence by 12 weeks post-treatment. BV treatment temporarily reduced the relative abundance of BV-associated anaerobes (particularly Gardnerella vaginalis and Atopobium vaginae) and increased lactobacilli species (mainly L. iners), resulting in significantly altered mucosal immune milieu over time. In a linear mixed model, the median concentrations of pro-inflammatory cytokines and chemokines were significantly reduced in women who cleared BV compared to pre-treatment. BV persistence and recurrence were strongly associated with mucosal cytokine profiles that may increase the risk of HIV acquisition. Concentrations of these cytokines were differentially regulated by changes in the relative abundance of BVAB1 and G. vaginalis. We conclude that metronidazole for the treatment of BV induced short-term shifts in the vaginal microbiota and mucosal cytokines, while treatment failures promoted persistent elevation of pro-inflammatory cytokine concentrations in the genital tract. These data suggest the need to improve clinical management of BV to minimize BV related reproductive risk factors.

Impact of point-of-care testing and treatment of sexually transmitted infections and bacterial vaginosis on genital tract inflammatory cytokines in a cohort of young South African women

2021 ◽  
pp. sextrans-2020-054740
Author(s):  
Nigel Garrett ◽  
Andile Mtshali ◽  
Farzana Osman ◽  
Lindi Masson ◽  
Lyle R McKinnon ◽  
...  
Keyword(s):  
South African ◽  
Inflammatory Cytokines ◽  
Point Of Care ◽  
Principal Component ◽  
African Women ◽  
Tnf Α ◽  
Vaginal Health ◽  
South African Women ◽  
The Impact ◽  
Pro Inflammatory Cytokines

ObjectivesSTIs cause inflammation that is detrimental for both HIV risk and reproductive health. We assessed the impact of point-of-care (POC) STI testing, immediate treatment and expedited partner therapy (EPT) on genital tract cytokines among a cohort of young South African women.MethodsHIV-negative women underwent POC testing for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) by Xpert CT/NG and OSOM TV, and for bacterial vaginosis (BV) by microscopy. Women with STIs and/or BV received immediate treatment, EPT for STIs and retested after 6 and 12 weeks. Concentrations of 48 cytokines were measured in cervicovaginal fluid at each visit using multiplex ELISA technology. The impact of STI treatment on cytokine concentrations was assessed by multivariable linear mixed models and principal component analysis.ResultsThe study enrolled 251 women with median age of 23 years (IQR 21–27). The prevalence of CT, NG and TV were 14.3%, 4.4% and 4.0%, and 34.3% had BV. Women with STIs or BV at baseline (n=94) had significantly higher concentrations of pro-inflammatory cytokines (interleukin (IL)-1α, IL-1β, IL-6, tumour necrosis factor (TNF)-α, TNF-β, IL-18 and macrophage inflammatory factor (MIF)) and chemokines (IL-8, IL-16, macrophage inflammatory protein (MIP)-1α, IFN-α2, monokine induced by gamma interferon (MIG), monocyte chemoattractant protein (MCP)-3, regulated on activation normal T cell expressed and secreted and eotaxin) compared with women without (n=157). STI treatment was strongly associated with reduced concentrations of pro-inflammatory cytokines IL-6 (p=0.004), IL-1β (p=0.013), TNF-α (p=0.018) and chemokines MIG (p=0.008) and growth-related oncogene (GRO)-α (p=0.025). A lower Nugent score was associated with a reduction in pro-inflammatory cytokines IL-1α (p=0.003), TNF-related apoptosis-inducing ligand (p=0.004), MIF (p=0.010) and IL-18 (p<0.001), but an increase in chemokines MIG (p=0.020), GRO-α (p<0.001), IP-10 (p<0.001), MIP-1β (p=0.008) and MCP-1 (p=0.005). Principal component analysis showed differences in STI and BV-related inflammatory profiles, but that resolution restored a profile consistent with vaginal health.ConclusionsA comprehensive STI intervention effectively reduced genital inflammation among young women, thereby improving vaginal health and potentially reducing HIV risk.

scholarly journals High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

2017 ◽  
Vol 36 (1) ◽  
Author(s):  
Katie S. Lennard ◽  
Smritee Dabee ◽  
Shaun L. Barnabas ◽  
Enock Havyarimana ◽  
Shameem Z. Jaumdally ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Population Density ◽  
Bacterial Vaginosis ◽  
South African ◽  
Low Income ◽  
Cape Town ◽  
African Women ◽  
High Population Density ◽  
Nugent Score ◽  
South African Women

Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI) prevalence of 102; 16–22-year-old, HIV-negative South African women from a low-income, high-population-density community in Cape Town (CPT). Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV) status was established using Nugent scoring and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV) and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7), 7% as BV-intermediate (Nugent score 3–6) and 38% as BV-negative (Nugent 0–2). Group B Streptococcus (Streptococcus agalactiae), the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and BV may adversely affect reproductive health and place these women at additional risk for HIV acquisition. The high abundance of Prevotella amnii, in particular, may increase HIV risk, given its inflammatory capacity. Laboratory-based testing for STIs (Chlamydia and Gonorrhoeae in particular) appear to be warranted in this community, together with further monitoring or treatment of BV.Research correlation: This article is the original version, of which an Afrikaans translation was made available to provide access to a larger readership, available here: https://doi.org/10.4102/satnt.v36i1.1495

THE SINS OF THE FATHER: GENDER- BASED VIOLENCE IN POST-APARTHEID SOUTH AFRICA

2017 ◽  
Vol 14 (2) ◽  
pp. 57-70 ◽  
Author(s):  
Lyn Snodgrass
Keyword(s):  
South Africa ◽  
Black Women ◽  
South African ◽  
African Women ◽  
Gender Based Violence ◽  
Political Issues ◽  
Race And Gender ◽  
Gender Based ◽  
And Gender ◽  
South African Women

This article explores the complexities of gender-based violence in post-apartheid South Africa and interrogates the socio-political issues at the intersection of class, ‘race’ and gender, which impact South African women. Gender equality is up against a powerful enemy in societies with strong patriarchal traditions such as South Africa, where women of all ‘races’ and cultures have been oppressed, exploited and kept in positions of subservience for generations. In South Africa, where sexism and racism intersect, black women as a group have suffered the major brunt of this discrimination and are at the receiving end of extreme violence. South Africa’s gender-based violence is fuelled historically by the ideologies of apartheid (racism) and patriarchy (sexism), which are symbiotically premised on systemic humiliation that devalues and debases whole groups of people and renders them inferior. It is further argued that the current neo-patriarchal backlash in South Africa foments and sustains the subjugation of women and casts them as both victims and perpetuators of pervasive patriarchal values.

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