Bacterial vaginosis, the leading cause of genital discharge among women presenting with vaginal infection in Dar es Salaam, Tanzania

Background: Pathological vaginal discharge is a common complaint of women in reproductive age worldwide caused by various agents. The prevalence and etiologic agents vary depending on the population studied. Management of vaginal discharge in low-income countries, typically depend on the syndromic approach, which limits understanding the specific causative agents. We determined the proportion of bacterial vaginosis, candidiasis, and trichomoniasis among women with vaginal discharge at a regional referral hospital in Dar es Salaam, Tanzania. Methods: We conducted a cross-sectional study between June and August of 2017 among nonpregnant women at Amana Regional Referral Hospital. Experienced staff performed physical examination to establish a clinical diagnosis, and collection of the high vaginal swab for microscopic examination. Descriptive statistics were performed to assess the characteristics of study participants and the proportion of vaginal infections. Results: A total of 196 samples were collected, of all, 128 (65.3%) had either bacterial vaginosis, candidiasis, or trichomo- niasis. Bacterial vaginosis was the leading infection at 33.2%, followed by candidiasis (19.4%) and trichomoniasis (13.3%). Laboratory confirmed vaginal infection were generally found more in age below 25, unmarried, and those employed or petty business. Conclusion: The proportion of bacterial vaginosis in women with vaginal discharge was relatively higher than others, and the presence of vaginal infection relate to socio-demographic characteristics. Further advanced studies are needed to understand the potential role of aetiologic agents in causing vaginal infections. Keywords: Bacterial vaginosis; vaginal discharge; genital infection.

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BACTERIAL VAGINOSIS;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.02.520 ◽

2017 ◽

Vol 24 (02) ◽

pp. 252-257

Author(s):

Faiqa Saleem ◽

Munazza Malik ◽

Muhammad Sohaib Shahid ◽

Muhammad Tayyab

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Reproductive Age ◽

P Value ◽

Vaginal Infections ◽

Vaginal Gel ◽

Vaginal Cream ◽

Significant Difference ◽

Group A ◽

Group B

In women of reproductive age bacterial vaginosis is a most common polymicrobialdisease and is the leading reason for vaginal discharge in this age group. Additionally itis further linked with sizeable disease burden of community problem in terms of infectiouscomplications. Clindamycin vaginal cream and metronidazole vaginal gel are effective in themanagement of vaginal infections caused by multi bacteria. Objectives: To compare thetherapeutic efficacy of Metronidazole vaginal gel and clindamycin vaginal cream as modality oftreatment for bacterial vaginosis. Study Design: Randomized control trial. Setting: Departmentof Obstetrics and Gynaecology, Unit-3 Jinnah Hospital Lahore. Period: Six months from 02-05-2011 to 01-11-2011. Material & Methods: A total of 300 patients were included in this study.They were divided into two groups. Group A received metronidazole vaginal gel (5 g dailyfor 7 days) while group B administered with clindamycin vaginal cream (5g daily for 7 days).Results: Mean age of the patient was observed 34.3+3.5 and 32.9+ 2.1 years in group –A andB respectively. Vaginal discharge was absent in 104 patients (69.3%) from group A and 127(84.7%) from group-B. Absence of clue cells on microscopy revealed in 112 patients (74.7%)from group A and 137 patients (91.3%) from group B. Absence of amine odour found in 116patients (77.3%) of group A and 134 patients (89.3%) of group B. Significant difference wasfound between two groups with p value of 0.006 in respect of efficacy. Conclusion: Clindamycinvaginal cream is more effective in comparison to Metronidazole vaginal gel for the treatment ofbacterial vaginosis.

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MICROBIOLOGICAL PROFILE OF VAGINOSIS AMONG WOMEN OF THE REPRODUCTIVE AGE GROUP, WHO ATTENDED AT DMC, LAHERIASARAI, BIHAR

10.36106/ijsr/6130407 ◽

2020 ◽

pp. 82-85

Author(s):

Neha Jha ◽

R. S. Prasad ◽

P. N. Jha ◽

Debarshi Jana

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Cross Sectional Study ◽

Reproductive Age ◽

Yeast Cells ◽

Age Group ◽

Vaginal Infections ◽

Cross Sectional ◽

Abnormal Vaginal Discharge ◽

Reproductive Age Group

Background: An abnormal vaginal discharge is a common complaint in women and it can be due to vaginal infections like bacterial vaginosis, candidiasis and trichomoniasis. Aim: A descriptive cross sectional study was done at Microbiology Department, DMC, Laheriasarai, Bihar to find out the common pathogens which caused vaginosis in patients of the reproductive age group, who attended the Obstetrics and Gynaecology Department at the Darbhanga Medical College and Hospital, Laheriasarai, Bihar and referred to Microbiology Department of DMC, from 1st April to 30th September, 2020. Materials and Methods: All the 140 vaginal discharge samples were subjected to gram staining to view the morphological nature of the bacteria which caused bacterial vaginosis and gram positive, budding yeast cells, wet film for the motility of Trichomonas and Chlamydial antigen detection by ELISA. Results: The overall positivity was 44%, which included bacterial vaginosis (36.4%). The positivity of candidiasis was 4.2%, that of trichomoniasis was 2.1% and that of chlamydiasis was 1.4%. Conclusion: Bacterial vaginosis was found to be the commonest cause of the abnormal vaginal discharge in women of the reproductive age group.

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Gram stain and Giemsa stain as a rapid diagnostic tool for diagnosis of vaginal infections” in Western Nepal

Journal of Lumbini Medical College ◽

10.22502/jlmc.v5i1.105 ◽

2017 ◽

Vol 5 (1) ◽

pp. 5

Author(s):

Kishor Bajracharya ◽

Narinder Kaur ◽

Sushama Suresh Pant

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Specific Treatment ◽

Vaginal Swab ◽

Giemsa Stain ◽

Reproductive Age ◽

Vaginal Infections ◽

Medical College ◽

Child Bearing ◽

Litmus Paper

Abstract: Introduction: Infective vaginitis accounts for about 90% of all the cases of vaginal discharge in the women of reproductive age group. This includes triad of bacterial vaginosis, candidiasis and trichomoniasis. Method: The study was carried out in Lumbini Medical College and Teaching Hospital, Palpa, Nepal for a time period of 4 months. Total 125 high vaginal swabs from posterior fornix of vagina were collected from November 2014 to February 2015 in the department of Obstetrics and Gynecology, in the patients complaining of vaginal discharge. PH of the vaginal discharge was also determined by using litmus paper. Gram’s and Giemsa stain of vaginal swab smear were done to diagnose Bacterial vaginosis, Candidiasis and Trichomoniasis. Age, parity and pregnancy status of the patients were noted. Result: Out of 125 patient, bacterial vaginosis was found in 16% and candidiasis in 37%.Candidiasis and bacterial vaginosis were observed in child bearing sexually active women. Surprisingly bacterial vaginosis was not observed in pregnant women. Trichomoniasis infection was present in one case (0.8%) while severe invasive Candidiasis was observed in one woman. Conclusion: A definitive diagnosis can easily be made by Gram’s and Giemsa stain and microscopic examination of high vaginal swab. This may help in specific treatment and prevent associated morbidity and recurrence. Key words: Bacterial vaginosis, candidiasis, high vaginal swab, Gram’s stain, Giemsa stain.

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An analysis of emergency care delays experienced by traumatic brain injury patients presenting to a regional referral hospital in a low-income country

PLoS ONE ◽

10.1371/journal.pone.0240528 ◽

2020 ◽

Vol 15 (10) ◽

pp. e0240528

Author(s):

Armand Zimmerman ◽

Samara Fox ◽

Randi Griffin ◽

Taylor Nelp ◽

Erika Bárbara Abreu Fonseca Thomaz ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Emergency Care ◽

Low Income ◽

Referral Hospital ◽

Income Country ◽

Regional Referral Hospital ◽

Low Income Country

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Bacterial Vaginosis and its Relation with Sociodemographic Determinants in married reproductive age females

10.53350/pjmhs211561249 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1249-1252

Author(s):

R. Mukhtar ◽

A. U.- Rehman ◽

A. Ilyas ◽

M. J. Khan ◽

R. Liaqat ◽

...

Keyword(s):

Nutritional Status ◽

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Pap Smear ◽

Reproductive Age ◽

Age Group ◽

Women Of Reproductive Age ◽

Sociodemographic Determinants ◽

Reproductive Age Group ◽

Nonspecific Inflammation

Aim: To determine the frequency of Bacterial vaginosis by pap smear cytology and find its association with its sociodemographic determinants. Study design: Cross sectional analytical study Place and duration of study: Department of Histopathology, Shaikh Zayed Hospital, Lahore from 1st January 2016 to 31st October 2016. Methodology: Two hundred and sixty pap smears of married women of reproductive age group with vaginal discharge who attended Gynecology OPD were included. Proper history regarding age, socioeconomic status, age of marriage, literacy level, smoking, and nutritional status was taken. Results: Disease prevalence was found to be 19.2%(50)in this sample of 260 while 9.1% had Candidiasis, 47%, 17.2% ,3.7%, 4.1% had Mild nonspecific inflammation, Moderate nonspecific inflammation, Moderate to severe nonspecific inflammation, and negative smears respectively. Bacterial vaginosis was associated with age, monthly income, illiteracy, early age at marriage, history of abortion and nutritional status with significant p-value ≤ 0.05. However no association was found between the disease and marital status, smoking and pallor. Conclusion: Low socioeconomic status, literacy, age >35, nutritional status is strongly related to occurrence of bacterial vaginosis in women of reproductive age group with vaginal discharge. Key Words: Bacterial vaginosis, Pap smear, Sociodemographic determinants

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Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-023013 ◽

2018 ◽

Vol 8 (9) ◽

pp. e023013 ◽

Cited By ~ 6

Author(s):

Deogratius Bintabara ◽

Keiko Nakamura ◽

Kaoruko Seino

Keyword(s):

Health Insurance ◽

Low Income ◽

Formal Education ◽

Wealth Index ◽

Population Based ◽

Reproductive Age ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Low Income Country

ObjectiveThis study was performed to explore the factors associated with accumulation of multiple problems in accessing healthcare among women in Tanzania as an example of a low-income country.DesignPopulation-based cross-sectional survey.SettingNationwide representative data for women of reproductive age obtained from the 2015–2016 Tanzania Demographic and Health Survey were analysed.Primary outcome measuresA composite variable, ‘problems in accessing healthcare’, with five (1-5) categories was created based on the number of problems reported: obtaining permission to go to the doctor, obtaining money to pay for advice or treatment, distance to a health facility and not wanting to go alone. Respondents who reported fewer or more problems placed in lower and higher categories, respectively.ResultsA total of 13 266 women aged 15–49 years, with a median age (IQR) of 27 (20–36) years were interviewed and included in the analysis. About two-thirds (65.53%) of the respondents reported at least one of the four major problems in accessing healthcare. Furthermore, after controlling for other variables included in the final model, women without any type of health insurance, those belonging to the poorest class according to the wealth index, those who had not attended any type of formal education, those who were not employed for cash, each year of increasing age and those who were divorced, separated or widowed were associated with greater problems in accessing healthcare.ConclusionThis study indicated the additive effects of barriers to healthcare in low-income countries such as Tanzania. Based on these results, improving uptake of health insurance and addressing social determinants of health are the first steps towards reducing women’s problems associated with accessing healthcare.

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DESIGN OF A SURVEILLANCE SYSTEM FOR PREGNANCY AND ITS OUTCOMES IN RURAL NEPAL

Journal of Nepal Medical Association ◽

10.31729/jnma.784 ◽

2003 ◽

Vol 41 (143) ◽

pp. 411-422 ◽

Cited By ~ 7

Author(s):

David Osrin ◽

S Manandhar ◽

A Shrestha ◽

N Mesko ◽

K S Tumbahangphe ◽

...

Keyword(s):

Low Income ◽

Surveillance System ◽

Newborn Care ◽

Monitoring And Evaluation ◽

Reproductive Age ◽

Low Income Countries ◽

Care Seeking ◽

Research Activities ◽

Rural Nepal ◽

The Impact

IntroductionCommunity trials in low-income countries require monitoring and evaluation systems.The requirements of a community surveillance system include coherent design, training,field supervision and reporting, as well as the need for a robust and flexible database.Materials and methodsThis paper describes a surveillance system for identification of pregnancy and itsoutcomes in a rural area of Nepal. Mother Infant Research Activities (MIRA), incollaboration with the Institute of Child Health, London, are presently conducting astudy on the impact of a community-based participatory intervention to improveessential newborn care (ENC) in rural Nepal. The study is a cluster randomisedcontrolled trial involving 12 pairs of Village Development Committees (VDCs) inMakwanpur District. The surveillance system covers approximately 28 000 householdsand 28 000 married women of reproductive age. It was designed to identify pregnancy,its outcome for mother and infant, and activities such as antenatal care and problem-related health care seeking behaviour.DiscussionThe paper describes the processes of mapping and enumeration, pregnancyidentification, conduct of interviews, quality control and data management.Key Words: data quality, database, rural Nepal.

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Reversible Long Term Contraceptives Utilization among Married Women of Reproductive Age Group in Areka Town, Southern Ethiopia

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i6.9 ◽

2020 ◽

Vol 30 (6) ◽

Author(s):

Samson Kastro Dake ◽

Temesgen Lera Abiso

Keyword(s):

Low Income ◽

Statistical Significance ◽

Married Women ◽

Reproductive Age ◽

Low Income Countries ◽

Southern Ethiopia ◽

Age Group ◽

Women Of Reproductive Age ◽

Reproductive Age Group

BACKGROUND፡ In low income countries, bearing many children is the main factor affecting maternal health. This study aimed to estimate the prevalence of reversible long term contraceptives utilization and identify factors associated with it among married women of child bearing age in Areka District in South EthiopiaMETHODS: We conducted a community-based cross-sectional survey involving systematically recruited 346 married women of reproductive age group. Data was collected using a structured interviewer-administered questionnaire on May 2019. We used SPSS version 25 for data entry and analyses. Bivariate logistic regression analysis was used to select exposure variables with crude association. Multivariate analysis was done to control for potential confounders and identify predictors of the outcome. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI)was reported, and statistical significance was declared at p<0.05.RESULTS: The prevalence of reversible long term contraceptives utilization among married women of reproductive age group was 134(38.7%). Utilization of Reversible Long Term Contraceptives (RLTCs) was positively associated with being protestant Christian religion follower, advanced educational status, history of abortion, and having a better attitude towards reversible long term contraceptives. In other words, being housewife, being daily laborer, having no radio in the household and making fertility decisions alone were negatively associated.CONCLUSION: The prevalence of RLTCs in the study area was high. Women should be empowered educationally through other alternative opportunities to formal school. In addition to electronic media, different community events and community conversations should be used to convey messages on contraceptives particularly RLTCs. Behavioral change communications would benefit women in shaping their attitudestowards RLTCs.

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Geographical variations of early age sexual initiation among reproductive-age women in Ethiopia: Evidence from EDHS 2016

10.21203/rs.2.18827/v1 ◽

2019 ◽

Author(s):

Araya Mesfin Nigatu ◽

Abraham Yeneneh Birhanu ◽

Berhanu Fikadie Endehabtu

Keyword(s):

Low Income ◽

Wealth Index ◽

Sexual Initiation ◽

Reproductive Age ◽

Low Income Countries ◽

P Value ◽

Early Age ◽

Spatial Clusters ◽

Geographical Variations ◽

Early Sexual Initiation

Abstract Abstract Background : The early age of sexual initiation will contribute a lot for various risks such as mistimed pregnancy followed by insecure termination, developing fistula and contracting sexually transmitted infections which are currently the major public health concerns, particularly for low-income countries. Therefore, the purpose of this study was to detect spatial clusters and identify factors associated with an early age sexual initiation of women in the reproductive age group. Methods : We used a population-based nationwide representative Ethiopian demographic and health survey 2016 data for this analysis. A total of 12,033 respondents of reproductive age (15–49 years) who had at least one event of sexual initiation was retrieved and included for the analysis. Spatial cluster detection and autocorrelation analysis were also done to explore the patterns of early age sexual initiation. Results : The median age at first sexual intercourse among respondents was 16 (±3.3) years and more than half (66.2%), had their first intercourse before the age of 18 years. The spatial variations of the age of sexual initiation was nonrandom and clustered with a Moran's I = 0.413 (P-value < 0.001). In addition, five significant spatial clusters were also identified. Moreover, the probability of starting sex at an earlier age was associated with the respondent’s residence, marital status, educational attainment and wealth index. Conclusion : This study found a higher proportion of an early age sexual initiation of women. Socio-demographic variables were also significantly associated with early sexual initiation. The SaTScan analysis identified five statistical significant spatial clusters which indicate that there were geographical variations. Therefore, targeted and integrated interventions focusing on the identified high spot clustered areas are recommended to reduce early age sexual initiation. Keywords : Early sexual initiation, geographical variations, Ethiopia

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A Ten Years Retrospective Study of Hysterectomy in Goba Referral Hospital, Bale Zone, South East Ethiopia, Magnitude Indications and Outcomes

10.21203/rs.3.rs-77029/v1 ◽

2020 ◽

Author(s):

Aklilu Getachew ◽

Takele Mengistu ◽

Yaregal Asres

Keyword(s):

Retrospective Study ◽

Antenatal Care ◽

Low Income ◽

Uterine Rupture ◽

Female Genital Tract ◽

Referral Hospital ◽

Low Income Countries ◽

Categorical Variables ◽

P Value

Abstract Background: Hysterectomy is one of the major surgeries performed in clinical practice for commonly encountered diseases of the female genital tract worldwide. Even if Hysterectomy is widely performed surgery in both developed and low income countries little is known about is epidemiology in rural part of develop countries. Especially in developing countries like Ethiopia representative reliable statistics are rarely available on this important aspect of women’s health mainly on its prevalence, indication and outcome. So the aim of this study was to assess the magnitude indication and outcome of hysterectomy in Goba Referral Hospital from January 1, 2008 to January1, 2018. Methods: institutional based retrospective study was conducted in Goba Referral Hospital. Self-administered structured checklists were used to collect the data. The data were entered into Epi data version 3.1 and analyzed by SPSS version 20. Continuous and categorical variables were summarized by tables, graph and descriptive statistics. Logistic regression was used to determine association between predictors and Hysterectomy prevalence. P-value <0.05 was -considered as statistically significant. Results: a total of 200 hysterectomies were done for obstetrics and gynecology indications, of which the commonest, 47% (n=94), indication was uterine rupture. From the total of 116 women, who had no antenatal care follow up, 40% (n=47) had uterine rupture. This study also indicated that, most of uterine rupture cases 80% (n=76) were living far away from the hospital (> 50km from the hospital) 94.6% (n-89) were multiparous. This study has also indicated that from the total of 20 discharged dead, 90% (n=18)) were came from a distance of >100km far from the hospital and 95% (n=19) were those who didn’t attend antenatal care. Conclusions: the higher rate of uterine rupture was seen in those who were multi Para, far from Hospitals and those who have no ANC follow up. Large scale study for the identification of determinant factors for evidence based intervention will be very important.

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