BackgroundIn Yemen, the underlying causes of infectious vaginitis have been neglected. Therefore, this study aimed to determine the prevalence and risk factors associated with bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonal vaginitis (TV) among non-pregnant reproductive-aged women.MethodsA cross-sectional study was conducted among 347 non-pregnant reproductive-aged women seeking primary healthcare in Sana’a city, Yemen. Data about sociodemographic characteristics, lifestyle-related behaviors, routine hygienic practices, menstrual care and history and type of contraceptive intake were collected using a structured questionnaire. Vaginal discharge samples were collected and examined for discharge characteristics and pH by a gynecologist. Then, samples were examined for BV, VVC and TV. Data were analyzed using suitable statistical tests.ResultsVaginal infections were prevalent among 37.6% of reproductive-aged women, where BV was the most prevalent (27.2%). VVC was significantly higher among symptomatic women and significantly associated with itching (P = 0.005). Using bivariate analysis, the age of < 25 years (odds ratio [OR] = 1.9, 95% confidence interval [CI]: 1.16–3.10; P = 0.010) and using intrauterine contraceptive devices (IUCDs) (OR = 1.8, 95% CI: 1.09–2.89; P = 0.020) were significantly associated with BV, while history of miscarriage was significantly associated with a lower risk of BV (OR = 0.5, 95% CI: 0.31–0.85, P = 0.009). However, polygyny was significantly associated with VVC (OR = 3.4, 95% CI: 1.33–8.66; P = 0.007). Multivariable analysis confirmed that age of < 25 years and using IUCD were the independent predictors of BV, while history of miscarriage was an independent protective factor against BV. On the other hand, marriage to a polygamous husband was the independent predictor of VVC.ConclusionsMore than a third of non-pregnant reproductive-aged women seeking PHC in Sana’a have single or mixed infections with BV, VVC or TV. BV is the most frequent cause of vaginitis and is significantly associated with the age of < 25 years and using IUCDs, while VVC is significantly higher among women with polygamous husbands. Health education of polygamous husbands and their wives, regular monitoring of BV among IUCD users and screening women for vaginitis before treatment are recommended.

Background: Neonatal infection with group B Streptococcus (GBS) is still a threat to the life of fetus and mother, especially in developing countries that do not adopt a prenatal screening test policy such as Yemen. Objective: This study aimed to determine the vaginal colonization rates and antibiotic susceptibility pattern of group B Streptococcus among pregnant Yemeni women. Methods: We conducted a cross-sectional study over a four-month period involved 210 pregnant women who visited Gaza medical center (a primary health center in Sana’a city, Yemen) at the 35th to 39th gestational weeks. A vaginal swab from each pregnant woman was inoculated in Todd-Hewitt enrichment broth and after 24h incubation; the subculture on a 5% human blood agar plate was performed from inoculated Todd-Hewitt enrichment broth. All positive cultures identified as group B streptococcus were subjected to antibiotic susceptibility test using the disk-diffusion method. Results: Out of 210 recruited pregnant women, 23 (10.95%) were GBS vaginal carriers. All isolates showed no resistance to penicillin, ampicillin, levofloxacin, cefotaxime, and vancomycin. However, we observed decreased sensitivity to clindamycin (82.8%) and tetracycline (30.5%). Conclusion: Based on the study results; approximately eleven out of every 100 pregnant women were vaginal colonized by GBS in Sana'a governorate. Beta-lactam antibiotics remain the drug of choice for treatment and prophylaxis of GBS infections. Therefore, we recommend implementing a screening policy to detect GBS in Yemeni pregnant women.

Objective: To determine the frequency and pattern of abnormal cervical smear findings among women attending the University of Science and Technology Hospital (USTH) in Sana'a city. Methods: This study is a retrospective, cross-sectional study. Records of women examined by conventional Pap smears in the Histopathology Laboratory of USTH over a 4-year period (from January 2013 to December 2016) were retrieved and analyzed for abnormalities according to the Bethesda system. Results: Of 688 cases, 599 with satisfactory records were analyzed. The mean age of the cases was 39.18±10.23 years (range: 19–75). Epithelial cell abnormalities (ECAs) were found in 47 cases (7.8%), and these were categorized as follows: ASCUS in 4.5% (27/599) of cases followed by atypical glandular cells (AGC) (2.2%; 13/599) and LSIL (0.5%; 3/599), while ASCH and HSIL abnormalities were equally observed among 0.3% (2/599 each) of cases. Of patients positive Pap smear findings, ASCUS was the most frequent type of ECA (57.4%; 27/47) followed by AGC (27.7%; 13/47) and LSIL (6.4%; 3/47), while ASCH and HSIL were the least frequent ECAs among Yemeni patients. ECAs were significantly more prevalent among women aged >40 years (10.8%) compared with those aged <40 years (5.5%). Conclusions: Cervical cytological abnormalities are not uncommon among women in Yemen, where the AGC is frequent among about a third of women with abnormal Pap smear findings and affects women of different ages. This requires more attention and training of doctors to master good sample taking, preparation and diagnosis with a focus on glandular changes.

Background: Neonatal infection with group B Streptococcus (GBS) is still a threat to the life of fetus and mother, especially in developing countries that do not adopt a prenatal screening test policy. Objective: This study aimed to estimate the prevalence of group B Streptococcus in pregnant Yemeni women between the 35th and 39th weeks of gestation and also to assess group B Streptococcus sensitivity pattern to several antibiotics. Methods: The fieldwork was performed in a primary health centre and a private modern medical laboratory at Sana'a city, Yemen. The study was limited to taking one vaginal swab from each participant of 210 pregnant women, and it relied on the cultural characteristics and biochemical tests for identifying the bacteria as group B Streptococcus. Antibiotic susceptibility testing was performed using the Kirby-Bauer test. Results: Among the 210 pregnant women who were participating in this study, 23 (10.95%) were vaginally colonized with group B Streptococcus. Beta-lactam antibiotics and vancomycin were completely effective against group B Streptococcus. Conclusion: Based on this study results, at least one out of every ten Ymenei pregenant women is GBS vaginally colonized therefore we recommend routine prenatal GBS screening among pregnant women in the third trimester in Yemen and conducting extensive epidemiological studies in other Yemeni cities to detect the extent prevalence of GBS among pregnant mothers in Yemen in order to develop an appropriate preventive strategy.