Genital Tract Infections in an Isolated Community: 100 Women of the Príncipe Island

Abstract

Objective To characterize the vaginal microbiome and the rate of sexually transmitted infections (STIs) in the women of Príncipe (São Tomé and Príncipe). Methods Cross-sectional study of 100 consecutive women, invited for a free appointment and cervical cancer screening. A vaginal slide (wet mount microscopy) and a cervical sample (ThinPrep®) (Pap test, high risk human papillomavirus [HR-HPV], N. gonorrhea [NG], T. vaginalis [TV], and C. trachomatis [CT]) were obtained. Results TV, NG, CT, and HIV were found in 8.0%, 2.0%, 3.0%, and 2.0%, respectively, and were more prevalent in younger women. HR-HPV was positive in 36.7%; 2 were positive for HPV18, but none for HPV16. Coinfection of HPV with other STIs was 8.3%. Prevalence of abnormal vaginal flora (AVF) was 82.5%, mostly bacterial vaginosis (BV) 54.6%, and moderate/severe aerobic vaginitis (msAV) 25.8%. HR-HPV was not related to BV (p = 0.67). The association of abnormal Pap test with msAV was not significant (p = 0.08). Conclusion The prevalence of NG, CT, TV, and HR-HPV was according to expected, while that of HR-AVF was higher. The surprisingly low prevalence of HPV16 and HPV18 must be considered in the design of programs for prevention and vaccination; this setting can be useful as a model for postvaccination scenarios.

Prevalence of Infectious Organisms Observed in Cervical Smears Between 1997–2014 at Mubarak Al-Kabeer Hospital, Kuwait

“…A similar pattern was noted in other studies, wherein fungal agents were most prevalent, followed by Trichomonas species. [8][9][10][11][12] As mentioned earlier, the number of specific infectious agents detected was lower in modified compared to conventional CS samples; this reduction was noted in almost all infectious agents, except HSV. This finding has been supported by other researchers.…”

Candidiasis, Bacterial Vaginosis, Trichomoniasis and Other Vaginal Conditions Affecting the Vulva

“…Global prevalence (symptomatic and asymptomatic) varies widely according to the population studied (12-55%), being consistently higher in black women (50-55%) [86,87]. BV is much rarer in non-sexually experienced women, especially in those without any kind of sexual contact [88], but is very high (20-50%) in women with female partners [89].…”

“…Among gynaecological complications, there are studies relating it to an increased risk of having an abnormal Pap test and of acquiring STIs. The presence of inflammation and erosions, the lack of lactobacilli, and the associated increased levels of sialidase can easily explain the increased risk for STIs; diagnosing and treating AV can be highly relevant in populations at elevated risk, namely in Africa [87,118].…”

<p>The Pathogenesis Of<em> Streptococcus anginosus</em> In Aerobic Vaginitis</p>

“…Previous studies have shown that AV is associated with miscarriage,6 increased risk of amnionitis,7 placental histological inflammation,8 premature rupture of membranes,9 preterm delivery,6,10 foetal funisitis,8 and major cervical cytological abnormalities 11,12. The prevalence of AV is reported to be 5–27.6% in various areas 6,9,12–17. Thus, it is vital to identify AV so that standardized treatments can be developed to avoid complications.…”