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

Abstract

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, highpopulation-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. Laboratorybased testing for STIs (Chlamydia and Gonorrhoeae in particular) appear to be warranted in this community, together with further monitoring or treatment of BV. Hoë voorkomskoers van bakteriële vaginose en Chlamydia in 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Jong Suid-Afrikaanse vroue uit hulpbron-arm gemeenskappe staar verskeie uitdagings in die gesig in terme van hul seksuele en reproduktiewe gesondheid. Hier beskryf ons die voorkoms van vaginale mikrobiota en seksueel oordraagbare infeksies (SOI's) onder 102; 16-22-jarige MIV-negatiewe Suid-Afrikaanse vroue uit 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Vaginale mikrobiota is met behulp van 16S rRNA amplikon volgorde-bepaling geprofileer; bakteriese vaginose (BV) status is met behulp van 'n Nugent-telling vasgestel; en SOI's is deur middel van 'n multipleks polimerase kettingreaksie bepaal. SOI's was algemeen, met 55% van die vroue wat ten minste een SOI gehad het; 41% wat met hoë-risiko menslike papillomavirus (MPV) besmet was, en 'n verdere 28% wat met laerisiko-MPV besmet was; 44% van die vroue was met Chlamydia besmet, waarvan 16% een of meer addisionele SOI gehad het. BV persentasies was ook baie hoog, met 55% van die vroue wat as BV-positief (Nugent-telling ≥7) geklassifiseer is, 7% as BV-intermediêr (Nugent-telling 3-6), en 38% as BVnegatief (Nugent-telling 0-2). Streptococcus (Streptococcus agalactiae), die grootste oorsaak van neonatale sepsis, was teenwoordig in 25% van die BV-positiewe vroue en 28% van die BV-negatiewe vroue, en was dus meer onder BV-negatiewe vroue. Beide Chlamydia-infeksie en BV kan re...

Human microbiota research in Africa: a systematic review reveals gaps and priorities for future research

“…Laboratory-based testing for STIs (chlamydia and gonorrhea in particular) appear to be warranted in this community, together with further monitoring or treatment of BV. [ 23 ] South Africa Bacterial vaginosis Vulvo-vaginal swabs 16S rRNA, V4 region, Illumina MiSeq Australia, South Africa, USA European and Developing Countries Clinical Trials Partnership (EDCTP), South African Department of Science and Technology Cohort 168 We propose that women with this BVAB1-dominated subtype may have chronic genital inflammation due to persistent BV, which may place them at a particularly high risk for HIV infection. [ 24 ] South Africa Bacterial vaginosis Vaginal swabs 16S rRNA, V4 region, Illumina MiSeq Australia, South Africa, USA European and Developing Countries Clinical Trials Partnership (EDCTP) Strategic Primer grant, South African Department of Science and Technology Cohort 181 Our results therefore suggest that HIV prophylactic approaches targeting the vaginal microbiota should be geographically tailored.…”