Hoë voorkomskoers van bakteriële vaginose en Chlamydia in ’n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad

Abstract

Jong Suid-Afrikaanse vroue uit hulpbron-arm gemeenskappe staar verskeie uitdagings in die gesig in terme van hulle seksuele en reproduktiewe gesondheid. Hier beskryf ons die voorkoms van vaginale mikrobiota en seksueel oordraagbare infeksies (SOI's) onder 102; 16-22-jarige MIVnegatiewe 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 BVintermediêr (Nugent-telling 3-6), en 38% as BV-negatief (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. Chlamydia-infeksie sowel as BV kan reproduktiewe gesondheid nadelig beïnvloed en verhoog hierdie vroue se risiko vir die verkryging van MIV. Die voorkoms van veral Prevotella amnii kan die MIV-risiko verhoog as gevolg van sy inflammatoriese kapasiteit. Laboratoriumgebaseerde toetsing vir SOI's (veral Chlamydia en Gonorrhoeae) blyk in hierdie gemeenskap geregverdig te wees, tesame met verdere monitering en/of behandeling van BV. High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town. 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 ...