# Prevalence of bacterial vaginosis and its associated risk factors among women of reproductive age attending Jos University Teaching Hospital, Plateau State, Nigeria

## TL;DR

This study found a 33.6% prevalence of bacterial vaginosis among women in Nigeria, with higher rates in symptomatic women and the presence of various bacterial species.

## Contribution

The study provides new insights into the prevalence and bacterial diversity associated with bacterial vaginosis in a Nigerian population.

## Key findings

- Bacterial vaginosis prevalence was 33.6%, with higher rates in symptomatic women (39.1%) compared to asymptomatic women (28.2%).
- Enterococcus faecalis was the most prevalent bacterial species identified in both symptomatic and asymptomatic women.
- Lactobacillus spp. were present but not dominant, indicating a potential risk for infections.

## Abstract

Bacterial vaginosis (BV) remains the most common cause of abnormal vaginal discharge due to altered vaginal flora with decreased Lactobacillus spp. and increased anaerobic bacteria. The objectives of this study were to establish the prevalence of BV and its risk factors among women of reproductive age.

This cross-sectional descriptive survey was conducted among 220 non-pregnant women of reproductive age attending Jos University Teaching Hospital (JUTH) in Plateau state, north central Nigeria, between August 2021 and January 2022, in which 110 women were asymptomatic, and 110 women were symptomatic. Self-administered questionnaires were used to identify the sociodemographic status and predisposing factors of the participants. Positive BV diagnosis was made using the Nugent scoring system and bacterial species were identified on selective media. A descriptive analysis was performed using the Chi-squared test at a 95% confidence interval to determine the prevalence of BV and its associated risk factors.

The overall BV prevalence was 33.6%. BV was higher in symptomatic women (39.1%) than in asymptomatic women (28.2%). No correlation was found between BV and demography, knowledge, or health behaviour, including age, education, marital status, number of children, occupation, income, alcohol, tobacco smoking, or sexual as well as hygienic behaviour (p≥0.05).

A total of 328 bacterial isolates from 16 species were identified, with Enterococcus (E.) faecalis being the most prevalent species, accounting for 39.3% of the total isolates. Other species isolated include Staphylococcus
(S.) saprophyticus (13.6%), S. epidermidis (13.0%), S. aureus (4.7%), Streptococcus (Sr.) agalactiae (5.9%), Klebsiella (K.) pneumoniae (4.1%), Proteus (P.) mirabilis (2.4%), and Pseudomonas (P.) aeruginosa (3.6%) in the symptomatic group. S. saprophyticus (10,7%), S. aureus (3.8%), K. pneumoniae (2.5%), and P. aeruginosa (1.9%) were isolated in the asymptomatic group. P. mirabilis was not detected. Lactobacillus spp. were present but not dominant, with an overall prevalence of 8.2%.

The observed diversity in vaginal microbiota, particularly the higher prevalence of E. faecalis in asymptomatic women, suggests the complexity of microbial interactions. The low prevalence of Lactobacillus spp. indicates a potential risk for infections, while the presence of potentially pathogenic bacteria such as S. saprophyticus and Streptococcus agalactiae underscores the need for further research. Overall, the understanding of the vaginal microbiome is crucial for developing effective healthcare interventions for managing BV.