| dc.description.abstract | Background
Bacterial vaginosis (BV) is a lower genital tract infection characterized by the presence of thin,
white, homogeneous, fishy-smelling vaginal discharge. This discharge is present in the absence
of signs of vaginal irritation. It is also characterized by a disruption of the normal vaginal
equilibrium. BV accounts for 40% to 50% of all gynecologic conditions encountered by primary
health care physicians. Its prevalence is reported to be generally high among women who are
sexually active than those who are not. Some antimicrobials have been associated with marked
evidence of resistance among vaginal anaerobic bacteria. Since the prevalence of BV in women
of reproductive age is shown to be high in Kenya, there is need to investigate the antimicrobial
susceptibility pattern of anaerobic bacteria isolated from BV in female sex workers in Nairobi,
Kenya.
Broad objective
The goal of this study was to determine the susceptibility of vaginal anaerobic bacterial isolates
from female sex workers with bacterial vaginosis in Nairobi, Kenya.
Study design
This was a cross-sectional study. High Vaginal Swab (HVS) specimen was obtained from
Female Sex Workers (FSW) attending Sex Workers Operating Point (SWOP) clinics and sociodemographic data obtained using questionnaires.
Methodology
Structured questionnaires were used to collect the socio-demographic features of the participants.
These included age, educational level and residence of the participants. It was also used to elicit
information on participants’ knowledge and attitude towards their reproductive health. Vaginal
secretions were taken using sterile swabs at the SWOP clinic and cultured for isolation of
Gardnerella vaginalis, Mobiluncus species, Ureaplasma urealyticum, Peptostreptococcus
species. and Bacteroides species in an anaerobic environment at the University of Nairobi,
Institute of Tropical and Infectious diseases laboratory. Susceptibility test was done using the
disc diffusion and agar dilution technique.
Data analysis
The data collected was edited, coded and analyzed using SPSS version 21. Descriptive statistics
was used to analyze socio-demographic features while odds ratio was used to determine the risk
factors associated with bacterial vaginosis. Chi square was used to determine the difference in
response to the antimicrobials used to treat bacterial vaginosis.
Results
Out of 160 participants enrolled in to the study, 18.4% were confirmed to have Bacterial
vaginosis. Contraceptive use was found to be common among the participants (68.5%), 51.6%
practiced douching while only 18% indicated that they smoked. BV was found to be inversely
related to number sexual partners and contraceptive use (Pearson correlation -0.033 and -0.045
respectively) while douching and smoking were directly related to BV condition (Pearson
correlation 0.099 and 0.044 respectively). Bacteroides dominated the isolates at 16.3% while
Morbiluncus was at 3.1%. There was a significant difference in the antimicrobials used to treat
BV (P˂0.001). Most of the isolates were sensitive to clindamycin while majority were resistant
to metronidazole.
Conclusion
Hormonal contraceptives were negatively associated with BV while smoking and douching were
directly associated with the condition in FSW in Nairobi. Bacteroides sp was the most
commonly isolated organism from samples collected from FSW in Nairobi. Clindamycin was the
most effective drug for treating BV in FSW in Nairobi, Kenya. | en_US |
