{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T09:33:44Z","timestamp":1783157624051,"version":"3.54.6"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2005,3,9]],"date-time":"2005-03-09T00:00:00Z","timestamp":1110326400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2005,3,9]],"date-time":"2005-03-09T00:00:00Z","timestamp":1110326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Background<\/jats:title>\n                        <jats:p>Bacterial vaginosis (BV) \u2013 a syndrome characterised by a shift in vaginal flora \u2013 appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge syndrome (VDS) in The Gambia, West Africa.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>We enrolled 227 women with VDS from a large genito-urinary medicine clinic in Fajara, The Gambia. BV was diagnosed by the Nugent's score and Amsel's clinical criteria. Vaginal swabs were collected for <jats:italic>T vaginalis<\/jats:italic> and vaginal flora microscopy, and for <jats:italic>Lactobacillus<\/jats:italic> spp, aerobic organisms, <jats:italic>Candida<\/jats:italic> spp and BV-associated bacteria (<jats:italic>Gardnerella vaginalis<\/jats:italic>, anaerobic bacteria, and <jats:italic>Mycoplasma<\/jats:italic> spp) cultures; and cervical swabs were collected for <jats:italic>N gonorrhoeae<\/jats:italic> culture and <jats:italic>C trachomatis<\/jats:italic> PCR. Sera were tested for HIV-1 and HIV-2 antibodies. Sexual health history including details on sexual hygiene were obtained by standardised questionnaire.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>BV prevalence was 47.6% by Nugent's score and 30.8% by Amsel's clinical criteria. <jats:italic>Lactobacillus<\/jats:italic> spp were isolated in 37.8% of women, and 70% of the isolates were hydrogen-peroxide (H<jats:sub>2<\/jats:sub>0<jats:sub>2<\/jats:sub>)-producing strains. Prevalence of BV-associated bacteria were: <jats:italic>G vaginalis<\/jats:italic> 44.4%; <jats:italic>Bacteroides<\/jats:italic> 16.7%; <jats:italic>Prevotella<\/jats:italic> 15.2%; <jats:italic>Peptostretococcus<\/jats:italic> 1.5%; <jats:italic>Mobiluncus<\/jats:italic> 0%; other anaerobes 3.1%; and <jats:italic>Mycoplasma hominis<\/jats:italic> 21.4%. BV was positively associated with isolation of <jats:italic>G vaginalis<\/jats:italic> (odds-ratio [OR] 19.42, 95%CI 7.91 \u2013 47.6) and anaerobes (P = 0.001 [OR] could not be calculated), but not with <jats:italic>M hominis<\/jats:italic>. BV was negatively associated with presence of <jats:italic>Lactobacillus<\/jats:italic> (OR 0.07, 95%CI 0.03 \u2013 0.15), and H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub>-producing lactobacilli (OR 0.12, 95% CI 0.05 \u2013 0.28). Presence of H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub>-producing lactobacilli was associated with significantly lower prevalence of <jats:italic>G vaginalis<\/jats:italic>, anaerobes and <jats:italic>C trachomatis<\/jats:italic>. HIV prevalence was 12.8%. Overall, there was no association between BV and HIV, and among micro-organisms associated with BV, only <jats:italic>Bacteroides<\/jats:italic> spp. and <jats:italic>Prevotella<\/jats:italic> spp. were associated with HIV. BV or vaginal flora patterns were not associated with any of the factors relating to sexual hygiene practices (vaginal douching, menstrual hygiene, female genital cutting).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>In this population, BV prevalence was higher than in corresponding populations in industrialised countries, but the pattern of vaginal micro-flora associated with BV was similar. BV or vaginal flora patterns were not associated with HIV nor with any of the vaginal hygiene characteristics.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/1471-2334-5-12","type":"journal-article","created":{"date-parts":[[2005,3,10]],"date-time":"2005-03-10T13:53:40Z","timestamp":1110462820000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa"],"prefix":"10.1186","volume":"5","author":[{"given":"Edward","family":"Demba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Morison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten Schim","family":"van der Loeff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akum A","family":"Awasana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euphemia","family":"Gooding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Mayaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beryl","family":"West","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2005,3,9]]},"reference":[{"key":"160_CR1","first-page":"563","volume-title":"Sexually Transmitted Diseases","author":"SL Hillier","year":"1999","unstructured":"Hillier SL, Holmes KK: Bacterial vaginosis. 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