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Women in sub-Saharan Africa have a higher prevalence of these high-risk bacterial communities when compared to Western populations. However, the transition of cervicovaginal communities between high- and low-risk community states over time is not well described in African populations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We profiled the bacterial composition of 316 cervicovaginal swabs collected at 3-month intervals from 88 healthy young Black South African women with a median follow-up of 9 months per participant and developed a Markov-based model of transition dynamics that accurately predicted bacterial composition within a broader cross-sectional cohort. We found that\n                      <jats:italic>Lactobacillus iners<\/jats:italic>\n                      -dominant, but not\n                      <jats:italic>Lactobacillus crispatus<\/jats:italic>\n                      -dominant, communities have a high probability of transitioning to high-risk states. Simulating clinical interventions by manipulating the underlying transition probabilities, our model predicts that the population prevalence of low-risk microbial communities could most effectively be increased by manipulating the movement between\n                      <jats:italic>L. iners<\/jats:italic>\n                      - and\n                      <jats:italic>L. crispatus<\/jats:italic>\n                      -dominant communities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The Markov model we present here indicates that\n                      <jats:italic>L. iners<\/jats:italic>\n                      -dominant communities have a high probability of transitioning to higher-risk states. We additionally identify transitions to target to increase the prevalence of\n                      <jats:italic>L. crispatus<\/jats:italic>\n                      -dominant communities. These findings may help guide future intervention strategies targeted at reducing bacteria-associated adverse reproductive outcomes among women living in sub-Saharan Africa.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40168-021-01096-9","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T13:05:56Z","timestamp":1627304756000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Modeling the temporal dynamics of cervicovaginal microbiota identifies targets that may promote reproductive health"],"prefix":"10.1186","volume":"9","author":[{"given":"Alexander","family":"Munoz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth M.","family":"Bloom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muntsa","family":"Rocafort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinaye","family":"Ngcapu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomfuneko A.","family":"Mafunda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nondumiso","family":"Xulu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista L.","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasreen","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thumbi","family":"Ndung\u2019u","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musie S.","family":"Ghebremichael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8521-8735","authenticated-orcid":false,"given":"Douglas S.","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"issue":"35","key":"1096_CR1","doi-asserted-by":"publisher","first-page":"11060","DOI":"10.1073\/pnas.1502875112","volume":"112","author":"DB DiGiulio","year":"2015","unstructured":"DiGiulio DB, Callahan BJ, McMurdie PJ, Costello EK, Lyell DJ, Robaczewska A, et al. 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