埃塞俄比亚奥罗米亚州西肖阿区公立医院产前保健诊所孕妇细菌性阴道病患病率及其相关因素-动脉网

Prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics at public hospitals in West Shoa Zone, Oromia, Ethiopia

Nature 等信源发布 2024-09-14 16:15

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AbstractBacterial vaginosis is a polymicrobial syndrome characterized by the decrease of Lactobacilli and an overgrowth of facultative and anaerobic bacteria in vaginal fluid. Though it has received little attention, it has been associated with poor pregnancy outcomes, such as pre-term labor and delivery, premature rupture of membranes, low birth weight, spontaneous abortion, and postpartum infections.

摘要细菌性阴道病是一种多微生物综合征，其特征是阴道液中乳酸杆菌减少，兼性和厌氧细菌过度生长。虽然它很少受到关注，但它与不良妊娠结局有关，如早产和分娩，胎膜早破，低出生体重，自然流产和产后感染。

This study aimed to determine the prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics from September 15 to December 14, 2021, at public hospitals in West Shoa Zone, Oromia, Ethiopia. An institutional-based cross-sectional study was conducted on 260 pregnant women, and systematic random sampling was employed to recruit the study participants.

这项研究旨在确定2021年9月15日至12月14日在埃塞俄比亚奥罗米亚西肖亚区公立医院参加产前保健诊所的孕妇中细菌性阴道病的患病率及其相关因素。。

Data were collected through a structured questionnaire and the vaginal swab was collected using a sterile cotton swab. The gram staining result was interpreted using the Nugent scoring system. Data was entered into an Excel spreadsheet and exported to STATA-14 for analysis. Data were presented using tables and graphs.

通过结构化问卷收集数据，并使用无菌棉签收集阴道拭子。使用Nugent评分系统解释革兰氏染色结果。数据被输入Excel电子表格并导出到STATA-14进行分析。数据使用表格和图表表示。

Binary and multivariable logistic regressions were performed. Variables with a P value ≤ 0.25 at the binary logistic regression were entered into the multivariable logistic regression. Finally, variables with a P value ≤ 0.05 were considered predictors of bacterial vaginosis and interpreted using adjusted Odds Ratios (AOR) with a 95% confidence interval (CI).

进行了二元和多变量逻辑回归。在二元逻辑回归中P值≤0.25的变量被输入多变量逻辑回归。。

A total of 260 pregnant women attending antenatal care were included in the study. The prevalence of bacterial vaginosis according to the Nugent scoring system was 22.3% (95% CI 17.4 to 27.9%). Pregnant women with other marital status were at reduced risk of bacterial vaginosis as compared with married p.

该研究共纳入260名接受产前保健的孕妇。根据Nugent评分系统，细菌性阴道病的患病率为22.3%（95%CI为17.4-27.9%）。与已婚p相比，具有其他婚姻状况的孕妇患细菌性阴道病的风险降低。

IntroductionBacterial vaginosis is a polymicrobial syndrome where the complex balance of microflora in the vagina is changed. There is a depletion of Lactobacilli and an overgrowth of facultative and anaerobic bacteria either singly or in combination. These bacteria include Gardnerella vaginalis, Bacteroides fragilis, Mobiluncus species, and many more others.

引言细菌性阴道病是一种多微生物综合征，阴道中微生物群落的复杂平衡发生了变化。乳酸杆菌耗竭，兼性和厌氧细菌单独或组合过度生长。这些细菌包括阴道加德纳菌，脆弱拟杆菌，运动菌等。

This list continues to expand, and the specific causes of bacterial vaginosis are poorly understood1,2. It is an extremely common reproductive tract disorder worldwide accounting for one-third of vaginal infections3. It can occur in any age group but it is more prevalent in females of reproductive age groups worldwide4.

这个列表继续扩大，细菌性阴道病的具体原因知之甚少1,2。它是全世界极为常见的生殖道疾病，占阴道感染的三分之一3。它可以发生在任何年龄组，但在全球生殖年龄组的女性中更为普遍4。

It has been shown that nearly 5–10 million females every year seek gynecologic advice for vaginitis5.The prevalence of bacterial vaginosis ranges between 8 and 75%6 with higher magnitudes in parts of Africa7. Commonly, the problem occurs among pregnant women, and studies have consistently shown BV to be a risk factor for adverse obstetric and gynecological outcomes such as pre-term labor and delivery8,9,10, premature rupture of membranes, and low birth weight11, spontaneous abortion12, postpartum infections such as endometritis13, and cesarean section wound infections14.Regarding the associated factors, researchers reported that marital status15, residence2, multiparity15, history of abortion16,17, frequency of douching2,18 as well as multiple sexual partners15,16,17 are associated with bacterial vaginosis.

研究表明，每年有近500-1000万女性为阴道炎寻求妇科咨询。细菌性阴道炎的患病率在8%至75%之间6，在非洲部分地区更高7。通常，这个问题发生在孕妇中，研究一直表明BV是早产和分娩8,9,10，胎膜早破和低出生体重11，自然流产12，产后感染如子宫内膜炎13和剖宫产伤口感染14的危险因素。关于相关因素，研究人员报告说，婚姻状况15，居住地2，多胎15，流产史16,17，分娩频率2,18以及多个性伴侣15,16,17与细菌性阴道病有关。

However, the associated factors of bacterial vaginosis are poorly understood as reports have been conflicting. Some of the studies reported that socio-demographic, behavioral, and clinical characteristics of pregnant women are associated with bacterial vaginosis8,18,19,20,21, while another study .

然而，由于报道相互矛盾，细菌性阴道病的相关因素知之甚少。一些研究报道，孕妇的社会人口统计学，行为和临床特征与细菌性阴道病有关8,18,19,20,21，而另一项研究。

Large Gram-positive rods (indicative of Lactobacillus spp),

大型革兰氏阳性杆菌（指示乳酸杆菌属），

Small Gram-negative or variable rods (indicative of Gardnerella, Bacteroides, and other anaerobic bacteria), and

小革兰氏阴性或可变杆（指示加德纳菌，拟杆菌和其他厌氧细菌），以及

Curved, Gram-variable rods (indicative of Mobiluncus spp).

弯曲的革兰氏可变杆（指示Mobiluncus spp）。

Each morphotype was quantified from 1 to 4 + concerning the number of morphotypes per oil immersion field (zero, no morphotypes; 1+, less than 1 morphotypes; 2+, 1 to 4 morphotypes; 3+, 5 to 30 morphotypes; 4+, 30 or more morphotypes). Then, the results of the three different morphotypes were added to give the final score.

关于每个油浸田的形态类型数量（零，无形态类型；1+，少于1个形态类型；2+，1至4个形态类型；3+，5至30个形态类型；4+，30或更多形态类型），每个形态类型从1到4+量化。。

The scores between 0 and 3 represented normal vaginal flora; between 4 and 6, intermediate vaginal flora; and scores between 7 and 10 were considered diagnostic for bacterial vaginosis (BV). In this study, the microbiological definition of BV was a score of 7–10 according to the Nugent’s criteria. As previously described by Shayo and others22, two experienced medical laboratory professionals were recruited at each study hospital to score the vaginal smears independently, and in case of discrepancy, a third opinion was sought for confirmation and her/his opinion was the final.Data quality assurance and managementData quality was ensured through the use of pre-tested tools for data collection, proper data collection, and processing of all activities.

0到3之间的分数代表正常的阴道菌群；在4到6之间，中间阴道菌群；得分在7到10之间被认为是细菌性阴道病（BV）的诊断标准。。数据质量保证和管理通过使用预先测试的工具进行数据收集，适当的数据收集和所有活动的处理，确保了数据质量。

Training was given to midwives on specimen collection, and smear preparation. Every activity in the laboratory was done in adherence to standard operational procedures. To ensure good and uniform practice in the preparation and reading of gram stains, Medical laboratory technologists were trained on Nugent scoring before the study.Data processing and analysisAfter data collection, each questionnaire was checked for completeness, and missing, and edited for other errors.

对助产士进行了标本采集和涂片准备方面的培训。实验室的每项活动都是按照标准操作程序进行的。为了确保在制备和读取革兰氏染色剂方面有良好且统一的做法，医学实验室技术人员在研究前接受了Nugent评分的培训。数据处理和分析数据收集后，检查每个问卷的完整性和缺失，并编辑其他错误。

Data was entered into an Excel spreadsheet and exported to STATA-14 for analysis. Data were organized and presented using tables and graphs. Binary and multivariable logistic regressions were performed to examine the presence of association .

数据被输入Excel电子表格并导出到STATA-14进行分析。数据使用表格和图表进行组织和呈现。进行二元和多变量逻辑回归以检查关联的存在。

Data availability

数据可用性

Data will be available upon reasonable request from the corresponding author.

数据将在通讯作者的合理要求下提供。

AbbreviationsANC:

缩写ANC：

Antenatal care

产前保健

AOR:

AOR：

Adjusted odds ratio

调整后的优势比

AURH:

平均零售价：

Ambo University Referral Hospital

安博大学转诊医院

BV:

BV公司：

Bacterial vaginosis

细菌性阴道病

CI:

CI公司：

Confidence interval

置信区间

COR:

客户关系：

Crude odds ratio

粗比值比

HIV:

艾滋病毒：

Human immunodeficiency virus

人类免疫缺陷病毒

HSV:

HSV：

Herpes simplex virus

单纯疱疹病毒

OR:

或：

Odds ratio

优势比

STDs:

性病：

Sexually transmitted diseases

性传播疾病

STIs:

TSI：

Sexually transmitted infections

性传播感染

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Download referencesAcknowledgementsAuthors have special thanks to Ambo University for the opportunity given to us to carry out this research. The authors also thank data collectors for their unreserved contribution; and study participants who shared their valuable information for this study.FundingAmbo University funded this study.

下载参考文献致谢作者特别感谢安博大学为我们提供了进行这项研究的机会。；以及为这项研究分享了宝贵信息的研究参与者。FundingAmbo大学资助了这项研究。

However, it has no role in the decision to publish, manuscript preparation, and publication.Author informationAuthors and AffiliationsDepartment of Medical Laboratory Sciences, College of Health Sciences and Referral Hospital, Ambo University, Ambo, EthiopiaBelay Tafa Regassa, Chala Kumsa & Abarra Ol’aanaa ShuuleeDepartment of Midwifery, College of Health Sciences and Referral Hospital, Ambo University, Ambo, EthiopiaFikadu Wondimu & Bikila Tefera DebeloDepartment of Obstetrics/Gynecology, College of Health Sciences and Referral Hospital, Ambo University, Ambo, EthiopiaShemeket YilmaDepartment of Pediatrics and Child Health, College of Health Sciences and Referral Hospital, Ambo University, Ambo, EthiopiaAmmar Barba MoredaDepartment of Pediatrics and Child Health Nursing, College of Health Sciences and Referral Hospital, Ambo University, Ambo, EthiopiaWubet Tazeb WondieClinical Laboratory Services Unit, Ambo University Referral Hospital, Ambo, EthiopiaSileshi Lamesa DesisaAuthorsBelay Tafa RegassaView author publicationsYou can also search for this author in.

然而，它在出版，稿件准备和出版的决定中没有任何作用。。

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PubMed Google ScholarAmmar Barba MoredaView author publicationsYou can also search for this author in

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PubMed Google ScholarContributionsB.T.R., the principal investigator, contributed to the conception, study design, execution, and acquisition of data, analysis, and interpretation of data, manuscript drafting, and revising of the manuscript. C.K., F.W., S.Y., A.B.M., and A.O.S.

PubMed谷歌学术贡献b。T、首席研究员R.为数据的概念，研究设计，执行和获取，数据的分析和解释，稿件的起草和稿件的修订做出了贡献。C、 K.，F.W.，S.Y.，A.B.M。和A.O.S。

contributed to the study design, execution, acquisition of data, and revising of the manuscript. W.T.W., S.L.D., and B.T.D. contributed to the analysis and interpretation, manuscript drafting, and revising of the manuscript. All authors read and approved the final manuscript.Corresponding authorCorrespondence to.

为研究设计，执行，数据获取和手稿修订做出了贡献。W、 T.W.，S.L.D。和B.T.D.为稿件的分析和解释，稿件起草和修订做出了贡献。所有作者都阅读并批准了最终手稿。对应作者对应。

Belay Tafa Regassa.Ethics declarations

。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

Ethics approval and consent to participate

道德批准和同意参与

Ethical clearance was obtained from Ambo University, the College of Health Sciences, and the Referral Hospital Institutional Review Board with a reference number of “CMHS/R-MLT/06/13”. Permissions were also secured from the included hospital administration offices and oral informed consent was taken from all study participants.

从安博大学，健康科学学院和转诊医院机构审查委员会获得了伦理许可，参考号为“CMHS/R-MLT/06/13”。还获得了包括医院管理办公室的许可，并获得了所有研究参与者的口头知情同意。

The laboratory procedures for diagnosing bacterial vaginosis were performed following relevant guidelines. Data were collected anonymously and the privacy of the information was kept and protected from unintended manipulations..

诊断细菌性阴道病的实验室程序按照相关指南进行。数据是匿名收集的，信息的隐私得到了保护，免受意外操作。。

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同意出版

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不适用。

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Reprints and permissionsAbout this articleCite this articleRegassa, B.T., Kumsa, C., Wondimu, F. et al. Prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics at public hospitals in West Shoa Zone, Oromia, Ethiopia.

转载和许可本文引用了这篇文章Regassa，B.T.，Kumsa，C.，Wondimu，F。等人。在埃塞俄比亚奥罗米亚西肖亚区公立医院产前保健诊所就诊的孕妇中细菌性阴道病的患病率及其相关因素。

Sci Rep 14, 21474 (2024). https://doi.org/10.1038/s41598-024-72644-0Download citationReceived: 08 May 2024Accepted: 09 September 2024Published: 14 September 2024DOI: https://doi.org/10.1038/s41598-024-72644-0Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1421474（2024）。https://doi.org/10.1038/s41598-024-72644-0Download引文接收日期：2024年5月8日接受日期：2024年9月9日发布日期：2024年9月14日OI：https://doi.org/10.1038/s41598-024-72644-0Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsAntenatal careAssociated factorsBacterial vaginosisPregnant women

关键词阴道护理相关因素细菌性阴道病孕妇

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