Bacterial Vaginosis in Women of Reproductive Age: Burden and Predictors in Western Kenya DOI: https://dx.doi.org/10.4314/ajhs.v38i2.5

Abstract

Background: Bacterial vaginosis (BV) is one of the most common Lower genital tract infections among women of reproductive age, resulting from the imbalanced microbiota of the vaginal ecosystem. BV is a common vaginal infection caused by disruption of the normal vaginal microbiota. Despite its high burden in sub-Saharan Africa, bacterial vaginosis (BV) remains underdiagnosed, yet it is associated with adverse pregnancy outcomes and an increased risk of acquiring sexually transmitted infections, including HIV. Therefore, this study was undertaken to determine the burden and predictors of BV among women of reproductive age in Western Kenya.

Methods: This cross-sectional study, conducted between January and December 2024, enrolled 227 consenting non-pregnant women of reproductive age (18-49 years) at Kakamega County General Teaching and Referral Hospital (KCGTRH), Western Kenya. Vaginal swabs were collected, and an associated demographic questionnaire was administered. BV was diagnosed using Nugent's scoring system. Descriptive statistics were used to characterise the population, while logistic regression analysis was used to determine factors associated with BV infection using STATA v 13 (StataCorp LP, Texas, USA). The significance level was established at p ≤ 0.05.

Results: A total of 129/227 (64.5%) women exhibited abnormal vaginal flora with a Nugent score (NS) of 4–10, while 78 (39%) were diagnosed with BV (NS 7–10). Four (2%) women had Trichomonas vaginalis, and 19 (9.5%) had a yeast infection. Women whose partners used condoms during sexual intercourse (adjusted odds ratio - aOR 0.6; 95% confidence interval - CI 0.4 – 0.8) were less likely to be infected with BV. Women aged 26 to 30 years (aOR 2.0; 95% CI 1.0 – 4.2), experiencing lower abdominal pain (aOR 1.7; 95% CI 1.1 – 2.9), with milky vaginal discharge (aOR 1.5; 95% CI 1.0 – 2.6), and those with yeast infection (aOR 2.0; 95% CI 1.03 – 4.1) were associated with BV infection.

Conclusions: This study highlights a high burden of BV among women of reproductive age in Western Kenya. Risk factors include age, lower abdominal pain, vaginal discharge, and co-infection with yeast, while condom use was protective. These findings underscore the need for improved screening, health education, and targeted interventions to reduce the impact of BV and associated reproductive health risks.