Prevalence and Risk Factors for Bacterial Vaginosis and Other Vulvovaginitis in a Population of Sexually Active Adolescents from Salvador, Bahia, Brazil
Bacterial vaginosis, trichomoniasis, and genital candidiasis are considered the main etiologies of vulvovaginitis. Few studies estimate the prevalence of vulvovaginitis among adolescents, especially in Brazil. This study aimed to determine the prevalence and main risk factors associated with bacterial vaginosis and genital infection by C. albicans and Trichomonas vaginalis among a group of adolescents from Salvador, Bahia, Brazil. One hundred sexually active adolescents followed at an adolescent gynecology clinic were included. Endocervical and vaginal samples were obtained during gynecological examination. Nugent criteria were applied for the diagnosis of bacterial vaginosis. For Candida albicans and Trichomonas vaginalis detection, culture in Sabouraud agar plates and Papanicolaou cytology were used, respectively. The mean age of participants was years. The prevalence of bacterial vaginosis was 20% (95% CI 12–28) and of genital infection by Candida was 22% (95% CI 14–30). Vaginal cytology detected Trichomonas vaginalis in one patient. Alcohol, tobacco, and illegal drug use ( ) and multiple lifetime partners were statistically related to bacterial vaginosis ( ). The prevalence of bacterial vaginosis and genital candidiasis was similar to other studies carried out among adolescents worldwide. 1. Introduction Sexually transmitted diseases (STDs) are prevalent, it is estimated that 340 million new cases occur among adults worldwide [1]. These conditions are also regarded as an important public health problem for its medical, social and economic implications [2]. Vaginal infection is one of the most common gynecological affections and vaginal discharge is one of the most common reasons for which women seek medical attention [3]. Vulvovaginitis is a usual cause of genital infection in women. Bacterial vaginosis, Candida albicans genital infection and trichomoniasis are considered the main etiologies of vulvovaginitis [4, 5]. Bacterial vaginosis is a dysbiosis, in which a decrease in resident vaginal lactobacilli is associated with a growth of anaerobic polymicrobial flora. Bacterial vaginosis is not considered a STD, being usually described, however, as a sexually enhanced disease, in which the frequency of intercourse plays a critical role [6]. Furthermore, bacterial vaginosis has been associated with increased susceptibility to HIV-AIDS and other STD [7]. Candida genital infection is the leading cause of fungal vulvovaginitis. Pregnancy, broad-spectrum antibiotic use, diabetes mellitus, and immunodeficiency have been described as important risk factors
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