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The Short-term Variability of Bacterial Vaginosis Diagnosed by Nugent Gram Stain Criteria Among Sexually Active Women in Rakai, Uganda

Background: Studies evaluating clinical and behavioral factors related to short-term fluctuations in vaginal microbiota are limited. We sought to describe changes in vaginal microbiota evaluated by Gram stain and assess factors associated with progression to and resolution of bacterial vaginosis (BV... Full description

Journal Title: Sexually transmitted diseases 2011-02-01, Vol.38 (2), p.111-116
Main Author: THOMA, Marie E
Other Authors: GRAY, Ronald H , KIWANUKA, Noah , ALUMA, Simon , WANG, Mei-Cheng , SEWANKAMBO, Nelson , WAWER, Maria J
Format: Electronic Article Electronic Article
Language: English
Subjects:
STD
Quelle: Alma/SFX Local Collection
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
ID: ISSN: 0148-5717
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recordid: cdi_proquest_miscellaneous_848685855
title: The Short-term Variability of Bacterial Vaginosis Diagnosed by Nugent Gram Stain Criteria Among Sexually Active Women in Rakai, Uganda
format: Article
creator:
  • THOMA, Marie E
  • GRAY, Ronald H
  • KIWANUKA, Noah
  • ALUMA, Simon
  • WANG, Mei-Cheng
  • SEWANKAMBO, Nelson
  • WAWER, Maria J
subjects:
  • Adolescent
  • Adult
  • Bacterial diseases
  • Bacterial diseases of the genital system
  • Biological and medical sciences
  • Diagnosis
  • Epidemiology. Vaccinations
  • Female
  • General aspects
  • Gentian Violet
  • Gram's stain
  • Human bacterial diseases
  • Human infectious diseases. Experimental studies and models
  • Humans
  • Indexing in process
  • Infectious diseases
  • Medical sciences
  • Original Study
  • Phenazines
  • Pregnancy
  • Pregnancy Complications, Infectious - diagnosis
  • Pregnancy Complications, Infectious - epidemiology
  • Pregnancy Complications, Infectious - microbiology
  • Sexual Behavior
  • Sexually transmitted diseases
  • Staining and Labeling - methods
  • STD
  • Studies
  • Time Factors
  • Uganda - epidemiology
  • Usage
  • Vagina - microbiology
  • Vaginal Smears
  • Vaginosis
  • Vaginosis, Bacterial - diagnosis
  • Vaginosis, Bacterial - epidemiology
  • Vaginosis, Bacterial - microbiology
  • Women
  • Young Adult
ispartof: Sexually transmitted diseases, 2011-02-01, Vol.38 (2), p.111-116
description: Background: Studies evaluating clinical and behavioral factors related to short-term fluctuations in vaginal microbiota are limited. We sought to describe changes in vaginal microbiota evaluated by Gram stain and assess factors associated with progression to and resolution of bacterial vaginosis (BV) at weekly intervals. Methods: A cohort of 255 sexually experienced, postmenarcheal women provided self-collected vaginal swabs to assess vaginal microbiota by Nugent score criteria at weekly visits for up to 2 years contributing 16,757 sequential observations. Absolute differences in Nugent scores (0-10) and transition probabilities of vaginal microbiota states classified by Nugent score into normal (0-3), intermediate (4-6), and BV (7-10) between visits were estimated. Allowing each woman to serve as her own control, weekly time-varying factors associated with progression from normal microbiota to BV and resolution of BV to normal microbiota were estimated using conditional logistic regression. Results: The distribution of absolute difference in Nugent scores was fairly symmetric with a mode of 0 (no change) and a standard deviation of 2.64. Transition probabilities showed weekly persistence, was highest for normal (76.1%) and BV (73.6%) states; whereas, intermediate states had similar probabilities of progression (36.6%), resolution (36.0%), and persistence (27.4%). Weekly fluctuation between normal and BV states was associated with menstrual cycle phase, recency of sex, treatment for vaginal symptoms, pregnancy, and prior Nugent score. Conclusions: Weekly changes in vaginal microbiota were common in this population. Clinical and behavioral characteristics were associated with vaginal microbiota transitioning, which may be used to inform future studies and clinical management of BV.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0148-5717
fulltext: fulltext
issn:
  • 0148-5717
  • 1537-4521
url: Link


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titleThe Short-term Variability of Bacterial Vaginosis Diagnosed by Nugent Gram Stain Criteria Among Sexually Active Women in Rakai, Uganda
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creatorTHOMA, Marie E ; GRAY, Ronald H ; KIWANUKA, Noah ; ALUMA, Simon ; WANG, Mei-Cheng ; SEWANKAMBO, Nelson ; WAWER, Maria J
creatorcontribTHOMA, Marie E ; GRAY, Ronald H ; KIWANUKA, Noah ; ALUMA, Simon ; WANG, Mei-Cheng ; SEWANKAMBO, Nelson ; WAWER, Maria J
descriptionBackground: Studies evaluating clinical and behavioral factors related to short-term fluctuations in vaginal microbiota are limited. We sought to describe changes in vaginal microbiota evaluated by Gram stain and assess factors associated with progression to and resolution of bacterial vaginosis (BV) at weekly intervals. Methods: A cohort of 255 sexually experienced, postmenarcheal women provided self-collected vaginal swabs to assess vaginal microbiota by Nugent score criteria at weekly visits for up to 2 years contributing 16,757 sequential observations. Absolute differences in Nugent scores (0-10) and transition probabilities of vaginal microbiota states classified by Nugent score into normal (0-3), intermediate (4-6), and BV (7-10) between visits were estimated. Allowing each woman to serve as her own control, weekly time-varying factors associated with progression from normal microbiota to BV and resolution of BV to normal microbiota were estimated using conditional logistic regression. Results: The distribution of absolute difference in Nugent scores was fairly symmetric with a mode of 0 (no change) and a standard deviation of 2.64. Transition probabilities showed weekly persistence, was highest for normal (76.1%) and BV (73.6%) states; whereas, intermediate states had similar probabilities of progression (36.6%), resolution (36.0%), and persistence (27.4%). Weekly fluctuation between normal and BV states was associated with menstrual cycle phase, recency of sex, treatment for vaginal symptoms, pregnancy, and prior Nugent score. Conclusions: Weekly changes in vaginal microbiota were common in this population. Clinical and behavioral characteristics were associated with vaginal microbiota transitioning, which may be used to inform future studies and clinical management of BV.
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subjectAdolescent ; Adult ; Bacterial diseases ; Bacterial diseases of the genital system ; Biological and medical sciences ; Diagnosis ; Epidemiology. Vaccinations ; Female ; General aspects ; Gentian Violet ; Gram's stain ; Human bacterial diseases ; Human infectious diseases. Experimental studies and models ; Humans ; Indexing in process ; Infectious diseases ; Medical sciences ; Original Study ; Phenazines ; Pregnancy ; Pregnancy Complications, Infectious - diagnosis ; Pregnancy Complications, Infectious - epidemiology ; Pregnancy Complications, Infectious - microbiology ; Sexual Behavior ; Sexually transmitted diseases ; Staining and Labeling - methods ; STD ; Studies ; Time Factors ; Uganda - epidemiology ; Usage ; Vagina - microbiology ; Vaginal Smears ; Vaginosis ; Vaginosis, Bacterial - diagnosis ; Vaginosis, Bacterial - epidemiology ; Vaginosis, Bacterial - microbiology ; Women ; Young Adult
ispartofSexually transmitted diseases, 2011-02-01, Vol.38 (2), p.111-116
rights
0Copyright © 2011 American Sexually Transmitted Diseases Association
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2COPYRIGHT 2011 American Venereal Disease Association
3Copyright Lippincott Williams & Wilkins Feb 2011
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descriptionBackground: Studies evaluating clinical and behavioral factors related to short-term fluctuations in vaginal microbiota are limited. We sought to describe changes in vaginal microbiota evaluated by Gram stain and assess factors associated with progression to and resolution of bacterial vaginosis (BV) at weekly intervals. Methods: A cohort of 255 sexually experienced, postmenarcheal women provided self-collected vaginal swabs to assess vaginal microbiota by Nugent score criteria at weekly visits for up to 2 years contributing 16,757 sequential observations. Absolute differences in Nugent scores (0-10) and transition probabilities of vaginal microbiota states classified by Nugent score into normal (0-3), intermediate (4-6), and BV (7-10) between visits were estimated. Allowing each woman to serve as her own control, weekly time-varying factors associated with progression from normal microbiota to BV and resolution of BV to normal microbiota were estimated using conditional logistic regression. Results: The distribution of absolute difference in Nugent scores was fairly symmetric with a mode of 0 (no change) and a standard deviation of 2.64. Transition probabilities showed weekly persistence, was highest for normal (76.1%) and BV (73.6%) states; whereas, intermediate states had similar probabilities of progression (36.6%), resolution (36.0%), and persistence (27.4%). Weekly fluctuation between normal and BV states was associated with menstrual cycle phase, recency of sex, treatment for vaginal symptoms, pregnancy, and prior Nugent score. Conclusions: Weekly changes in vaginal microbiota were common in this population. Clinical and behavioral characteristics were associated with vaginal microbiota transitioning, which may be used to inform future studies and clinical management of BV.
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34Vaginosis, Bacterial - diagnosis
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titleThe Short-term Variability of Bacterial Vaginosis Diagnosed by Nugent Gram Stain Criteria Among Sexually Active Women in Rakai, Uganda
authorTHOMA, Marie E ; GRAY, Ronald H ; KIWANUKA, Noah ; ALUMA, Simon ; WANG, Mei-Cheng ; SEWANKAMBO, Nelson ; WAWER, Maria J
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abstractBackground: Studies evaluating clinical and behavioral factors related to short-term fluctuations in vaginal microbiota are limited. We sought to describe changes in vaginal microbiota evaluated by Gram stain and assess factors associated with progression to and resolution of bacterial vaginosis (BV) at weekly intervals. Methods: A cohort of 255 sexually experienced, postmenarcheal women provided self-collected vaginal swabs to assess vaginal microbiota by Nugent score criteria at weekly visits for up to 2 years contributing 16,757 sequential observations. Absolute differences in Nugent scores (0-10) and transition probabilities of vaginal microbiota states classified by Nugent score into normal (0-3), intermediate (4-6), and BV (7-10) between visits were estimated. Allowing each woman to serve as her own control, weekly time-varying factors associated with progression from normal microbiota to BV and resolution of BV to normal microbiota were estimated using conditional logistic regression. Results: The distribution of absolute difference in Nugent scores was fairly symmetric with a mode of 0 (no change) and a standard deviation of 2.64. Transition probabilities showed weekly persistence, was highest for normal (76.1%) and BV (73.6%) states; whereas, intermediate states had similar probabilities of progression (36.6%), resolution (36.0%), and persistence (27.4%). Weekly fluctuation between normal and BV states was associated with menstrual cycle phase, recency of sex, treatment for vaginal symptoms, pregnancy, and prior Nugent score. Conclusions: Weekly changes in vaginal microbiota were common in this population. Clinical and behavioral characteristics were associated with vaginal microbiota transitioning, which may be used to inform future studies and clinical management of BV.
copHagerstown, MD
pubLippincott Williams & Wilkins
pmid20921931
doi10.1097/OLQ.0b013e3181f0bdd0