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The Natural History of Bacterial Vaginosis Diagnosed by Gram Stain Among Women in Rakai, Uganda

Background: Large datasets for investigating vaginal flora change at frequent, repeated intervals are limited and graphical methods for exploring such data are inadequate. We report 2-year weekly vaginal flora changes based on Gram stain using lasagna plots. Methods: Weekly vaginal flora patterns we... Full description

Journal Title: Sexually transmitted diseases 2011, Vol.38 (11), p.1040-1045
Main Author: THOMA, Marie E
Other Authors: GRAY, Ronald H , KIWANUKA, Noah , 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_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3192988
title: The Natural History of Bacterial Vaginosis Diagnosed by Gram Stain Among Women in Rakai, Uganda
format: Article
creator:
  • THOMA, Marie E
  • GRAY, Ronald H
  • KIWANUKA, Noah
  • WANG, Mei-Cheng
  • SEWANKAMBO, Nelson
  • WAWER, Maria J
subjects:
  • Adolescent
  • Adult
  • Article
  • Bacterial diseases
  • Bacterial diseases of the genital system
  • Biological and medical sciences
  • Care and treatment
  • Cohort Studies
  • Demographic aspects
  • Diagnosis
  • Epidemiology. Vaccinations
  • Female
  • General aspects
  • Gentian Violet
  • Gram's stain
  • Gram-positive bacteria
  • Health aspects
  • Human bacterial diseases
  • Human infectious diseases. Experimental studies and models
  • Humans
  • Hydrogen-Ion Concentration
  • Indexing in process
  • Infectious diseases
  • Longitudinal Studies
  • Medical diagnosis
  • Medical sciences
  • Original Study
  • Phenazines
  • Prevalence
  • Reproductive system
  • Sexual Behavior
  • Sexually transmitted diseases
  • STD
  • Uganda - epidemiology
  • Usage
  • Vagina - microbiology
  • Vaginal Smears
  • Vaginosis
  • Vaginosis, Bacterial - diagnosis
  • Vaginosis, Bacterial - epidemiology
  • Vaginosis, Bacterial - microbiology
  • Women
  • Womens health
  • Womens history
  • Young Adult
ispartof: Sexually transmitted diseases, 2011, Vol.38 (11), p.1040-1045
description: Background: Large datasets for investigating vaginal flora change at frequent, repeated intervals are limited and graphical methods for exploring such data are inadequate. We report 2-year weekly vaginal flora changes based on Gram stain using lasagna plots. Methods: Weekly vaginal flora patterns were evaluated among 211 sexually experienced women with ≥18 months of follow-up in Rakai, Uganda. Vaginal flora swabs were self-collected weekly and categorized by Nugent Gram stain criteria (0-3, normal; 4-6, intermediate; 7-10, bacterial vaginosis [BV]). Vaginal flora patterns were analyzed as the percentage of weekly observations with BV (longitudinal prevalence) and illustrated by lasagna plots. Characteristics of women were compared across tertiles of longitudinal prevalence of BV. Results: Ninety-five percent of women had at least 1 episode of BV over 2 years, with one-third of women spending more than half (52%-100%) of their time with BV. Vaginal pH >4.5 increased with increasing tertiles of longitudinal prevalence of BV (P < 0.001). Weekly fluctuation in vaginal flora states, as measured by a change in flora states from the before current visit, was highest in the middle (41.9%) compared with the lower (30.1%) and upper tertiles (27.8%, P < 0.001). HIV status and reported vaginal symptoms did not differ significantly across BV tertiles. Conclusions: Women exhibited different patterns of vaginal flora changes over time, which could not be described by baseline behaviors. Lasagna plots aided in describing the natural history of BV within and across women and may be applied to future BV natural history studies.
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 Natural History of Bacterial Vaginosis Diagnosed by Gram Stain Among Women in Rakai, Uganda
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creatorTHOMA, Marie E ; GRAY, Ronald H ; KIWANUKA, Noah ; WANG, Mei-Cheng ; SEWANKAMBO, Nelson ; WAWER, Maria J
creatorcontribTHOMA, Marie E ; GRAY, Ronald H ; KIWANUKA, Noah ; WANG, Mei-Cheng ; SEWANKAMBO, Nelson ; WAWER, Maria J
descriptionBackground: Large datasets for investigating vaginal flora change at frequent, repeated intervals are limited and graphical methods for exploring such data are inadequate. We report 2-year weekly vaginal flora changes based on Gram stain using lasagna plots. Methods: Weekly vaginal flora patterns were evaluated among 211 sexually experienced women with ≥18 months of follow-up in Rakai, Uganda. Vaginal flora swabs were self-collected weekly and categorized by Nugent Gram stain criteria (0-3, normal; 4-6, intermediate; 7-10, bacterial vaginosis [BV]). Vaginal flora patterns were analyzed as the percentage of weekly observations with BV (longitudinal prevalence) and illustrated by lasagna plots. Characteristics of women were compared across tertiles of longitudinal prevalence of BV. Results: Ninety-five percent of women had at least 1 episode of BV over 2 years, with one-third of women spending more than half (52%-100%) of their time with BV. Vaginal pH >4.5 increased with increasing tertiles of longitudinal prevalence of BV (P < 0.001). Weekly fluctuation in vaginal flora states, as measured by a change in flora states from the before current visit, was highest in the middle (41.9%) compared with the lower (30.1%) and upper tertiles (27.8%, P < 0.001). HIV status and reported vaginal symptoms did not differ significantly across BV tertiles. Conclusions: Women exhibited different patterns of vaginal flora changes over time, which could not be described by baseline behaviors. Lasagna plots aided in describing the natural history of BV within and across women and may be applied to future BV natural history studies.
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subjectAdolescent ; Adult ; Article ; Bacterial diseases ; Bacterial diseases of the genital system ; Biological and medical sciences ; Care and treatment ; Cohort Studies ; Demographic aspects ; Diagnosis ; Epidemiology. Vaccinations ; Female ; General aspects ; Gentian Violet ; Gram's stain ; Gram-positive bacteria ; Health aspects ; Human bacterial diseases ; Human infectious diseases. Experimental studies and models ; Humans ; Hydrogen-Ion Concentration ; Indexing in process ; Infectious diseases ; Longitudinal Studies ; Medical diagnosis ; Medical sciences ; Original Study ; Phenazines ; Prevalence ; Reproductive system ; Sexual Behavior ; Sexually transmitted diseases ; STD ; Uganda - epidemiology ; Usage ; Vagina - microbiology ; Vaginal Smears ; Vaginosis ; Vaginosis, Bacterial - diagnosis ; Vaginosis, Bacterial - epidemiology ; Vaginosis, Bacterial - microbiology ; Women ; Womens health ; Womens history ; Young Adult
ispartofSexually transmitted diseases, 2011, Vol.38 (11), p.1040-1045
rights
0Copyright © 2011 American Sexually Transmitted Diseases Association
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descriptionBackground: Large datasets for investigating vaginal flora change at frequent, repeated intervals are limited and graphical methods for exploring such data are inadequate. We report 2-year weekly vaginal flora changes based on Gram stain using lasagna plots. Methods: Weekly vaginal flora patterns were evaluated among 211 sexually experienced women with ≥18 months of follow-up in Rakai, Uganda. Vaginal flora swabs were self-collected weekly and categorized by Nugent Gram stain criteria (0-3, normal; 4-6, intermediate; 7-10, bacterial vaginosis [BV]). Vaginal flora patterns were analyzed as the percentage of weekly observations with BV (longitudinal prevalence) and illustrated by lasagna plots. Characteristics of women were compared across tertiles of longitudinal prevalence of BV. Results: Ninety-five percent of women had at least 1 episode of BV over 2 years, with one-third of women spending more than half (52%-100%) of their time with BV. Vaginal pH >4.5 increased with increasing tertiles of longitudinal prevalence of BV (P < 0.001). Weekly fluctuation in vaginal flora states, as measured by a change in flora states from the before current visit, was highest in the middle (41.9%) compared with the lower (30.1%) and upper tertiles (27.8%, P < 0.001). HIV status and reported vaginal symptoms did not differ significantly across BV tertiles. Conclusions: Women exhibited different patterns of vaginal flora changes over time, which could not be described by baseline behaviors. Lasagna plots aided in describing the natural history of BV within and across women and may be applied to future BV natural history studies.
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titleThe Natural History of Bacterial Vaginosis Diagnosed by Gram Stain Among Women in Rakai, Uganda
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abstractBackground: Large datasets for investigating vaginal flora change at frequent, repeated intervals are limited and graphical methods for exploring such data are inadequate. We report 2-year weekly vaginal flora changes based on Gram stain using lasagna plots. Methods: Weekly vaginal flora patterns were evaluated among 211 sexually experienced women with ≥18 months of follow-up in Rakai, Uganda. Vaginal flora swabs were self-collected weekly and categorized by Nugent Gram stain criteria (0-3, normal; 4-6, intermediate; 7-10, bacterial vaginosis [BV]). Vaginal flora patterns were analyzed as the percentage of weekly observations with BV (longitudinal prevalence) and illustrated by lasagna plots. Characteristics of women were compared across tertiles of longitudinal prevalence of BV. Results: Ninety-five percent of women had at least 1 episode of BV over 2 years, with one-third of women spending more than half (52%-100%) of their time with BV. Vaginal pH >4.5 increased with increasing tertiles of longitudinal prevalence of BV (P < 0.001). Weekly fluctuation in vaginal flora states, as measured by a change in flora states from the before current visit, was highest in the middle (41.9%) compared with the lower (30.1%) and upper tertiles (27.8%, P < 0.001). HIV status and reported vaginal symptoms did not differ significantly across BV tertiles. Conclusions: Women exhibited different patterns of vaginal flora changes over time, which could not be described by baseline behaviors. Lasagna plots aided in describing the natural history of BV within and across women and may be applied to future BV natural history studies.
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