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High Prevalence of Lactobacillus crispatus Dominated Vaginal Microbiome Among Kenyan Secondary School Girls: Negative Effects of Poor Quality Menstrual Hygiene Management and Sexual Activity

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Metha, Supriya D, Zulaika, Garazi, Otieno, Fredrick O, Nyothach, Elizabeth, Agingu, Walter, Bhaumik, Runa, Green, Stefan J, vanEijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Kwaro, Daniel and Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X (2021) 'High Prevalence of Lactobacillus crispatus Dominated Vaginal Microbiome Among Kenyan Secondary School Girls: Negative Effects of Poor Quality Menstrual Hygiene Management and Sexual Activity'. Frontiers in Cellular and Infection Microbiology, Vol 11, Issue 716537.

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Official URL: https://www.frontiersin.org/articles/10.3389/fcimb...

Abstract

The vaginal microbiome (VMB) impacts numerous health outcomes, but evaluation among adolescents is limited. We characterized the VMB via 16S rRNA gene amplicon sequencing, and its association with Bacterial vaginosis (BV) and sexually transmitted infections (STIs; chlamydia, gonorrhea, trichomoniasis) among 436 schoolgirls in Kenya, median age 16.9 years. BV and STI prevalence was 11.2% and 9.9%, respectively, with 17.6% of girls having any reproductive tract infection. Three community state types (CST) accounted for 95% of observations: CST-I L.crispatus-dominant (N=178, BV 0%, STI 2.8%, sexually active 21%); CST-III L.iners-dominant (N=152, BV 3.3%, STI 9.7%, sexually active 35%); CST-IV G.vaginalis-dominant (N=83, BV 51.8%, STI 25.3%, sexually active 43%). In multivariable adjusted analyses, sexually active girls had increased odds of CST-III and CST-IV, and use of cloth to manage menses had 1.72-fold increased odds of CST-IV vs. CST-I. The predominance of L.crispatus-dominated VMB, substantially higher than observed in prior studies of young adult and adult women in sub-Saharan Africa, indicates that non-optimal VMB can be an acquired state. Interventions to maintain or re-constitute L.crispatus dominance should be considered even in adolescents.

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Article

Subjects:

QW Microbiology and Immunology > Bacteria > QW 142 Gram-positive bacteria (General)
WA Public Health > WA 19 Schools, colleges, and specialized departments and facilities
WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > WA 4 Works on general hygiene
WP Gynecology > WP 100 General works
WS Pediatrics > By Age Groups > WS 460 Adolescence (General)

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