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Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial

Czapar, Anna E, Paul, Souvik, Zulaika, Garazi, Otieno, Fredrick, Agingu, Walter, Chaudhary, Adit, Bhaumik, Runa, vanEijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Green, Stefan J, Nyothach, Elizabeth, Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X and Mehta, Supriya D. (2024) 'Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial'. BMC Infectious Diseases, Vol 24, Issue 1, p. 1419.

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Abstract

Background
Less than one-third of sub-Saharan Africans have access to improved water sources. In US, Indian, and African studies, Bacterial vaginosis (BV) is increased among women with poor water, sanitation, and hygiene (WASH). We examined water source, sanitation (latrine type), and rainfall in relation to the vaginal microbiome (VMB).

Methods
In a cluster randomized controlled trial of menstrual cups and cash transfer, we measured the impact of cups on VMB via 16S rRNA gene amplicon sequencing in a subset of 436 adolescent girls. We analyzed how self-reported water source and latrine type at home related to VMB over 18-months, examining community state type I (CST-I, L. crispatus dominant) vs. other CST; alpha diversity; targeted taxa (coliform and other water-related pathogens); and non-targeted taxa via machine learning approaches. Mixed effects multivariable longitudinal models were adjusted for intervention arm, age, socioeconomic status, sexual activity, and cluster-level school WASH and rainfall (in millimeters).

Results
Adjusting for all covariates in all models: (1) the odds of CST-I were increased among participants with piped water (vs. pond), and decreased with traditional pit latrine vs. flush toilet. (2) Alpha diversity varied by water source and latrine type without consistent trends. (3) Coliform bacteria relative abundance (RA) was higher among participants with traditional pit or ventilated improved pit latrines vs. flush toilet, and higher among participants relying on stream vs. pond water. Streptococcus agalactiae RA was higher among participants with non-flush toilets, while Bacteroides fragilis RA was lower with non-flush toilets. (4) Key taxa from non-targeted analyses associated with water source and latrine type included typical vaginal bacteria, opportunistic pathogens, and urinary tract pathobionts. (6) Increased rainfall was associated with decreased odds of CST-I.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > WA 30.2 Climate Change
WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12879-024-10313-3
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 13 Jan 2025 09:57
Last Modified: 13 Jan 2025 09:57
URI: https://archive.lstmed.ac.uk/id/eprint/25854

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