Bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis in reproductive-age women in Yunnan, China: a descriptive study

Abstract

This study aimed to determine the prevalence of and risk factors associated with BV(bacterial vaginosis, BV), VVC (vulvovaginal candidiasis, VVC) and TV (trichomonal vaginitis, TV) among non-pregnant women. Among 770 women included in analyses, surveyed using a questionnaire and subsequently diagnosed with BV, VVC and TV via Gram staining and vaginal swab microscopy. Vaginal infections were prevalent in 31.30%, with BV being the most prevalent (21.35%). Single-variable analysis revealed that an age of 20–29 years (odds ratio [OR] = 2.31, 95% CI: 1.24–4.29; p = .007) and lack of education (OR = 0.50, 95% CI: 0.28-0.89; p = .018) were significantly associated with BV. However, an age of 30–39 years was significantly associated with VVC (OR = 2.12, 95% CI: 1.03–4.38; p = .038). Multivariable analysis confirmed that miscarriage was an independent predictor of BV and VVC. Miscarriage was significantly associated with the incidence of BV and VVC (OR = 1.680, 95% CI: 1.146–2.462; p = .011 and OR = 2.04, 95% CI: 1.30–3.20; p = .002, respectively). In conclusion, BV appears to be the predominant cause of vaginitis, risk factors for vaginitis include age and level of education and miscarriage.

IMPACT STATEMENT

• What is already known on this subject? Inflammation of the vagina, or vaginitis, is caused by various infectious and non-infectious factors. The most common causes of infectious vaginitis are BV, VVC and TV. Kunming located at the southwestern border of China, However, there is still no systematic research investigating the status of vaginitis infection in Yunnan Province. Therefore, the present study aimed to determine the prevalence of these vaginal infections; BV, VVC, and TV, among women of childbearing age, and to assess the prevalence of vaginal infections and the associated risk factors.

• What do the results of this study add? In our study we found that vaginal infections were prevalent in 31.30% of reproductive-age women, with BV being the most prevalent (21.35%). We believe that our study makes a significant contribution to the literature because we report that BV appears to be the predominant cause of vaginitis, followed by VVC and TV. Risk factors for vaginitis include age, miscarriage and level of education.

• What are the implications of these findings for clinical practice and/or further research? This study aimed to determine the prevalence of these vaginal infections, BV, VVC and TV, and to assess the prevalence of vaginal infections and the associated risk factors. Health education interventions are recommended to raise women’s awareness of vaginitis and its prevention.

Keywords:

• Bacterial vaginosis
• vulvovaginal candidiasis
• trichomonal vaginitis
• vaginitis
• reproductive-age women
• Yunnan

Acknowledgements

The authors thank the women who participated in the study, as well as the management of the Department of Gynecology, First People’s Hospital of Yunnan Province, where the study was conducted, for their cooperation. The authors thank Editage (www.editage.cn) for English language editing.

Ethics approval and consent to participate

This study was approved by the Ethical Research Committee at the First People’s Hospital of Yunnan Province (approval number: 2018GJ037). All participants provided informed consent for their study participation.

Medical ethics committee of the first people's hospital of Yunnan province project demonstration report (2018GJ037)

Project leader: Wu Xiaomei

Syndrome undertaking unit: The First People's Hospital of Yunnan Province

1. The ethics committee has demonstrated the project plan, and especially following three aspects were seriously discussed:

   1. The rights and interests of the research object;

   2. Measures to ensure that informed consent is obtained;

   3. Existing dangers and possible benefits.

2. Agree to implement the project plan. In the implementation process, please use the proven informed consent form, questionnaire, explanatory letter and other materials.

3. If the project plan needs to be modified, it must be verified by the ethics committee in advance it can be implemented, and the modification content and its reasons need to be filed in detail.

4. If there is any adverse reaction during the implementation process, immediately report to the Ethics Committee the staff will make a written report.

Consent for publication

All participants provided informed consent for the publication of this report.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work received financial support from the Basic Research Program of Yunnan Province [2019FE001-174, 2018FE117, 202001AY070001-115]; the Project Funding Project and Open Subject of Clinical Medicine Centre [2019LCZXF-SZ003]; the Talent Development Program of Yunnan Province [D-2018054]; Major Science And Technology Projects [Biomedicine, 2019ZF004-1-5]; and the Provincial Innovation Team of Research on Mechanisms and Translational Application of Intestinal Microecology Related Diseases [202005AE160010].