Prevalence and Microbial Distribution of Bacterial Vaginosis Among Women of Reproductive Age at Kilimanjaro Christian Medical Centre: A Three-Year Retrospective Laboratory Based Study

Abstract

Background: Bacterial vaginosis is a prevalent and often asymptomatic vaginal condition affecting women of reproductive age, posing significant reproductive health risks. Despite its importance, data on BV prevalence, microbial profiles, and associated factors at Kilimanjaro Christian Medical Centre, a major tertiary hospital in northern Tanzania, remain limited. Therefore, this study aimed to address these gaps.
Methods: This was a three-year retrospective laboratory based study of 891 high vaginal swab samples collected from women aged 15–49 years at KCMC between January 2021 and December 2023. Bacterial vaginosis was diagnosed using Amsel criteria and Nugent scoring. Demographic and clinical data were retrieved from the hospital electronic medical system. Data were analysed using descriptive and inferential statistics. P value of <.05 was considered statistically significant.
Results: Overall prevalence of bacterial vaginosis was 324 (36.4%). The majority of the studied vaginal samples belonged to women aged 25–34 years 359 (40.3%), and most samples were collected from the Outpatient Department 618 (69.4%). Microbiological analysis revealed that no bacterial growth was the most common finding 565 (63.4%), followed by Candida albicans 205 (23.0%) and Escherichia coli 58 (6.5%). In multivariable logistic regression, attendance at the Labour Ward was significantly protective against BV (AOR = 0.096; 95% CI: 0.012–0.787; P= .029), while the year of sample collection also predicted BV: samples from 2022 had reduced odds (AOR=0.63; 95% CI: 0.40–0.96; P=.035), and samples from 2023 had increased odds (AOR=2.24; 95% CI: 1.51–3.32; P<.01) compared to 2021. Age category and individual microorganisms were not independent predictors of BV.
Conclusion: This study showed a high prevalence of bacterial vaginosis (36.4%) with flactating trend among women of reproductive age at KCMC. The most affected were women of reproductive age attending labour ward. The high prevalence among pregnant women has important reproductive health implications, highlighting the need for routine screening to prevent adverse pregnancy outcomes.