The Microbiology of Bacterial Vaginosis: A Systematic Review

Abstract

Bacterial vaginosis (BV) is a common vaginal infection with high occurrence in women of child-bearing age.  The infection was first described by Gardner and Dukes in 1955 that is now referred to as BV. The normal healthy vagina is populated mainly by hydrogen-peroxide-producing lactobacilli that inhibit the growth of other vaginal flora.  BV is characterized by a loss of these protective lactobacilli, an increase in vaginal pH to >4.5, and the proliferation of a variety of anaerobic species. Electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for observational studies such as case series, cross-sectional and cohort studies, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide. Data extracted included (i) patient demography (age), (ii) marital status, (iii) vaginal discharge and lower abdominal pain (iv) vaginal douching (v) use of contraceptive devices. Higher prevalence of BV is seen among women who have sex with women (WSW). In Nigeria, a prevalence rate of 17%, 17.3%, 19.0% and 25% have been reported from separate studies done in the south-east, north-east, north-west and south-west Nigeria respectively. The epidemiology of BV robustly implies that it is acquired through sexual transmission. This article has reviewed that BV is a public health infection because of the impact it has on the health, social, sexual, emotional and economic status of females, there is need for public awareness on health educational programs through different media on the impact of BV. Routine screening of especially high risk groups; (such as women of reproductive age group, women who practice vaginal douching, pregnant women, women in high institutions of learning) is recommended to avoid complications such as; (preterm birth (premature birth, low birth weight or miscarriage), sexually transmitted diseases, risk of infection following gynecological surgery, and pelvic inflammatory disease,) that could result from infections from bacterial vaginosis. The golden method for screening is by Gram's Method to stain vaginal smear. The method is simple and easy without invasion. It is cheap, sensitive, and specific.