title: Bacterial vaginosis in female facility workers in north-western Tanzania: prevalence and risk factors.
abstract: OBJECTIVE
  To determine prevalence of, and risk factors for, bacterial vaginosis (BV) among herpes simplex virus (HSV) 2 seropositive Tanzanian women at enrollment into a randomised, placebo-controlled trial of HSV suppressive treatment.
  
  
  METHODS
  1305 HSV-2 seropositive women aged 16-35 years working in bars, guesthouses and similar facilities were interviewed, examined and tested for HIV, syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, BV, candidiasis and trichomoniasis. Factors associated with BV were analysed using logistic regression to estimate odds ratios and 95% confidence intervals.
  
  
  RESULTS
  BV prevalence was 62.9%; prevalence of Nugent score 9-10 was 16.1%. Independent risk factors for BV were work facility type, fewer dependents, increasing alcohol consumption, sex in the last week (adjusted OR 2.03; 95% CI 1.57 to 2.62), using cloths or cotton wool for menstrual hygiene, HIV (adjusted OR 1.41; 95% CI 1.09 to 1.83) and Trichomonas vaginalis infection. There was no association between BV and the frequency or method of vaginal cleansing. However, BV was less prevalent among women who reported inserting substances to dry the vagina for sex (adjusted OR 0.44; 95% CI 0.25 to 0.75).
  
  
  CONCLUSIONS
  BV was extremely prevalent among our study population of HSV-2 positive female facility workers in North-western Tanzania. Although recent sex was associated with increased BV prevalence, vaginal drying was associated with lower BV prevalence. Further studies of the effects of specific practices on vaginal flora are warranted.
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK. kathy.baisley@lshtm.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Baisley
authors.forename: J
authors.initials: J
authors.lastname: Changalucha
authors.forename: H A
authors.initials: HA
authors.lastname: Weiss
authors.forename: K
authors.initials: K
authors.lastname: Mugeye
authors.forename: D
authors.initials: D
authors.lastname: Everett
authors.forename: I
authors.initials: I
authors.lastname: Hambleton
authors.forename: P
authors.initials: P
authors.lastname: Hay
authors.forename: D
authors.initials: D
authors.lastname: Ross
authors.forename: C
authors.initials: C
authors.lastname: Tanton
authors.forename: T
authors.initials: T
authors.lastname: Chirwa
authors.forename: R
authors.initials: R
authors.lastname: Hayes
authors.forename: D
authors.initials: D
authors.lastname: Watson-Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D015497:HIV-1 / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D013587:Syphilis / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology; D014245:Trichomonas Infections / Q000453:epidemiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014621:Vagina / Q000382:microbiology*; D044364:Vaginal Douching; D016585:Vaginosis, Bacterial / Q000453:epidemiology*; D055815:Young Adult