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Bacterial vaginosis, vaginal Candida colonization and antifungal susceptibility patterns in pregnant women of eastern Ethiopia : a prospective study

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Abstract
Bacterial vaginosis (BV) and vaginal candidiasis are prominent causes of vaginal infections, leading to discomfort and negative pregnancy outcomes. Despite their significance, there is limited data on the prevalence, progression, and contributing factors of BV and vaginal Candida colonization among pregnant women in low-resource settings such as Ethiopia. Thus, the aim of this paper is to determine the prevalence and associated factors of BV and vaginal Candida colonization, and antifungal susceptibility patterns in Eastern Ethiopia. Exploratively, we assessed the relationship between these infections and adverse pregnancy outcomes among pregnant women. A total of 217 pregnant women, ranging from 12 to 22 weeks of gestation, were enrolled and followed until birth or pregnancy termination. Data on sociodemographic information, pregnancy history, and current conditions were gathered through interviews. Two vaginal swabs were collected for microbiological analysis, using Nugent scoring for BV, culture and Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry for Candida detection. Data were collected using Redcap and analyzed using STATA version 17. Multivariable logistic regression was employed to identify associated factors at a significance level of p < 0.05. This study indicated that 43% (95% confidence interval (CI): 36.6%, 50.2%) of the participants had BV or vaginal Candida colonization or both. The overall prevalence of BV and vaginal Candida colonization were 27.7% (95% CI: 21.8%, 34.1%) and 23.5% (95% CI: 18.4%, 29.6%), respectively. Factors associated with BV included antibiotic use (AOR = 9.47, 95% CI: 4.09-21.94) and vaginal douching (AOR = 6.93, 95% CI: 2.86-16.77). Similarly, antibiotic use (AOR = 4.18, 95% CI: 1.78-9.80) and vaginal douching (AOR = 5.48, 95% CI: 2.39-12.56) were significantly associated with Candida colonization. BV increased the likelihood of adverse birth outcomes by 1.89 times and preterm birth alone by 3.89 times. BV and vaginal Candida colonization are highly prevalent among pregnant women in Eastern Ethiopia and are associated with modifiable behavioral and clinical factors. The findings underscore the importance of improved understanding of vaginal microbiota dynamics during pregnancy and their potential links with adverse maternal and neonatal outcomes.
Keywords
Bacterial vaginosis, Adverse pregnancy outcomes, Vaginal Candida colonization, Pregnant women, Ethiopia, ATTENDING ANTENATAL CARE, RISK, EPIDEMIOLOGY, PREVALENCE, BEHAVIORS, ALBICANS, HEALTH

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MLA
Mlashu, Fitsum Weldegebreal, et al. “Bacterial Vaginosis, Vaginal Candida Colonization and Antifungal Susceptibility Patterns in Pregnant Women of Eastern Ethiopia : A Prospective Study.” SCIENTIFIC REPORTS, vol. 15, no. 1, 2025, doi:10.1038/s41598-025-26128-4.
APA
Mlashu, F. W., Negesa, A. S., Ayana, D. A., Wilfong, T., Dheresa, M., Yadeta, T. A., … Cools, P. (2025). Bacterial vaginosis, vaginal Candida colonization and antifungal susceptibility patterns in pregnant women of eastern Ethiopia : a prospective study. SCIENTIFIC REPORTS, 15(1). https://doi.org/10.1038/s41598-025-26128-4
Chicago author-date
Mlashu, Fitsum Weldegebreal, Akewok Sime Negesa, Desalegn Admassu Ayana, Tara Wilfong, Merga Dheresa, Tesfaye Assebe Yadeta, Bodine Van Eenooghe, et al. 2025. “Bacterial Vaginosis, Vaginal Candida Colonization and Antifungal Susceptibility Patterns in Pregnant Women of Eastern Ethiopia : A Prospective Study.” SCIENTIFIC REPORTS 15 (1). https://doi.org/10.1038/s41598-025-26128-4.
Chicago author-date (all authors)
Mlashu, Fitsum Weldegebreal, Akewok Sime Negesa, Desalegn Admassu Ayana, Tara Wilfong, Merga Dheresa, Tesfaye Assebe Yadeta, Bodine Van Eenooghe, Lisa Himschoot, Yohannes Mulugeta Demmu, Tewodros Tesfa, Fikru Tebeje, Tegbaru Nibrat Alemu, Tadesse Gure Eticha, Abraham Geremew, Kedir Teji Roba, Alemseged Abdissa, Nega Assefa, Abel Abera Negash, Abera Kenay Tura, and Piet Cools. 2025. “Bacterial Vaginosis, Vaginal Candida Colonization and Antifungal Susceptibility Patterns in Pregnant Women of Eastern Ethiopia : A Prospective Study.” SCIENTIFIC REPORTS 15 (1). doi:10.1038/s41598-025-26128-4.
Vancouver
1.
Mlashu FW, Negesa AS, Ayana DA, Wilfong T, Dheresa M, Yadeta TA, et al. Bacterial vaginosis, vaginal Candida colonization and antifungal susceptibility patterns in pregnant women of eastern Ethiopia : a prospective study. SCIENTIFIC REPORTS. 2025;15(1).
IEEE
[1]
F. W. Mlashu et al., “Bacterial vaginosis, vaginal Candida colonization and antifungal susceptibility patterns in pregnant women of eastern Ethiopia : a prospective study,” SCIENTIFIC REPORTS, vol. 15, no. 1, 2025.
@article{01KCKD9VG3RPYMZQC6FAVKHQXE,
  abstract     = {{Bacterial vaginosis (BV) and vaginal candidiasis are prominent causes of vaginal infections, leading to discomfort and negative pregnancy outcomes. Despite their significance, there is limited data on the prevalence, progression, and contributing factors of BV and vaginal Candida colonization among pregnant women in low-resource settings such as Ethiopia. Thus, the aim of this paper is to determine the prevalence and associated factors of BV and vaginal Candida colonization, and antifungal susceptibility patterns in Eastern Ethiopia. Exploratively, we assessed the relationship between these infections and adverse pregnancy outcomes among pregnant women. A total of 217 pregnant women, ranging from 12 to 22 weeks of gestation, were enrolled and followed until birth or pregnancy termination. Data on sociodemographic information, pregnancy history, and current conditions were gathered through interviews. Two vaginal swabs were collected for microbiological analysis, using Nugent scoring for BV, culture and Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry for Candida detection. Data were collected using Redcap and analyzed using STATA version 17. Multivariable logistic regression was employed to identify associated factors at a significance level of p < 0.05. This study indicated that 43% (95% confidence interval (CI): 36.6%, 50.2%) of the participants had BV or vaginal Candida colonization or both. The overall prevalence of BV and vaginal Candida colonization were 27.7% (95% CI: 21.8%, 34.1%) and 23.5% (95% CI: 18.4%, 29.6%), respectively. Factors associated with BV included antibiotic use (AOR = 9.47, 95% CI: 4.09-21.94) and vaginal douching (AOR = 6.93, 95% CI: 2.86-16.77). Similarly, antibiotic use (AOR = 4.18, 95% CI: 1.78-9.80) and vaginal douching (AOR = 5.48, 95% CI: 2.39-12.56) were significantly associated with Candida colonization. BV increased the likelihood of adverse birth outcomes by 1.89 times and preterm birth alone by 3.89 times. BV and vaginal Candida colonization are highly prevalent among pregnant women in Eastern Ethiopia and are associated with modifiable behavioral and clinical factors. The findings underscore the importance of improved understanding of vaginal microbiota dynamics during pregnancy and their potential links with adverse maternal and neonatal outcomes.}},
  articleno    = {{42059}},
  author       = {{Mlashu, Fitsum Weldegebreal and Negesa, Akewok Sime and Ayana, Desalegn Admassu and Wilfong, Tara and Dheresa, Merga and Yadeta, Tesfaye Assebe and Van Eenooghe, Bodine and Himschoot, Lisa and Demmu, Yohannes Mulugeta and Tesfa, Tewodros and Tebeje, Fikru and Alemu, Tegbaru Nibrat and Gure Eticha, Tadesse and Geremew, Abraham and Roba, Kedir Teji and Abdissa, Alemseged and Assefa, Nega and Negash, Abel Abera and Tura, Abera Kenay and Cools, Piet}},
  issn         = {{2045-2322}},
  journal      = {{SCIENTIFIC REPORTS}},
  keywords     = {{Bacterial vaginosis,Adverse pregnancy outcomes,Vaginal Candida colonization,Pregnant women,Ethiopia,ATTENDING ANTENATAL CARE,RISK,EPIDEMIOLOGY,PREVALENCE,BEHAVIORS,ALBICANS,HEALTH}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{14}},
  title        = {{Bacterial vaginosis, vaginal Candida colonization and antifungal susceptibility patterns in pregnant women of eastern Ethiopia : a prospective study}},
  url          = {{http://doi.org/10.1038/s41598-025-26128-4}},
  volume       = {{15}},
  year         = {{2025}},
}

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