Prevalence of Bacterial Vaginosis among HIV-Positive Women in Machakos County Hospital, Kenya

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Mutuku Onesmus Muia
Scholastica Gatwiri Mathenge
Wachuka Gathigia Njoroge
Titus Kamau Karuga
Kyama Cleophas Mutinda


Background: Bacterial vaginosis (BV) is a common infection in women during their reproductive age. However, the burden of BV among HIV-positive women in Kenya is not clear. This study aimed to determine the prevalence of BV in HIV-positive women visiting the comprehensive care center in Machakos county hospital, Kenya.

Study Design: Cross-sectional study.

Place and Duration of Study: Machakos County Hospital Comprehensive Care Centre and Machakos Cancer Care and Research Centre, between August 2020 and December 2020.

Methodology: We conducted a cross-sectional study at Machakos county hospital in Kenya by enrolling 400 women who were HIV-positive and attending the comprehensive care center at the facility. Convenience sampling was used to select the study participants. Cytological samples obtained using a cytobrush were processed using manual liquid based cytology technique. All smears were stained using the Papanicolaou staining method and examined microscopically for the presence of clue cells. A Chi-square test was performed to evaluate the association between BV and the demographic variables.

Results: Out of the 400 participants enrolled in this study, 41 (10.3%) had BV. The age groups 30-39 years (n=14, 34.1%) and 40-49 years (n=14, 34.1%) had the highest BV burden. Based on marital status, married women had the highest cases of BV (n=18, 43.9%) while divorced women had the least cases of BV (n=4, 9.8%). Women who used condom as the method of family planning showed to have the highest cases of BV (n=18, 43.9%). Of all the variables studied, only age had a statistically significant association with BV (P=0.002).

Conclusion: The prevalence of BV among HIV-positive women in Machakos county hospital, Kenya in this study was 10.3%. Age and BV were significantly associated.

Age, bacterial vaginosis, cervical cytology, HIV-positive women, pap smear.

Article Details

How to Cite
Muia, M. O., Mathenge, S. G., Njoroge, W. G., Karuga, T. K., & Mutinda, K. C. (2021). Prevalence of Bacterial Vaginosis among HIV-Positive Women in Machakos County Hospital, Kenya. Asian Research Journal of Gynaecology and Obstetrics, 5(1), 28-34. Retrieved from
Original Research Article


Peebles K, Velloza J, Balkus J, McClelland R, Barnabas R. High global burden and costs of bacterial vaginosis. Sexually Transmitted Diseases. 2019;46:304-311.

Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: A systematic review. American Journal of Obstetrics and Gynecology. 2013;209:505-523.

Kamga Y, Ngunde J, Akoachere J. Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon. BMC Pregnancy and Childbirth. 2019;19.

Donders, Gilbert. "Diagnosis and management of bacterial vaginosis and other types of abnormal vaginal bacterial flora: a review." Obstetrical & gynecological survey. 2010;65;7:462-473.

Centers for Disease Control and Prevention. CDC - Bacterial vaginosis statistics [Internet].; 2020.
[Cited 22 January 2021].

Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of bacterial vaginosis and associated risk factors among women complaining of genital tract infection. International Journal of Microbiology. 2017;2017:1-8.

Taylor B, Darville T, Haggerty C. Does Bacterial vaginosis cause pelvic inflammatory disease?. Sexually Transmitted Diseases. 2013;40:117-122.

Gillet E, Meys J, Verstraelen H, Verhelst R, De Sutter P, Temmerman M, et al. Association between bacterial vaginosis and cervical intraepithelial neoplasia: systematic review and meta-analysis. PLoS ONE. 2012;7:e45201.

Champer M, Wong A, Champer J, Brito I, Messer P, Hou J, et al. The role of the vaginal microbiome in gynaecological cancer. BJOG: An International Journal of Obstetrics & Gynaecology. 2017;125:309-315.

Mutuku OM, Kavoi BM, Kahato MN, Kyama CM. The utility of manual liquid based cytology in screening for pre-cancerous lesions and cervical cancer. Journal of Medical Science and Clinical Research. 2018;6;(2):600-605.

Joshi S, Mane A, Muwonge R, Divate U, Padbidri V, Kulkarni V, et al. Prevalence and predictors of bacterial vaginosis in HIV-infected women in Maharashtra, India. International Journal of STD & AIDS. 2020;31:541-552.

French A, Adeyemi O, Agniel D, Evans C, Yin M, Anastos K, et al. The association of HIV status with bacterial vaginosis and vitamin D in the United States. Journal of Women's Health. 2011;20:1497-1503.

Sha B, Chen H, Wang Q, Zariffard M, Cohen M, Spear G. Utility of Amsel criteria, Nugent score, and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis, and Lactobacillus spp. for diagnosis of bacterial vaginosis in Human Immunodeficiency Virus-infected women. Journal of Clinical Microbiology. 2005;43: 4607-4612.

Paladine HL, Desai UA. Vaginitis: Diagnosis and treatment. American Family Physician. 2018;97:321-329.

Center for Disease Control and Prevention (CDC). Bacterial vaginosis - 2015 STD treatment guidelines [Internet].; 2015
[Cited 27 January 2021].

Tokyol Ç, Aktepe OC, Cevrioğlu AS, Altındiş M, Dilek FH. Bacterial vaginosis: Comparison of Pap smear and microbiological test results. Modern Pathology. 2004;17:857-860.

Kamga YM, Ngunde JP, Akoachere JF. Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon. BMC Pregnancy and Childbirth. 2019;19:166.

Ibrahim SM, Bukar M, Galadima GB, Audu BM, Ibrahim HA. Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North Eastern Nigeria. Nigerian Journal of Clinical Practice. 2014;17:154-158.

Gad GF, El-Adawy AR, Mohammed MS, Ahmed AF, Mohamed HA. Evaluation of different diagnostic methods of bacterial vaginosis. IOSR Journal of Dental and Medical Sciences. 2014;13:15–23.

Abdul-Aziz M, Mahdy MA, Abdul-Ghani R, Alhilali NA, Al-Mujahed LK, Alabsi SA, et al. Bacterial vaginosis, vulvovaginal candidiasis and trichomonal vaginitis among reproductive-aged women seeking primary healthcare in Sana’a city, Yemen. BMC Infectious Diseases. 2019;19:1-0.

Vaca M, Guadalupe I, Erazo S, Tinizaray K, Chico ME, Cooper PJ, et al. High prevalence of bacterial vaginosis in adolescent girls in a tropical area of Ecuador. BJOG: An International Journal of Obstetrics & Gynaecology. 2010;117: 225-228.

Yen S, Shafer MA, Moncada J, Campbell CJ, Flinn SD, Boyer CB. Bacterial vaginosis in sexually experienced and non–sexually experienced young women entering the military. Obstetrics & Gynecology. 2003;102:927-933.

Yotebieng M, Turner AN, Hoke TH, Van Damme K, Rasolofomanana JR, Behets F. Effect of consistent condom use on 6‐month prevalence of bacterial vaginosis varies by baseline BV status. Tropical Medicine & International Health. 2009; 14:480-486.

Singh HO, Singh A, Dhole TN, Nain S. Factor associated to bacterial vaginosis in non-pregnant women of North Indian population. Journal of Biotechnology Biomaterials. 2015;5:195.

Vodstrcil LA, Hocking JS, Law M, Walker S, Tabrizi SN, Fairley CK, et al. Hormonal contraception is associated with a reduced risk of bacterial vaginosis: A systematic review and meta-analysis. PloS One. 2013;8:e73055.