Clinical and etiological aspects of vulvovaginitis: a prospective and cross-sectional study from North India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20253882Keywords:
Bacterial vaginosis, Trichomoniasis, Vulvovaginal candidiasis, VulvovaginitisAbstract
Background: Vulvovaginitis is the inflammation and infection of the vulva and vagina, which commonly presents with itching, vaginal discharge and burning. It accounts for more than 30% of cases in healthcare clinics. Most common vaginal infections include bacterial vaginosis, trichomoniasis and vulvovaginal candidiasis. Accurate assessment of risk factors and diagnosis of vulvovaginitis are essential key to initiate effective management, thereby alleviating associated complications. This study was aimed to study the clinical and etiological aspects of vulvovaginitis.
Methods: This was a tertiary care hospital based prospective cross-sectional study conducted on 250 women presenting with vulvovaginitis from January 2023 till August 2023. All patients presenting with vulvovaginitis were selected. Detailed history was taken. Demographic variables were assessed. Diagnosis was established based on clinical examination, microscopy, culture techniques and molecular assays.
Results: Vulvovaginitis was seen commonly in married, multiparous women of reproductive age group, mostly in lower class strata. Common risk factors encountered were diabetes, douching, sanitary napkin reuse and amongst OCP users. Most common characteristics of vaginal discharge were greyish white, thin, scanty and associated with malodour. The most common cause leading to vulvovaginitis was bacterial vaginosis followed by vulvovaginal Candidiasis and Trichomoniasis.
Conclusions: The reproductive age group was more susceptible to vulvovaginitis. Predisposing factors leading to vulvovaginitis included diabetes, multiple sexual partners, douching and sanitary napkin reuse. Bacterial vaginosis was the leading cause of vulvovaginitis (43.2%). Molecular tools may aid in the diagnosis of vulvovaginitis with unknown etiology. Primary prevention and timely diagnosis can avert complications and initiate treatment earlier.
Metrics
References
Vaginitis in Nonpregnant Patients. Obst Gynecol. 2020;135:1–17. DOI: https://doi.org/10.1097/AOG.0000000000003604
Thulkar J, Kriplani A, Agarwal N, Vishnubhatla S. Aetiology & risk factors of recurrent vaginitis & its association with various contraceptive methods. Indian J Med Res. 2010;131:83-7.
Benedict K, Singleton AL, Jackson BR, Molinari NAM. Survey of incidence, lifetime prevalence and treatment of self-reported vulvovaginal candidiasis, United States, 2020. BMC Women’s Health. 2022;10:22. DOI: https://doi.org/10.1186/s12905-022-01741-x
Sood N, Sud SS. Profile of infection in women with vaginal discharge in North India. Int J Reprod, Contrac, Obst Gynecol. 2018;7:4184–9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20184149
Mahur J, Humera A. A clinicoetiological study of vulvovaginitis in a tertiary care hospital. International J Reprod, Contrac, Obstet Gynecol. 2019;8:1999. DOI: https://doi.org/10.18203/2320-1770.ijrcog20191957
Mujuzi H, Siya A, Wambi R. Infectious vaginitis among women seeking reproductive health services at a sexual and reproductive health facility in Kampala, Uganda. BMC Women’s Health. 2023;19;23. DOI: https://doi.org/10.1186/s12905-023-02835-w
Shankari P, Usha MG. Microbiological study of vaginitis among women of reproductive age group. IP Int J Med Microbiol Trop Dis. 2023;8(3):232-6. DOI: https://doi.org/10.18231/j.ijmmtd.2022.045
Altaf N, Quddoos MY, Mahmood S, Rehman MA, Ullah TS, Ainee A, et al. Relationship of Socioeconomic Status with Special Reference to Leucorrhoea: Socioeconomic Status with Leucorrhoea. Pakistan J Heal Sci. 2022;5:203-8. DOI: https://doi.org/10.54393/pjhs.v3i07.420
Rodrigues CF, Rodrigues ME, Henriques M. Candida sp. Infections in Patients with Diabetes Mellitus. J Clin Med. 2019;8:76. DOI: https://doi.org/10.3390/jcm8010076
Kiran CK, Kandati J, Ponugoti M. Etiologic characterization of vulvovaginitis among females attending a tertiary care hospital: a one year study. Int J Reprod, Cont, Obst Gynecol. 2017;6:2246. DOI: https://doi.org/10.18203/2320-1770.ijrcog20172026
John N, Rahima S, Raji TK, Santhosh P, Kidangazhiathmana A, Sukumarakurup S. Clinicoetiological study on vaginal discharge among sexually active women attending a tertiary center in North Kerala, India. Indian J Sex Transmit Dis AIDS. 2023;44:1–5. DOI: https://doi.org/10.4103/ijstd.ijstd_65_21
Archana B, Rani UV, Swetha KS, Jyothi K, Zaib S. Prevalence of infective vaginitis in females with vaginal discharge attending at a tertiary care hospital. European J Mol Clin Med. 2022;9:7434-8.
Bahram A, Hamid B, Zohre T. Prevalence of bacterial vaginosis and impact of genital hygiene practices in non-pregnant women in Zanjan, Iran. Oman Med J. 2009;24:288. DOI: https://doi.org/10.5001/omj.2009.58
Hillier SL, Austin M, Macio I, Meyn LA, Badway D, Beigi R. Diagnosis and treatment of vaginal discharge syndromes in community practice settings. Clin Infect Dis. 2021;72:1538-43 DOI: https://doi.org/10.1093/cid/ciaa260
Huang SH, Hsu HC, Lee TF, Fan HM, Tseng CW, Chen IH, et al. Prevalence, Associated Factors and Appropriateness of Empirical Treatment of Trichomoniasis, Bacterial Vaginosis and Vulvovaginal Candidiasis among Women with Vaginitis. Microbiol Spectr. 2023;11:16123. DOI: https://doi.org/10.1128/spectrum.00161-23
Al-Mamari A. Determining the prevalence of bacterial vaginosis & vulvovaginal candidiasis among married and unmarried women & evaluating the association socio-demographic risk factors & symptoms-related variables in women attending gynecology clinic in Hargeisa group hospital, Hargeisa City, Somaliland. Open J Med Microbiol. 2020;10:114–28. DOI: https://doi.org/10.4236/ojmm.2020.103010