ArticleSexually transmitted diseases2011
The natural history of bacterial vaginosis diagnosed by gram stain among women in Rakai, Uganda.
Article in Sexually transmitted diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Functional data analysis to characterize disease patterns in frequent longitudinal data: application to bacterial vaginal microbiota patterns using weekly Nugent scores and identification of pattern-specific risk factors.BMC medical research methodology · 2023Article
- Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities.Frontiers in cellular and infection microbiology · 2020Review
- Article
- Antimicrobial and immune modulatory effects of lactic acid and short chain fatty acids produced by vaginal microbiota associated with eubiosis and bacterial vaginosis.Frontiers in physiology · 2015Review
- A mixture of transition models for heterogeneous longitudinal ordinal data: with applications to longitudinal bacterial vaginosis data.Statistics in medicine · 2014Article
- The epidemiology of sexually transmitted co-infections in HIV-positive and HIV-negative African-Caribbean women in Toronto.BMC infectious diseases · 2013Article
- Vaginal concentrations of lactic acid potently inactivate HIV.The Journal of antimicrobial chemotherapy · 2013Article
- Article
- Prevalent and incident bacterial vaginosis are associated with sexual and contraceptive behaviours in young Australian women.PloS one · 2013Article
- Developing multipurpose reproductive health technologies: an integrated strategy.AIDS research and treatment · 2013Article
- More than meets the eye: associations of vaginal bacteria with gram stain morphotypes using molecular phylogenetic analysis.PloS one · 2013Article
- An evaluation of the natural history of bacterial vaginosis using transition models.Sexually transmitted diseases · 2011Article
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6 authors.
Funding
Abstract
backgroundLarge datasets for investigating vaginal flora change at frequent, repeated intervals are limited and graphical methods for exploring such data are inadequate. We report 2-year weekly vaginal flora changes based on Gram stain using lasagna plots.
methodsWeekly vaginal flora patterns were evaluated among 211 sexually experienced women with ≥18 months of follow-up in Rakai, Uganda. Vaginal flora swabs were self-collected weekly and categorized by Nugent Gram stain criteria (0-3, normal; 4-6, intermediate; 7-10, bacterial vaginosis [BV]). Vaginal flora patterns were analyzed as the percentage of weekly observations with BV (longitudinal prevalence) and illustrated by lasagna plots. Characteristics of women were compared across tertiles of longitudinal prevalence of BV.
resultsNinety-five percent of women had at least 1 episode of BV over 2 years, with one-third of women spending more than half (52%-100%) of their time with BV. Vaginal pH >4.5 increased with increasing tertiles of longitudinal prevalence of BV (P < 0.001). Weekly fluctuation in vaginal flora states, as measured by a change in flora states from the before current visit, was highest in the middle (41.9%) compared with the lower (30.1%) and upper tertiles (27.8%, P < 0.001). HIV status and reported vaginal symptoms did not differ significantly across BV tertiles.
conclusionsWomen exhibited different patterns of vaginal flora changes over time, which could not be described by baseline behaviors. Lasagna plots aided in describing the natural history of BV within and across women and may be applied to future BV natural history studies.
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