PREVALENCE AND ASSOCIATED FACTORS OF VAGINITIS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE AT HEALTH FACILITY IN HARAMAYA UNIVERSITY HEALTH AND DEMOGRAPHIC SURVEILLANCE SYSTEM SITES, EASTERN ETHIOPIA

Abstract

Inflammation of the vagina, or vaginitis, is caused by various infectious and non-infectious factors. The most common causes of infectious vaginitis are bacterial vaginosis (BV), vaginal candidiasis (VC), and trichomonas vaginitis (TV). Owing to the scarcity of research on Vaginal candidiasis and Bacterial vaginosis amongst pregnant women in Ethiopia, a significant gap exists concerning the prevalence and progression in this population. Objective: This study aimed to assess the prevalence and associated factors of vaginitis among pregnant women attending antenatal care at a Health facility in Haramaya University Health and Demographic Surveillance System sites in Eastern Ethiopia from July 1 to August 31, 2024. Methods: An institutional-based cross-sectional study was performed on 217 pregnant women attending antenatal care at Haramaya University Health and Demographic Surveillance System sites, at Kersa and Harar Health facilities. Data were collected using a structured questionnaire from consented pregnant women. Vaginal swab specimens were collected and transported to the Medical Microbiology Laboratory of the School of Medical Laboratory Science, for fungal culture and identification. A Nugent grade score system was used to identify bacterial vaginosis. The data were collected by Redcap software, and transported to Stata version 14 for analysis. Factors associated with different etiologies of vaginitis were determined in multivariable logistic regression models. Adjusted odd ratios and P-values <0.05 were considered statistically significant. Result: The overall prevalence of vaginitis in this study was 51.2% (111/217 The prevalence of vaginal candidiasis and bacterial vaginosis among pregnant women was 23.50% (51/217) (95% CI: 18.35%, 29.57%) and 27.65% (60/217) (95% CI: 21.81%,34.11%), respectively. The prevalence of coinfection by both, vaginitis (VC and BV) was 7.8% (17/217). Use of antibiotics (AOR=4.18, CI:1.78,9.80), and regular douching practice (AOR = 5.48; 95% CI: 2.39,12.56), were statistically significant for vaginal candidiasis. Use of antibiotics (AOR= 9.47, 95% CI: 4.09-21.94), regular douching practice (AOR= 6.93, 95% CI: 2.86, 16.77), and no formal education (AOR= 0.11, 95% CI: 0.02,0.67) were significantly associated with the occurrence of bacterial vaginosis. Antifungal susceptibility indicates that Amphotericin B and Fluconazole were generally effective against C. albicans and C. krusei, with high susceptibility rates observed. Conclusion: The study found about one in four pregnant women who attend antenatal care were diagnosed with vaginal candidiasis and bacterial vaginosis. The use of antibiotics and regular douching practices were contributing factors to the occurrences of vaginal candidiasis and bacterial vaginosis