Mixed Vaginal Infections and Their Predictors Among Women With Abnormal Vaginal Discharges Attending Gynecological Clinics in Western Uganda: A Cross-Sectional Study.

Abstract

Background: Mixed vaginal infection involves the simultaneous presence of at least two types of vaginitis, including bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC), BV and Trichomonas vaginalis (TV), or TV and VVC. This condition disrupts the vaginal milieu, resulting in significant diagnostic and therapeutic challenges, recurrent infections, and increased antimicrobial resistance. This study aimed to assess the mixed vaginal infections and their predictors among women with abnormal vaginal discharges attending gynecological clinics in western Uganda. Methods: A cross-sectional study was conducted with 146 participants from the gynecology clinic at Fort Portal Regional Referral Hospital (FRRH) from January 2024 to April 2024. Data collection included medical record reviews, structured interviews, and swab culture testing. Data were compiled in Microsoft Excel 16.0, cleaned, and imported into SPSS Version 22.0 for analysis. Logistic regression and descriptive statistics were utilized for data analysis. Results: The overall prevalence of mixed vaginal infections among women with abnormal vaginal discharges attending the gynecological clinic at FRRH was 28.1% (41/146). Among those with mixed infections, the most common type was BV/VVC (19.2%), followed by TV/BV (4.8%) and TV/VVC (4.1%). Significant factors associated with mixed vaginal infections were rural residence (adjusted odds ratio [aOR] = 2.9, 95% confidence interval [CI]: 1.1-7.5, p = 0.03), HIV-positive status (aOR = 4.5, 95% CI: 1.4-14.3, p = 0.01), multiple sexual partners (aOR = 5.5, 95% CI: 1.31-23.8, p = 0.02), vaginal douching (aOR = 4.6, 95% CI: 1.6-13.3, p < 0.001), and having two or more previous vaginal infections (aOR = 9.5, 95% CI: 2.2-41.1, p = 0.001). Conclusions: A high prevalence of mixed vaginal infections was observed among women at FRRH, with BV/VVC being the most frequent combination among those with mixed infections. Identified risk factors included rural residence, HIV-positive status, multiple previous infections, multiple sexual partners, and vaginal douching. These results emphasize the need for comprehensive diagnostic, therapeutic, and preventive strategies to manage mixed vaginal infections effectively.