A Study of Bacterial Vaginosis and Associated Risk Factors among Married Women in Zakho City, Kurdistan Region, Iraq

Bacterial Vaginosis (BV) is a leading cause of reproductive tract problems, affecting mostly women of reproductive age group, worldwide. The aim of this study is to detect the infection rate of BV and then evaluate the risk factors associated with this bacterium among married women in Zakho city, Iraq. This cross-sectional study was performed among a 150-reproductive-age women's group from October 2021 till April 2022. The administered and structured questionnaire was designed to measure demographic, risk factors, and clinical characteristics. The vaginal swabs were collected from each subject and used for microscopical examination, including wet mount, vaginal pH, germ tube, and Gram stain methods to analyze the infection rate. The analysis of univariate regression analysis was applied to determine the relationships between BV and associated risk factors and clinical characteristics. The average age of participants was 32.64 years (±8.01 SD). The prevalence of BV was 41 (27.33%) among married women. About 12 (8%) and 1 (0.67%) of participants had mixed infections with Candida albicans and Trichomonas vaginalis, respectively. BV was found mostly among the age group less than 20 years (41.67) followed by age group of 40-50 years (37.93%). We found a higher infection rate among subjects from rural area (34.78%), but statistically not significant (p=0.17). Higher number of births was statistically associated to BV (OR 1.17, 1.006-1.37; p=0.003). BV was also highly associated among symptomatic patients with abnormal vaginal discharges (OR 4.18, 1.89-1.9.23; p=0.002), genital ulcer (OR 0.34, 0.13-0.84; p=0.01), and vaginal pH level more than 4.5 (OR 0.009, 0.002-0.043; p=0.001). BV is still prevalent among married women in our region. The higher infection rate was significantly associated with higher birth numbers, vaginal discharges, genital ulcers, and higher vaginal pH. There is an urgent requirement for regular screening for bacterial vaginosis among symptomatic women. Therefore, the early detection of risk factors associated with bacterial vaginal growth is critical to enhancing the health condition of married women, in order to prevent the risk of BV.