Nutritional status, bacterial vaginosis and cervical colonization in women living in an urban slum in India

The prevalence of bacterial vaginosis and cervical colonization, and association of bacterial vaginosis with serum nutrients were determined in women living in slum areas of Hyderabad, India. Bacterial vaginosis was diagnosed based on Nugents’ score. Cervical infections with human papilloma virus, herpes simplex virus type 2, Neisseria gonorrhea, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum were determined by PCR. Of the 260 women who participated in the study, 31% (81) had bacterial vaginosis and 48.8% (127) had intermediate flora based on Nugents’ score. Only 184 vaginal samples were processed for candidiasis, of which 66 showed Candida albicans, accounting for a prevalence of 36.0%. PCR analysis of cervical swabs obtained from 50 women with acute cervicitis showed the following trend of prevalence of various organisms: 30% U. urealyticum, 10% M. hominis, 2% herpes simplex virus and Human papilloma virus, while C. trachomatis and N. gonorrhea were not detected in any. In the 50 women without cervicitis, 6 (12%) had human papilloma virus, while other organisms were not detected. All the women with cervical colonization (U. urealyticum, M. hominis and herpes simplex virus type 2) and 6 of 7 women with human papilloma virus had bacterial vaginosis or intermediate flora. Thirty percent of the women were undernourished (body mass index <18.5), while all the women in the study were anemic (hemoglobin <12 g/dl). More than 50% of the women in the study had low serum iron, while more than 90% had low serum zinc levels. But vitamin A deficiency was prevalent in 3% of the study subjects. Low concentrations of serum iron, zinc and vitamin A were significantly associated with bacterial vaginosis.