Intermediate Vaginal Microbiota Linked to Cervicitis in Kenyan Cohort

Researchers analyzed data from a cohort of women who engage in sex work in Mombasa, Kenya, collected between 2004 and 2023. Across 1,615 participants and 25,322 visits, vaginal microbiota was classified by Nugent score as normal, intermediate, or bacterial vaginosis (BV). Cervicitis was defined as more than 30 polymorphonuclear cells per high-power field. The analysis also assessed cultured Lactobacillus by hydrogen peroxide production and used modified Poisson regression with generalized estimating equations.

Cervicitis prevalence was 5.8% with normal microbiota, 9.1% with intermediate microbiota (RR 1.39, 95% CI 1.24–1.56), and 6.8% with BV (RR 1.14, 95% CI 1.02–1.26). Prevalence was 5.1% when no Lactobacillus was detected, 8.5% with non-hydrogen-peroxide-producing Lactobacillus (RR 1.33, 95% CI 1.18–1.50), and 11.9% with hydrogen-peroxide-producing Lactobacillus (RR 1.70, 95% CI 1.52–1.90). Associations remained consistent in multivariable analyses.

The results identify associations, not causes, and the authors’ proposed inflammatory mechanism requires further study. Findings from this specific cohort may not generalize to other populations; the study does not establish a change in clinical management.