Why African Woman are more likely to have Bacterial Vaginosis than European Woman

In sub-Saharan Africa, there is a high incidence of bacterial vaginosis. Bacterial vaginosis is related to an increased risk of HIV transmission, as well as an increased risk of acquiring other sexually transmitted infections, preterm births, and pelvic inflammatory disease.

Recent Study Released by Fettweis et al, 2014 showed that women of European lineage are more likely to have a Lactobacillus-dominated microbiome, whereas African American women are more likely to display a diverse microbial profile. African American women are also twice as likely to be diagnosed with bacterial vaginosis and are twice as likely to encounter preterm birth.

This study also reported that non-Hispanic African Americans were more than twice as likely (prevalence 51.4 %) as non-Hispanic Caucasians (prevalence 23.2 %) to have BV. Importantly, BV predisposes women to an array of health issues including pelvic inflammatory disease, increased risk for acquisition and transmission of HIV, sexually transmitted diseases , increased risk for adverse pregnancy outcomes, including intrauterine infection, early miscarriage, premature rupture of membranes and they also suffer from a more than twofold increased risk of preterm birth (<37 weeks of gestation), and a threefold greater risk of very preterm birth (<32 weeks) relative to European ancestry women.

The scientific rational for the racial differences in the rates of BV and adverse pregnancy outcome are unclear, however the disparity cannot be explained using demographic and lifestyle factors alone, and it is likely that the composition of the microbial community of the urogenital tract (e.g. the vaginal microbiome) plays a significant role.

Earlier studies of the vaginal microbiome show significant differences between African American and European ancestry women. Previous studies using microscopy to assess the microbial profiles by morphotype found that African American women have greater Nugent scores and are less likely to be colonized by lactobacilli than women of European ancestry making them more prone to BV infections.

Fettweis JM, Brooks JP, Serrano MG, et al. Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiology (Reading). 2014;160(Pt 10):2272-2282. doi:10.1099/mic.0.081034-0

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