Relação entre agentes infecciosos de vulvovaginites e cor da pele

CONTEXT AND Objective: Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis. DESIGN AND SETTING: Cross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba). METHODS: Healthy women who underwent routine outpatient gynecological assessments were assessed for vulvovaginitis and vaginal flora and then divided into whites (n = 13,881) and nonwhites (n = 5,295). Statistical analysis was performed using the X² test, logistic regression and odds ratios. RESULTS: The vaginal microflora was skin-color dependent, with greater occurrence of clue cells, Trichomonas vaginalis and coccobacilli in nonwhite women (p < 0.0001). Döderlein bacilli and cytolytic flora were more prevalent in white women (p < 0.0001 and p < 0.05, respectively). The vaginal microflora was age-dependent within the skin color groups. Among the nonwhite women, clue cells were more prevalent in women aged 21 to 50 years; Trichomonas in women up to 40 years and coccobacili in women between 21 and 40 years (P < 0.05). During the proliferative and secretory phases, the nonwhite women were more likely to present clue cells, Trichomonas, Candida and coccobacilli (OR, proliferative phase: 1.31, 1.79, 1.6 and 1.25 respectively; secretory phase: 1.31, 2.88, 1.74 and 1.21 respectively), while less likely to present Döderlein flora (OR, proliferative phase: 0.76; secretory phase: 0.66), compared with white women, irrespective of age. CONCLUSIONS: There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.CONTEXTO E OBJETIVO: Muitos fatores influenciam a ocorrência de vulvovaginites. Os objetivos foram avaliar diferenças relacionadas à cor da pele e idade na flora vaginal e vulvovaginites. TIPO DE ESTUDO E LOCAL: Estudo transversal; hospital de referência terciário (Universidade Federal do Triângulo Mineiro, Uberaba). MÉTODOS: Mulheres saudáveis em atendimento de rotina para exames ginecológicos foram divididas em brancas (n = 13.881) e não brancas (n = 5.295) e avaliadas quanto a vulvovaginites e flora vaginal. Para análise estatística, foram utilizados teste X², regressão logística e odds ratio. RESULTADOS: Microflora vaginal foi dependente da cor da pele, com maior ocorrência de "clue cells", Trichomonas vaginalis e bacilos cocoides em não brancas (p < 0,0001); bacilos de Döderlein e flora citolítica foram mais prevalentes em brancas (p < 0,0001 e p < 0,05, respectivamente). Flora vaginal foi dependente da idade nos grupos de cor da pele. Entre não brancas, "clue cells", Trichomonas e bacilos cocoides foram mais prevalentes nas idades: 21 a 50 anos, até 40 anos, e 21 a 40 anos respectivamente (p < 0,05). Durante as fases proliferativa e secretória, mulheres não brancas tiveram maior probabilidade de apresentar "clue cells", Trichomonas, Candida e cocoides (odds ratio, OR - fase proliferativa: 1,31; 1,79; 1,6 e 1,25 respectivamente; fase secretória: 1,31; 2,88; 1,74 e 1,21 respectivamente), e menor chance de apresentarem flora Döderlein (OR - fase proliferativa: 0,76; fase secretória: 0,66) comparadas com brancas, independentemente da idade. CONCLUSÕES: Há diferenças na ocorrência de vulvovaginites relacionadas com a cor da pele, podendo haver associação com variações na flora vaginal.(FAPEMIG) Fundação de Amparo à Pesquisa do Estado de Minas Gerai

Relationship between infectious agents for vulvovaginitis and skin color

CONTEXT AND Objective: Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis. DESIGN AND SETTING: Cross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba). METHODS: Healthy women who underwent routine outpatient gynecological assessments were assessed for vulvovaginitis and vaginal flora and then divided into whites (n = 13,881) and nonwhites (n = 5,295). Statistical analysis was performed using the X² test, logistic regression and odds ratios. RESULTS: The vaginal microflora was skin-color dependent, with greater occurrence of clue cells, Trichomonas vaginalis and coccobacilli in nonwhite women (p < 0.0001). Döderlein bacilli and cytolytic flora were more prevalent in white women (p < 0.0001 and p < 0.05, respectively). The vaginal microflora was age-dependent within the skin color groups. Among the nonwhite women, clue cells were more prevalent in women aged 21 to 50 years; Trichomonas in women up to 40 years and coccobacili in women between 21 and 40 years (P < 0.05). During the proliferative and secretory phases, the nonwhite women were more likely to present clue cells, Trichomonas, Candida and coccobacilli (OR, proliferative phase: 1.31, 1.79, 1.6 and 1.25 respectively; secretory phase: 1.31, 2.88, 1.74 and 1.21 respectively), while less likely to present Döderlein flora (OR, proliferative phase: 0.76; secretory phase: 0.66), compared with white women, irrespective of age. CONCLUSIONS: There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora