Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial
Abstract Background Less than one-third of sub-Saharan Africans have access to improved water sources. In US, Indian, and African studies, Bacterial vaginosis (BV) is increased among women with poor water, sanitation, and hygiene (WASH). We examined water source, sanitation (latrine type), and rainf...
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BMC
2024-12-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-10313-3 |
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| author | Anna E Czapar Souvik Paul Garazi Zulaika Fredrick Otieno Walter Agingu Adit Chaudhary Runa Bhaumik Anna Maria van Eijk Stefan J Green Elizabeth Nyothach Penelope A Phillips-Howard Supriya D. Mehta |
| author_facet | Anna E Czapar Souvik Paul Garazi Zulaika Fredrick Otieno Walter Agingu Adit Chaudhary Runa Bhaumik Anna Maria van Eijk Stefan J Green Elizabeth Nyothach Penelope A Phillips-Howard Supriya D. Mehta |
| author_sort | Anna E Czapar |
| collection | DOAJ |
| description | Abstract Background Less than one-third of sub-Saharan Africans have access to improved water sources. In US, Indian, and African studies, Bacterial vaginosis (BV) is increased among women with poor water, sanitation, and hygiene (WASH). We examined water source, sanitation (latrine type), and rainfall in relation to the vaginal microbiome (VMB). Methods In a cluster randomized controlled trial of menstrual cups and cash transfer, we measured the impact of cups on VMB via 16S rRNA gene amplicon sequencing in a subset of 436 adolescent girls. We analyzed how self-reported water source and latrine type at home related to VMB over 18-months, examining community state type I (CST-I, L. crispatus dominant) vs. other CST; alpha diversity; targeted taxa (coliform and other water-related pathogens); and non-targeted taxa via machine learning approaches. Mixed effects multivariable longitudinal models were adjusted for intervention arm, age, socioeconomic status, sexual activity, and cluster-level school WASH and rainfall (in millimeters). Results Adjusting for all covariates in all models: (1) the odds of CST-I were increased among participants with piped water (vs. pond), and decreased with traditional pit latrine vs. flush toilet. (2) Alpha diversity varied by water source and latrine type without consistent trends. (3) Coliform bacteria relative abundance (RA) was higher among participants with traditional pit or ventilated improved pit latrines vs. flush toilet, and higher among participants relying on stream vs. pond water. Streptococcus agalactiae RA was higher among participants with non-flush toilets, while Bacteroides fragilis RA was lower with non-flush toilets. (4) Key taxa from non-targeted analyses associated with water source and latrine type included typical vaginal bacteria, opportunistic pathogens, and urinary tract pathobionts. (6) Increased rainfall was associated with decreased odds of CST-I. Trial registration ClinicalTrials.gov NCT03051789, February 14, 2017. |
| format | Article |
| id | doaj-art-e890f54c7ef94cd3bcbe7cb00e5a989e |
| institution | OA Journals |
| issn | 1471-2334 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-e890f54c7ef94cd3bcbe7cb00e5a989e2025-08-20T01:59:48ZengBMCBMC Infectious Diseases1471-23342024-12-0124111410.1186/s12879-024-10313-3Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trialAnna E Czapar0Souvik Paul1Garazi Zulaika2Fredrick Otieno3Walter Agingu4Adit Chaudhary5Runa Bhaumik6Anna Maria van Eijk7Stefan J Green8Elizabeth Nyothach9Penelope A Phillips-Howard10Supriya D. Mehta11Department of Medicine, Division of Infectious Diseases, Loyola University Stritch School of MedicineDivision of Epidemiology & Biostatistics, University of Illinois Chicago School of Public HealthDepartment of Clinical Sciences, Liverpool School of Tropical MedicineNyanza Reproductive Health SocietyNyanza Reproductive Health SocietyGenomics and Microbiome Core Facility, Rush University Medical CollegeDivision of Epidemiology & Biostatistics, University of Illinois Chicago School of Public HealthDepartment of Clinical Sciences, Liverpool School of Tropical MedicineGenomics and Microbiome Core Facility, Rush University Medical CollegeKenya Medical Research InstituteDepartment of Clinical Sciences, Liverpool School of Tropical MedicineDivision of Epidemiology & Biostatistics, University of Illinois Chicago School of Public HealthAbstract Background Less than one-third of sub-Saharan Africans have access to improved water sources. In US, Indian, and African studies, Bacterial vaginosis (BV) is increased among women with poor water, sanitation, and hygiene (WASH). We examined water source, sanitation (latrine type), and rainfall in relation to the vaginal microbiome (VMB). Methods In a cluster randomized controlled trial of menstrual cups and cash transfer, we measured the impact of cups on VMB via 16S rRNA gene amplicon sequencing in a subset of 436 adolescent girls. We analyzed how self-reported water source and latrine type at home related to VMB over 18-months, examining community state type I (CST-I, L. crispatus dominant) vs. other CST; alpha diversity; targeted taxa (coliform and other water-related pathogens); and non-targeted taxa via machine learning approaches. Mixed effects multivariable longitudinal models were adjusted for intervention arm, age, socioeconomic status, sexual activity, and cluster-level school WASH and rainfall (in millimeters). Results Adjusting for all covariates in all models: (1) the odds of CST-I were increased among participants with piped water (vs. pond), and decreased with traditional pit latrine vs. flush toilet. (2) Alpha diversity varied by water source and latrine type without consistent trends. (3) Coliform bacteria relative abundance (RA) was higher among participants with traditional pit or ventilated improved pit latrines vs. flush toilet, and higher among participants relying on stream vs. pond water. Streptococcus agalactiae RA was higher among participants with non-flush toilets, while Bacteroides fragilis RA was lower with non-flush toilets. (4) Key taxa from non-targeted analyses associated with water source and latrine type included typical vaginal bacteria, opportunistic pathogens, and urinary tract pathobionts. (6) Increased rainfall was associated with decreased odds of CST-I. Trial registration ClinicalTrials.gov NCT03051789, February 14, 2017.https://doi.org/10.1186/s12879-024-10313-3Vaginal microbiomeWater sanitation and hygieneWASHClimate changeWaterLatrine |
| spellingShingle | Anna E Czapar Souvik Paul Garazi Zulaika Fredrick Otieno Walter Agingu Adit Chaudhary Runa Bhaumik Anna Maria van Eijk Stefan J Green Elizabeth Nyothach Penelope A Phillips-Howard Supriya D. Mehta Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial BMC Infectious Diseases Vaginal microbiome Water sanitation and hygiene WASH Climate change Water Latrine |
| title | Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial |
| title_full | Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial |
| title_fullStr | Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial |
| title_full_unstemmed | Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial |
| title_short | Water source, latrine type, and rainfall are associated with detection of non-optimal and enteric bacteria in the vaginal microbiome: a prospective observational cohort study nested within a cluster randomized controlled trial |
| title_sort | water source latrine type and rainfall are associated with detection of non optimal and enteric bacteria in the vaginal microbiome a prospective observational cohort study nested within a cluster randomized controlled trial |
| topic | Vaginal microbiome Water sanitation and hygiene WASH Climate change Water Latrine |
| url | https://doi.org/10.1186/s12879-024-10313-3 |
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