Medical data from the DMSS can not be used to determine whether repeat bacterial vaginosis infections were because of treatment failure. According to Joesoef et al. (1999), oral metronidazole (500mg twice daily for a week) is the conventional antibiotic to treat bacterial vaginosis per the U.S. Centers for Disease Control and Prevention recommendation. This antibiotic treatment is followed by U.S. military hospitals, but the efficacy has reportedly declined from 90% to 50-80% over the past three decades, and this might explain in part the high recurrence rate following treatment among female personnel (Joesoef et al. (1999). In fact, Bradshaw et al. (2006) found that among women treated with oral metronidazole, the rate of recurrence of
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It is possible that the high recurrence of this common condition is due to metronidazole resistance. Goldstein et al. (1993, 2002) affirm that the rate of metronidazole resistance has increased from 20% in 1993 to 29% in 2002, and thus, it is necessary to evaluate the therapy of bacterial vaginosis involving G. vaginalis, the main bacterial species associated with the development of bacterial vaginosis. The recommendations given by Goldstein et al. (2002) are supported by Nagaraja (2008), who determined that 34 (68%) out of 50 strains of G. vaginalis are resistant to metronidazole. It is also possible that the high recurrence of bacterial vaginosis is a consequence of reinfection from sexual partners (Fethers et al., 2008), or by women engaging in the same risk behaviours for primary infection. For this reason, condom use is recommended for 3-6 months after treatment, although the evidence is contradictory. For Hutchinson et al. (2007), consistent condom use may reduce the risk of bacterial vaginosis by about half. Bradshaw et al. (2006) state that condom use is not associated with recurrence of bacterial vaginosis, and this lack of association may be due to unmeasured …show more content…
Army population (Rothman et al., 2008). The rate of bacterial vaginosis among chlamydia and gonorrhea controls (female service members without infection) was 15% and 19%, respectively. Therefore, on average, the prevalence of bacterial vaginosis among female service members of the U.S. Army was 16% during the study period. A direct comparison of this overall estimate with other groups of women, for instance, from the U.S. civilian population, is not possible because bacterial vaginosis is a condition that can be asymptomatic, and therefore confirmed prevalence data can not be determined. Egan and Lipsky (2000) argue that one-third of affected women are asymptomatic. The results suggest that, more bacterial vaginosis infections occurred among African-American personnel than other racial / ethnic groups. A similar racial disparity has been reported by Yen et al. (2003) who found that bacterial vaginosis prevalence differed by race among women entering the U.S. Marine Corps during 1999-2000 (32% in African-Americans and 25% in whites). The observed racial disparity in the occurrence of bacterial vaginosis is consistent with that reported by Koumans et al. (2007), who, after analyzing data from the 2001-2004 NHANES, found that the prevalence of
It is possible that the high recurrence of this common condition is due to metronidazole resistance. Goldstein et al. (1993, 2002) affirm that the rate of metronidazole resistance has increased from 20% in 1993 to 29% in 2002, and thus, it is necessary to evaluate the therapy of bacterial vaginosis involving G. vaginalis, the main bacterial species associated with the development of bacterial vaginosis. The recommendations given by Goldstein et al. (2002) are supported by Nagaraja (2008), who determined that 34 (68%) out of 50 strains of G. vaginalis are resistant to metronidazole. It is also possible that the high recurrence of bacterial vaginosis is a consequence of reinfection from sexual partners (Fethers et al., 2008), or by women engaging in the same risk behaviours for primary infection. For this reason, condom use is recommended for 3-6 months after treatment, although the evidence is contradictory. For Hutchinson et al. (2007), consistent condom use may reduce the risk of bacterial vaginosis by about half. Bradshaw et al. (2006) state that condom use is not associated with recurrence of bacterial vaginosis, and this lack of association may be due to unmeasured …show more content…
Army population (Rothman et al., 2008). The rate of bacterial vaginosis among chlamydia and gonorrhea controls (female service members without infection) was 15% and 19%, respectively. Therefore, on average, the prevalence of bacterial vaginosis among female service members of the U.S. Army was 16% during the study period. A direct comparison of this overall estimate with other groups of women, for instance, from the U.S. civilian population, is not possible because bacterial vaginosis is a condition that can be asymptomatic, and therefore confirmed prevalence data can not be determined. Egan and Lipsky (2000) argue that one-third of affected women are asymptomatic. The results suggest that, more bacterial vaginosis infections occurred among African-American personnel than other racial / ethnic groups. A similar racial disparity has been reported by Yen et al. (2003) who found that bacterial vaginosis prevalence differed by race among women entering the U.S. Marine Corps during 1999-2000 (32% in African-Americans and 25% in whites). The observed racial disparity in the occurrence of bacterial vaginosis is consistent with that reported by Koumans et al. (2007), who, after analyzing data from the 2001-2004 NHANES, found that the prevalence of