TY - JOUR
T1 - Novel risk factors associated with common vaginal infections
T2 - a nationwide primary health care cohort study: Novel risk factors for vaginal infections
AU - Jansåker, Filip
AU - Frimodt-Møller, Niels
AU - Li, Xinjun
AU - Sundquist, Kristina
N1 - Funding Information:
This work was supported by noncommercial research grants, that is, funding granted to Filip Jansåker from the Primary Healthcare Management and by governmental funding (Alf funding) of clinical research within the National Health Services and Region Skåne (Sweden), Tore Nilsons Stiftelse för Medicinsk Forskning, and the Swedish Society of Medicine. It was also funded by grants provided to Kristina Sundquist from the Swedish Research Council.
Funding Information:
This work was supported by noncommercial research grants, that is, funding granted to Filip Jans?ker from the Primary Healthcare Management and by governmental funding (Alf funding) of clinical research within the National Health Services and Region Sk?ne (Sweden), Tore Nilsons Stiftelse f?r Medicinsk Forskning, and the Swedish Society of Medicine. It was also funded by grants provided to Kristina Sundquist from the Swedish Research Council. This study made use of several national registers, and, owing to legal concerns, data cannot be made openly available. Further information regarding the health registries is available from the Swedish National Board of Health and Welfare: https://www.socialstyrelsen.se/en/statistics-and-data/registers/. The code used in the analysis can be provided upon request. All authors have approved the final version of the manuscript. Concept: FJ. Development of idea: FJ, NFM and KS. Design: All authors. Access, acquisition, and analysis of data: KS and XL. Statistical analysis: XL. Tables: XL and FJ. Interpretation of data: All authors. Literature search: FJ supported by NFM. Drafting of manuscript: FJ. Critical revision of the manuscript for intellectual content: KS, NFM and XL. The authors attest that all listed authors meet the authorship criteria and that no others meeting the criteria have been omitted.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/3
Y1 - 2022/3
N2 - Objective: This study aimed to estimate the association between potential risk factors and common vaginal infections using nationwide primary health care and other national registers. Methods: An open cohort study consisting of 2,357,711 women aged 15 years to 50 years (2001 to 2018) was conducted in Sweden. The outcomes were first event of vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV) in relation to sociodemographic factors. Cox regression models were used. Sensitivity analyses including diabetes mellitus, contraceptive use, and cervical cancer were conducted. Results: The incidence rates per 1,000 person-years for VVC and BV were 3.3 (95% confidence interval [CI] 3.2-3.3) and 3.4 (95% CI 3.4-3.4), respectively. In the fully adjusted model, sociodemographic factors were significantly associated with both outcomes. Compared with Swedish-born women, women from Middle East/North Africa had the highest risk of VVC (hazard ratio [HR] 2.77, 95% CI, 2.72-2.83), followed by Africa (excluding North Africa) (HR 2.53, 95% CI, 2.45-2.61), and Latin America and the Caribbean (HR 2.18, 95% CI, 2.09-2.27). For BV, women from Latin America and the Caribbean had the highest risk (HR 1.83, 95% CI, 1.75-1.92). Conclusion: This study presents novel risk factors associated with medically attended vaginal infections. Women from non-Western countries seem to develop these conditions disproportionately.
AB - Objective: This study aimed to estimate the association between potential risk factors and common vaginal infections using nationwide primary health care and other national registers. Methods: An open cohort study consisting of 2,357,711 women aged 15 years to 50 years (2001 to 2018) was conducted in Sweden. The outcomes were first event of vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV) in relation to sociodemographic factors. Cox regression models were used. Sensitivity analyses including diabetes mellitus, contraceptive use, and cervical cancer were conducted. Results: The incidence rates per 1,000 person-years for VVC and BV were 3.3 (95% confidence interval [CI] 3.2-3.3) and 3.4 (95% CI 3.4-3.4), respectively. In the fully adjusted model, sociodemographic factors were significantly associated with both outcomes. Compared with Swedish-born women, women from Middle East/North Africa had the highest risk of VVC (hazard ratio [HR] 2.77, 95% CI, 2.72-2.83), followed by Africa (excluding North Africa) (HR 2.53, 95% CI, 2.45-2.61), and Latin America and the Caribbean (HR 2.18, 95% CI, 2.09-2.27). For BV, women from Latin America and the Caribbean had the highest risk (HR 1.83, 95% CI, 1.75-1.92). Conclusion: This study presents novel risk factors associated with medically attended vaginal infections. Women from non-Western countries seem to develop these conditions disproportionately.
KW - Cervical cancer
KW - Risk factors
KW - Sociodemographic factors
KW - Vaginal infections
KW - Vaginosis
KW - Vulvovaginal candidiasis
UR - http://www.scopus.com/inward/record.url?scp=85124416185&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.01.021
DO - 10.1016/j.ijid.2022.01.021
M3 - Article
C2 - 35038603
AN - SCOPUS:85124416185
SN - 1201-9712
VL - 116
SP - 380
EP - 386
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -