Cervical-vaginal dysbiosis: Clinical query of infections in selected private medical laboratories in Abakaliki Ebonyi State Nigeria

Abstract

Cervical-Vaginal Dysbiosis refers to an imbalance or disruption in the microbial communities inhabiting the cervix and vaginal tract, leading to an altered composition of microorganisms, often accompanied by a decline in overall vaginal health. This phenomenon contrasts with the notion of a balanced and stable vaginal microbiome, which is characterized by the predominance of Lactobacillus species, known for their protective properties against infections and maintenance of a low pH environment This study evaluates the potential of cervical-vaginal dysbiosis among patients with clinical presentation of cervical vaginal infection in Private Medical Laboratories with limited diagnostics resources and specialization. It addresses the need for cytological investigation in addition to microbiological techniques. Clinical queries of cervical-vaginal infections of patients in twelve selected private medical laboratories in Abakaliki Ebonyi state Nigeria was studied. A total number of 38 patients who met the eligibility criteria were recruited into this study. Cervical- vaginal smear was collected from each subject, samples were fixed, and stained using Papanicolaou and Diff-Quick staining method. Out of these 38 smear samples, 17 (44.7%) had normal cytological features with no microbial features observed. Out of the remaining 21 smear samples, Trichomonas vaginalis occurred 9 times(42.9%), followed by fungi occurring 6 times (28.5%), Human papillomavirus occurring 4 times (19.1%) and Actinomyces occurring 2 times(9.5%). Notable cytological features were revealed, these included squamous intraepithelial lesions characterized by parabasal cells showing perinuclear halo, hyperchromatic nuclei, and slight nuclei polymorphism. Inflammatory lesions were also observed, characterized by the conspicuous number of superficial cells, inflammatory background, red blood cells, and infiltrating polymorphs. This study has highlighted the need to adopt a more proactive approach by evaluating the microbial profile of the cervical smear, which can be a risk factor for cervical malignancy; it has also buttressed the need to retrain and incorporate cytology services in private laboratories.