Impact of Daily Acetylsalicylic Acid Intake on Commensal Vaginal Bacteria and Yeast
| dc.contributor.author | Onyango, Anne Wendy Adhiambo | |
| dc.date.accessioned | 2026-03-30T09:06:35Z | |
| dc.date.available | 2026-03-30T09:06:35Z | |
| dc.date.issued | 2025-10 | |
| dc.description | A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of Degree of Master of Science (Medical Microbiology) in the School of Pure and Applied Sciences of Kenyatta University, October, 2025 Supervisor: 1.Keith Fowke 2.Anthony Kebira | |
| dc.description.abstract | Genital inflammation plays a crucial role in the acquisition of Human Immunodeficiency Virus (HIV) as it leads to the migration of susceptible HIV target cells to the genital mucosa. Mucosal surfaces, such as the female genital tract, are critical in understanding HIV transmission since they form the first point of contact for HIV during sexual transmission. Certain factors like bacterial vaginosis and yeast infection trigger inflammation at the mucosal barrier. The reduction in the levels of Lactobacillus spp. and increased diversity of microbial communities such as Gardnerella vaginalis, Prevotella bivia and other anaerobes have been associated with genital inflammation and increased risk of HIV infection by enhancing high infiltration of immune cells that are susceptible target cells for HIV infection and disruption of the epithelial barriers. Bacterial vaginosis (BV) is a prevalent condition among women in Kenya, particularly among high-risk populations such as female sex workers. Some studies reported a BV prevalence of 38% among female sex workers in Nairobi, indicating a significant public health challenge that could facilitate increased susceptibility to HIV and other sexually transmitted infections (STIs). These findings underscore the urgent need for targeted interventions to address BV and its implications for sexual health in this vulnerable population. Since women are more vulnerable and at higher risk of acquisition of HIV and other STIs, various interventions, including use of pharmacological drugs, have been rolled out as prevention tools. The purpose of this study was, therefore, to evaluate the impact of the daily acetylsalicylic acid (ASA) intake on the commensal vaginal bacteria. This study was designed as a prospective longitudinal study nested in a randomized open label clinical study. The study hypothesized that daily intake of acetylsalicylic acid would not alter commensal vaginal bacteria in the genital tract. The study involved 100 HIV seronegative female sex workers recruited from the Sex Workers Outreach Program (SWOP) Majengo clinic in , Nairobi. The participants were randomized to three arms (no drug, 81mg or 325 mg). Vaginal swabs were collected from consenting participants and smears were made and Gram stained for microscopy. Gram staining and the standard Nugent score system were used to measure the abundance of Lactobacillus spp. ,Gardnerella vaginalis morphotypes and yeast cells, thereby diagnosing and quantifying BV at baseline, 3 months and 6 months of (ASA) intake. Statistical analysis was conducted using ANOVA to compare differences in BV prevalence and bacterial populations across the treatment arms. Out of 100 women, only 64 had complete BV results at all time points in the study. In these 64 sex worker women, no significant differences were observed regarding the, proportion of women having bacterial vaginosis, across the drug arms at any point during drug intake. Arm D (p=0.1836), Arm K (p=0.0898), and Arm H (p=0.1181). Additionally, there were no significant differences observed in bacterial populations, Lactobacillus spp. median scores for Arm D were 2 (IQR 0-4), 2 (IQR 0-2), and 1 (IQR 0-3) at v1,v3 and v6 respectively. Arm K had median scores of 2 (IQR 0-4), 2 (IQR 0-3), and 0 (IQR 0-3) at v1,v3 and v6 respectively and Arm H had scores of 2 (IQR 0-3), 2 (IQR 0-3), and 1 (IQR 0-2) with corresponding p-values indicating no significant differences, Arm D (p > 0.9999), Arm K (p=0.2918), Arm H (p=0.4966). For Gardnerella vaginalis, median scores for Arm D were 0 (IQR 0-1), 0 (IQR 0-2), and 0 (IQR 0-0) for v1, v3 and v6 respectively. Arm D (p>0.9999), Arm K (p>0.9999), Arm H (p=0.8949). The median score for yeast cells was 0 for all arms and no significant difference was observed in the yeast cells scores Arm D (p>0.9999), Arm K (p>0.9999), Arm H (p>0.9999). Overall, the findings of this study suggested that acetylsalicylic acid (ASA) had no impact on the commensal vaginal bacteria associated with BV over the course of the study. The conclusion of the study is that taking ASA daily does not alter the vaginal microbiome and therefore does not put women at additional risk of HIV. The findings from this study can inform future research to evaluate the impact of ASA and other anti-inflammatory drugs on the vaginal microbiota | |
| dc.description.sponsorship | Kenyatta University | |
| dc.identifier.uri | https://ir-library.ku.ac.ke/handle/123456789/32879 | |
| dc.language.iso | en | |
| dc.publisher | Kenyatta University | |
| dc.title | Impact of Daily Acetylsalicylic Acid Intake on Commensal Vaginal Bacteria and Yeast | |
| dc.type | Thesis |