Key words: sexual and reproductive health, maternal health, sexually transmitted infections, vaginal microbiota, pregnancy, sub-Saharan Africa

"Friends, enemies and everything in between: Vaginal microbioticand sexually transmitted infections among sub-Saharan African pregnant women"

The vaginal microbiota, or vaginal bacterial ecosystems, are dynamic and change through a woman’s life. The most common bacterial species are Lactobacilli, which produce beneficial acidic substances. To investigate the vaginal microbiota’s diversity in pregnant sub-Saharan African women, data were combined from reviews on the entire region and original research in Pemba Island, Tanzania. The majority of pregnant women have a high abundance of Lactobacillus species. In women from Pemba Island, a vaginal microbiota dominated by non-Lactobacillus species was seen after delivery. Such composition can increase the susceptibility to vaginal conditions and sexually transmitted infections. In the same population, sexually transmitted pathogens, such as Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium and human papillomaviruses (also known as HPV), were present during and after pregnancy. These pathogens can increase the risk for maternal and newborn complications. This work contributes knowledge on vaginal bacterial diversity and burdensome sexually transmitted infections in a vulnerable population, namely sub-Saharan pregnant women.

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