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- Title
Modeling the temporal dynamics of cervicovaginal microbiota identifies targets that may promote reproductive health.
- Authors
Munoz, Alexander; Hayward, Matthew R.; Bloom, Seth M.; Rocafort, Muntsa; Ngcapu, Sinaye; Mafunda, Nomfuneko A.; Xu, Jiawu; Xulu, Nondumiso; Dong, Mary; Dong, Krista L.; Ismail, Nasreen; Ndung'u, Thumbi; Ghebermichael, Musie S.; Kwon, Douglas S.
- Abstract
Background: Cervicovaginal bacterial communities composed of diverse anaerobes with low Lactobacillus abundance are associated with poor reproductive outcomes such as preterm birth, infertility, cervicitis, and risk of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Women in sub-Saharan Africa have a higher prevalence of these high-risk bacterial communities when compared to Western populations. However, the transition of cervicovaginal communities between high- and low-risk community states over time is not well described in African populations. Results: We profiled the bacterial composition of 316 cervicovaginal swabs collected at 3-month intervals from 88 healthy young Black South African women with a median follow-up of 9 months per participant and developed a Markov-based model of transition dynamics that accurately predicted bacterial composition within a broader cross-sectional cohort. We found that Lactobacillus iners-dominant, but not Lactobacillus crispatus-dominant, communities have a high probability of transitioning to high-risk states. Simulating clinical interventions by manipulating the underlying transition probabilities, our model predicts that the population prevalence of low-risk microbial communities could most effectively be increased by manipulating the movement between L. iners- and L. crispatus-dominant communities. Conclusions: The Markov model we present here indicates that L. iners-dominant communities have a high probability of transitioning to higher-risk states. We additionally identify transitions to target to increase the prevalence of L. crispatus-dominant communities. These findings may help guide future intervention strategies targeted at reducing bacteria-associated adverse reproductive outcomes among women living in sub-Saharan Africa. 1LauPY4wMZcfM5CbQRn5pv Video Abstract
- Subjects
REPRODUCTIVE health; LACTOBACILLUS; PREMATURE labor; UTERINE cervicitis; SEXUALLY transmitted disease risk factors
- Publication
Microbiome, 2021, Vol 9, Issue 1, p1
- ISSN
2049-2618
- Publication type
Article
- DOI
10.1186/s40168-021-01096-9