Articles Vol. 67 No. 5 25/05/2026

TREATMENT OUTCOMES AND FACTORS ASSOCIATED WITH FAILURE IN VAGINITIS PATIENTS AGED 40 AND OLDER AT BINH DUONG PROVINCIAL GENERAL HOSPITAL

Lam Duc Tam1,2, Tran Thi En3,4, Le Nguyen Trong Nhan5,6
1 Can Tho University of Medicine and Pharmacy
2 Trường Đại học Y Dược Cần Thơ
3 Hon Quan Regional Health Center - Dong Nai
4 Trung tâm Y tế khu vực Hớn Quản- Đồng Nai
5 Vinmec Can Tho Hospital
6 Bệnh viện Vinmec Cần Thơ
DOI: 10.52163/yhc.v67i5.5159
30 Views
7 Downloads
Keywords
Vaginitis, perimenopause, treatment outcomes, Binh Duong.
Abstract

Objectives: To evaluate the therapeutic outcomes and identify factors associated with treatment failure for vaginitis in women aged 40 years and older at the Department of Obstetrics and Gynecology, Binh Duong General Hospital.

Subjects and methods: The prospective cohort study without a control group with follow-up included 152 patients (aged 40+) diagnosed with vaginitis due to at least one of three agents: bacteria, fungi, or Trichomonas.

Results: Among 152 patients, the majority fell within the 40–49 age group (75.7%). The study population was characterized by a high urban residency rate (82.9%) and a predominance of industrial workers, who accounted for 51.3% of the total sample. Additionally, 75.7% of the participants were identified as being in the perimenopausal stage. The 2-week total microbiological clearance rate (negative for both clinical symptoms and microbiological tests) was 69.7%. The efficacy in the mixed infection group was lower than in the single infection group (54.2% vs. 72.7%). Analysis of the treatment failure group identified behavioral barriers as the primary contributors. Medication non-adherence or premature cessation was associated with a nearly 28-fold surge in the risk of treatment failure (aOR = 27.69). Concurrently, improper vaginal insertion technique significantly elevated this risk by nearly eightfold (aOR = 7.58) relative to the compliant group. At the 3-month follow-up, the sustained cure rate was 77.4%, with the highest recurrence observed in the mixed infection group (30.8%), primarily due to the persistence of the index pathogens rather than reinfection.

Conclusions: The treatment regimen achieved a total microbiological clearance rate of 69.7%; however, this outcome faced significant hurdles from mixed infections (achieving only 54.2%) and behavioral execution errors. The study identified that medication non-adherence and incorrect insertion techniques were the primary drivers of treatment failure, with adjusted odds ratios of 27.69 and 7.58, respectively.  Therefore, implementing visual counseling and personalized medication technique guidance, combined with the management of occupational hygiene factors, is a pivotal strategy to enhance sustained cure rates and minimize the risk of recurrence—currently reaching 30.8% in the mixed infection group—for women over 40.

References
[1]
Huang SH, Hsu HC, Lee TF, et al. Prevalence, associated factors, and appropriateness of empirical treatment of trichomoniasis, bacterial vaginosis, and vulvovaginal candidiasis among women with vaginitis. Microbiology Spectrum. 2023;11(3):e0016123. Google Scholar
[2]
https://doi.org/10.1128/spectrum.00161-23 Google Scholar
[3]
The NAMS Management of Genitourinary Syndrome of Menopause Editorial Panel. The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause. 2020;27(9);976-992. Google Scholar
[4]
https://doi.org/10.1097/GME.0000000000001609 Google Scholar
[5]
Benyas D, Sobel JD. Mixed Vaginitis Due to Bacterial Vaginosis and Candidiasis. J Low Genit Tract Dis. 2022;26(1):68-70. Google Scholar
[6]
https://doi.org/10.1097/LGT.0000000000000641 Google Scholar
[7]
Muhleisen AL, Herbst-Kralovetz MM. Menopause and the vaginal microbiome. Maturitas. 2016;91:42-50. Google Scholar
[8]
https://doi.org/10.1016/j.maturitas.2016.05.015 Google Scholar
[9]
Lê Lam Hương. Tình hình viêm nhiễm đường sinh dục thấp ở phụ nữ mãn kinh đến khám tại Bệnh viện Trường Đại học Y Dược Huế. Tạp chí Phụ sản. 2016;14(2):56-61. Google Scholar
[10]
https://doi.org/10.46755/vjog.2016.2.733 Google Scholar
[11]
Trương Thị Hà Khuyên, Lê Thị Anh Đào, Nguyễn Thị Phương Anh, Tăng Văn Dũng. Đặc điểm lâm sàng, cận lâm sàng của bệnh nhân mãn kinh bị viêm âm đạo do nhiễm trùng tại Bệnh viện Phụ sản Hà Nội. Tạp chí Nghiên cứu Y học. 2025; 191(6):57-64. Google Scholar
[12]
https://doi.org/10.52852/tcncyh.v191i6.3234 Google Scholar
[13]
Nguyen Dinh Phuong Thao, Mai Thi Hien. Study on genitourinary disorders in postmenopausal women at Da Nang Hospital for women and children and some related factors. Vietnam Journal of Community Medicine. 2023;64(6):155-160. Google Scholar
[14]
https://scholar.dlu.edu.vn/thuvienso/bitstream/DLU123456789/202896/1/CVv417V64CDGT2023155.pdf Google Scholar
[15]
Lâm Hồng Trang, Bùi Chí Thương. Tỷ lệ viêm âm đạo và các yếu tố liên quan ở phụ nữ Khmer trong độ tuổi sinh sản tại huyện Trà Cú – Tỉnh Trà Vinh. Y Học TP. Hồ Chí Minh. 2018;22(1). Google Scholar
[16]
https://tapchiyhoctphcm.vn/upload/2018/22%201BAMEVATREEM/179.pdf Google Scholar
[17]
Nguyễn Thị Bé Ni, Trần Ngọc Dung, Lâm Đức Tâm, và cs. Tình hình nhiễm nấm Candida spp. ở phụ nữ viêm âm đạo tại Bệnh viện Đa khoa Trung ương Cần Thơ năm 2022-2023. Tạp chí Y Dược học Cần Thơ. 2023;(63):142-149. Google Scholar
[18]
https://doi.org/10.58490/ctump.2023163.1815 Google Scholar