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Vaginal herb use and Chlamydia trachomatis infection: cross-sectional study among women of various ethnic groups in Suriname
  1. Jannie J Van der Helm1,
  2. Maarten Franciscus Schim van der Loeff1,
  3. Esther de Vries1,
  4. Charlotte van der Veer1,
  5. Antoon W Grünberg2,
  6. Dennis Mans3,
  7. Henry J C de Vries1,4
  1. 1 Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
  2. 2 Department of Public Health, Ministry of Health, Paramaribo, Suriname
  3. 3 Department of Pharmacology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
  4. 4 Department of Dermatology, Amsterdam UMC location Academic Medical Centre, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam, The Netherlands
  1. Correspondence to Dr Henry J C de Vries; h.j.devries{at}


Objective Vaginal steam baths with herb leaves (herb use) is practised by some Surinamese women. We assessed herb use among women from the five most prevalent ethnic groups, and if herb use is associated with Chlamydia trachomatis infection.

Setting Participants were recruited at a sexually transmitted infection (STI) clinic and a family planning clinic (FP) in Paramaribo, Suriname.

Participants 1040 women were included subsequently, comprising the following ethnic groups: Creole (26.7%), Hindustani (24.6%), Javanese (15.7%), Maroon (13.3%) and mixed descent (19.7%).

Methods Nurses collected a questionnaire and vaginal swabs for nucleic acid amplification C. trachomatis testing.

Primary outcomes Determinants of vaginal herb use and C. trachomatis infection via univariable and multivariable logistic regression.

Results Herb use was most common among Maroon (68.8%) and Creole women (25.2%). In multivariable analysis including only Maroon and Creole women, determinants significantly associated with vaginal herb use were (OR; 95% CI): Maroon ethnic descent (5.33; 3.26 to 8.71 vs Creole), recruitment at the STI clinic (2.04; 1.24 to 3.36 vs FP), lower education levels (3.80; 1.68 to 8.57 lower vs higher, and 2.02; 0.90 to 4.51 middle vs higher). Lower age and recruitment at the STI clinic were associated with C. trachomatis infection, but not vaginal herb use.

Conclusion In Suriname, vaginal herb use is common among Maroon and Creole women. Education, ethnic group and recruitment site were determinants for herb use. Vaginal herb use was not a determinant of C. trachomatis infection. Future research should focus on the effect of herb use on the vaginal microbiome and mucosal barrier.

  • herb therapy
  • vaginal douching
  • vaginal
  • ethnicity
  • Suriname

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  • Contributors JJVdH collected the data, analysed the data and wrote the manuscript; MFSvdL supervised the analysis and wrote the manuscript; EdV analysed the data and wrote the first manuscript draft; CvdV wrote the manuscript; AWG designed the study, collected data and wrote the manuscript; DM collected the data and wrote the manuscript; and HJCdV designed the study, and wrote the manuscript.

  • Funding This work was supported by the Research and Development fund of the Public Health Service of Amsterdam [project nos 2369 and 2371] and AGIS healthcare insurance [RVVZ no 1417000].

  • Competing interests None declared.

  • Ethics approval The study was approved by the Ethics Committees of the Ministry of Health of the Republic of Suriname (VG010-2007) and the Academic Medical Center, University of Amsterdam, The Netherlands (MEC07/127).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Deidentified participant data are available upon request through the corresponding author HJCdV. ORCID identifier 0000-0001-9784-547X.

  • Correction notice This article has been corrected since it first published online. The open access licence type has been amended.

  • Patient consent for publication Not required.

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