Vaginal Infections in Haitian Immigrant Women Living in Miami, Florida

Haitian women in New York City use global food plants for women's health

BACKGROUND

Despite the availability of mainstream biomedical healthcare in New York City (NYC), community-based ethnomedicine practices remain a low-cost, culturally relevant treatment for many immigrants. Previous urban ethnobotany research in NYC has established that several Caribbean communities continue using medicinal plants for women's health after immigration. This study sought to address to what extent: (1) NYC Haitian women continue using medicinal plants for women's health after migration; (2) their plants and the conditions treated were similar to those identified in an earlier survey with NYC immigrants from the Dominican Republic.

METHODS

Through an ethnobotanical survey, 100 Haitian women living in NYC and born in Haiti were interviewed about their knowledge of medicinal plants for women's health conditions. Reported species were purchased based on local names in NYC Haitian stores and markets, vouchered, and identified.

RESULTS

Nearly all Haitian women (97%) reported using medicinal plants while living in Haiti. Most Haitian women continued using medicinal plants after coming to the USA (83%). The 14% decrease, although significant (z = 3.3; p = 0.001), was mainly due to logistical difficulties with sourcing plants after recent immigration. Popular medicinal plant species reported were primarily global food plants, re-emphasizing the intertwined food-medicine relationship in Caribbean diasporas. Comparison with data from NYC Dominicans identified childbirth and puerperium, gynecological infections, and vaginal cleansing as priority Haitian women's health concerns treated with plants.

CONCLUSION

Our findings support the global nature of Caribbean migrant plant pharmacopeia, predominantly centered around food plants and adapted to transnational urban settings. They underscore cultural diversity, dispelling the notion of one uniform traditional knowledge system labeled "Caribbean." The importance of preventative medicine for women's health, particularly the regular consumption of "healthy" foods or teas highlights the role food plants play in maintaining health without seeking treatment for a particular condition. Cross-cultural comparisons with other NYC Caribbean immigrants emphasize the importance of conducting ethnobotanical surveys to ground-truth plant use in the community. Such surveys can also identify culture-specific health priorities treated with these plants. Healthcare providers can leverage these insights to formulate culturally relevant and community-tailored healthcare strategies aligned with Haitian women's health beliefs and needs.

Caribbean Women's Health and Transnational Ethnobotany

Caribbean Women's Health and Transnational Ethnobotany. Immigrants from the Dominican Republic (DR) and Haiti are among the top foreign-born communities in New York City (NYC). As people migrate to new countries, they bring their ethnomedical beliefs and practices, and adapt their plant pharmacopoeias. Haiti and the DR share a flora on the island of Hispaniola. In NYC, the flora is limited to what is available in the city. We selected plants for future laboratory research based on ethnobotanical data from two surveys among Dominicans in the DR and NYC, and a Haitian literature review. In both Dominican datasets, gynecological infections were the top women's health condition treated with plants. We identified 10 species for this purpose reported by Dominicans that are also known medicines in Haitian culture, although not yet documented for women's health. Plants for gynecological infections potentially cause dysbiosis of the vaginal microbiota, and may increase rather than prevent disease. There is a public health need to assess traditional medicines for their ability to inhibit pathogenic bacteria, while causing minimal disruption to the vaginal flora. Several species are known antibacterials, but remain to be tested for their efficacy. These results also provide a foundation for a planned ethnobotanical survey among NYC Haitian women.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12231-021-09526-3.

Characterization of the vaginal microbiome during cytolytic vaginosis using high-throughput sequencing

Background

Cytolytic vaginosis (CV) is a common disease that results in pruritus, dyspareunia, and vulvar dysuria. However, the pathological mechanisms of the disease are still unclear. Compared to traditional methods, high‐throughput sequencing can obtain more accurate qualitative and quantitative information on the microbiome.

Methods

We collected 75 samples from 32 healthy women (average age 44 ± 8) and 43 patients with CV (average age 38 ± 8). We used high‐throughput sequencing of the 16S rRNA V3‐V4 region to characterize and compare the vaginal microbiota of patients with CV and healthy women and to identify potential biomarkers for CV.

Results

The vaginal pH of patients with CV was ≤3.8, and the vaginal concentration of H₂O₂ was ≥2 μmol/L. Colony densities of Lactobacillus spp. in patients with CV ranged from +++ (5‐30) to ++++ (>30) and were significantly higher than those in healthy women. High‐throughput sequencing showed that Lactobacillus was the most prominent genus both in patients with CV and in healthy women, with abundances of 83.8% and 97.2%, respectively (P < 0.001). Lactobacillus crispatus was more abundant in patients with CV, whereas Lactobacillus sp. L‐YJ was more abundant in healthy women, with area under the curve (AUC) values of 0.9375 and 0.8379, respectively.

Conclusion

The abundance of Lactobacillus spp. in CV patients was significantly different from that of healthy patients. Two suitable biomarkers, L. crispatus and Lactobacillus sp. L‐YJ, were identified. These results will be useful for the identification of women at risk of serious illness before they develop obvious symptoms.