UNVEIL-HMB: Uterine NK Cell and Vaginal Microbiome Interactome in Low-Resource Settings for Therapeutic Intervention of Heavy Menstrual Bleeding

Allan Omalla of Makerere University Walter Reed Program in Uganda will explore the potential role of microorganisms, immune dysregulation, behavioral factors, and the interaction of these elements in causing heavy menstrual bleeding. Samples for analysis, including cervical-vaginal lavage, menstrual flow, fecal, and peripheral blood samples, will be collected from 100 adolescent girls and young women in Uganda, half with and half without the condition. These samples will be used to screen for the schistosomiasis parasite, parasitic worms, and common sexually transmitted infections; to profile the vaginal microbiota and metabolome; and to profile immune system activity associated with NK cells. Participants will also be given a standard behavioral questionnaire. This combination of data will be analyzed to identify biological mechanisms as candidate targets for treatments of heavy menstrual bleeding.