BMC Infect Dis. 2013 Apr 30;13:195. doi: 10.1186/1471-2334-13-195.
Cervicitis is a syndrome of cervical inflammation and a common condition in female sex workers (FSW), a subpopulation vulnerable to sexually transmitted infections. Local data is essential for guiding syndromic management of cervicitis in FSW working in Peru. We sought to describe the prevalence and etiologies of cervicitis in this population. We also aimed to identify sociodemographic, behavioral and biological factors associated with cervicitis, including bacterial vaginosis (BV), a condition with a possible role in cervicitis.
FSW 18 years of age or older presenting to a free public sexual health clinic in Callao-Lima, Peru were eligible for inclusion upon consent. 467 participants completed a face-to-face questionnaire and underwent genital examination. Vaginal, endocervical and blood samples were collected and tested for C. trachomatis (CT), N. gonorrhea (GC), T. vaginalis (TV), BV, HIV and Human T-Cell Lymphotropic Virus -1. Logistic regression was used to determine whether sociodemographic, behavioral, or other sexual health related characteristics were associated with the diagnosis of cervicitis.
Cervicitis was detected in 99 (24.9%) of 397 FSW. The presence of cervicitis was unable to be determined in 70 participants. In women with cervicitis, CT was present in 4.6% (4/87), TV in 4.0% (4/99), GC in 0% (0/87) and no pathogen was detected on cervical microbiology in 91.9% (91/99). BV was detected on vaginal microbiology in 36.9% (31/84) of cervicitis cases. BV was more common in women with cervicitis, however this association did not reach statistical significance (aOR = 1.47 [0.87, 2.48], p = 0.15). Other STI were not associated with cervicitis. Regular clinic attendance (aOR = 0.54 [0.34, 0.87], p = 0.01) and Ecuadorian nationality (aOR = 0.31 [0.13, 0.76], p = 0.01) were associated with reduced risk of cervicitis.
Cervicitis was common in FSW working Peru and was predominantly nongonococcal and non-chlamydial in etiology. Further study is warranted to clarify the role of BV and other emerging cervicitis pathogens in this population. The current Peruvian program of free health checks for FSW may be effective for reducing rates of cervicitis. The protective effect of Ecuadorian nationality prompts further study.
宫颈炎是宫颈炎症的综合征，是女性性工作者（FSW）的常见病症，FSW 是易感染性传播感染的人群。当地数据对于指导秘鲁 FSW 中宫颈炎的症状管理至关重要。我们旨在描述该人群中宫颈炎的流行率和病因。我们还旨在确定与宫颈炎相关的社会人口统计学、行为和生物学因素，包括细菌性阴道病（BV），BV 可能在宫颈炎中起作用。
年龄在 18 岁或以上的 FSW 在秘鲁卡亚俄-利马的一家免费公共性健康诊所就诊，经同意后即可入组。467 名参与者完成了面对面的问卷调查并接受了生殖器检查。采集阴道、宫颈和血液样本，并检测沙眼衣原体（CT）、淋病奈瑟菌（GC）、阴道毛滴虫（TV）、BV、HIV 和人类 T 细胞嗜淋巴细胞病毒-1。使用逻辑回归确定社会人口统计学、行为或其他与性健康相关的特征是否与宫颈炎的诊断有关。
在 397 名 FSW 中，有 99 名（24.9%）患有宫颈炎。在 70 名参与者中，无法确定宫颈炎的存在。在患有宫颈炎的女性中，CT 阳性率为 4.6%（4/87），TV 阳性率为 4.0%（4/99），GC 阴性率为 0%（0/87），91.9%（91/99）的宫颈微生物学检测不到病原体。宫颈炎病例中有 36.9%（31/84）的 BV 在阴道微生物学上检测到。患有宫颈炎的女性中 BV 更为常见，但这种关联没有统计学意义（优势比=1.47[0.87, 2.48]，p=0.15）。其他性传播感染与宫颈炎无关。定期就诊（优势比=0.54[0.34, 0.87]，p=0.01）和厄瓜多尔国籍（优势比=0.31[0.13, 0.76]，p=0.01）与宫颈炎风险降低相关。
在秘鲁工作的 FSW 中，宫颈炎很常见，其病因主要是非淋球菌性和非衣原体性的。需要进一步研究以阐明 BV 和其他新兴宫颈炎病原体在该人群中的作用。目前秘鲁为 FSW 提供免费健康检查的项目可能有助于降低宫颈炎的发生率。厄瓜多尔国籍的保护作用促使进一步研究。
