Cytopathological Examination and Epidemiological Study of Cervicitis in Commercial Sex Workers (Csws) in Coal City (Enugu), Nigeria

Abstract

BACKGROUND: Illicit sexual behavior by commercial sex workers (CSW) may have a disproportionateimpact on the reproductive health of a woman that often leads to cervicitis. This study aimed atexamining the cytopathology, patterns, prevalence and burden of cervicitis in CSW in Enugu metropolis,Nigeria.METHODS: Cervical smear was collected from the endocervix of about one hundred and eighteen(n=118) CSWs between November, 2014 and February, 2015 using the liquid-based cytology (LBC)method. Smears were processed and stained by the modified Papanicolaou method. Leftover sampleswere tested for sexually transmitted diseases, especially N. gonorrhea, and C. trachomatis using ligasechain reaction and nucleic acid amplification test. A randomized sampling design was used for datacollection.RESULTS: Cytopathological examination of cervicitis in CSWs showed a moderate infection, andmoderately severe to chronic inflammatory cells. The epidemiological study revealed that acute cervicitisare predominant 7(5.9%) and 2(1.7%) are chronic cervicitis. The prevalence of CSWs living withcervicitis in Enugu, Nigeria (7.6%), is significantly affected by age and working duration as CSWs. Also,Chlamydia trachomatis is the solely associated pathogen implicated in cervicitis group (n=9). Candidiasisinfection (n=12) and T. vaginalis (n=3) are observed in non-cervicitis group (n=109) while theassociation between C. trachomatis and cervicitis infection is statistically significant (P= 0.0221).CONCLUSIONS: Acute cervicitis was prevalent with a preponderance of 4:1 in CSWs in Enugu,Nigeria. C. trachomatis infection was the most prevalent etiologic agent of cervicitis in this study.Further molecular study of LBC smears from CSWs using PCR is strongly recommended.