NONGONOCOCCAL CERVICITIS AMONG WOMEN ATTENDING THE GYNAECOLOGY CLINIC OF A TEACHING HOSPITAL IN SOUTHERN NIGERIA.

Abstract

Background: Gonococcal and nongonococcal organisms are known as important causes of cervicitis the world over; however, their effect on the cervical epithelium has not been well established.

Methodology: This cross-sectional comparative study was carried out to compare the cytological changes in gonococcal and nongonococcal cervicitis among women attending the gynaecology clinic of the University of Uyo Teaching Hospital, Nigeria. Pre-coded structured questionnaires were administered to 107 consenting women. Endo-cervical swabs and Papanicolaou smears were collected from each participant for microscopy, culture, sensitivity and cytology respectively.  The data collated were analysed using statistical package for social sciences version 20 (SPSS 20)

Results:   Sixty-two women (57.9%) were aged 15 to 29 years. Most of the women resided in urban areas (71.0%), were well educated (57.0%), and of low parity (69.2%). The most common risk factor for cervicitis was unprotected sexual intercourse (96.3%). Abnormal vaginal discharge occurred in all the women (100%) while purulent endocervical exudates and endocervical bleeding were the most common examination findings (100% each respectively}. The most common non gonococcal organism isolated was Gardnerella vaginalis.  Eleven (10.3%) women had abnormal cervical cytology and the most common cytological change was Low Grade Squamous intraepithelial lesion. Women with nongonococcal cervicitis had significantly more abnormal cytological changes compared with women with gonococcal cervicitis (p=0.001). The odds of having abnormal cervical cytology in gonococcal cervicitis was 5.7 times that of non-gonococcal cervicitis.

  Conclusion: The prevalence of non-gonococcal cervicitis among the study participants was significantly higher than gonococcal cervicitis.  Gonococcal and nongonococcal cervicitis were not associated with high grade cytological changes of the cervical epithelium.  It is important to increase screening for chlamydial and gonorrhoeal cervical infections particularly in young women to prevent the adverse reproductive consequences of the prolonged presence of these microbes in the reproductive tract.