Cerwicyt – Epidemiologia

Cerwicyt
Epidemiologia

Cerwicyt, definiowany jako zapalenie szyjki macicy, jest powszechnym schorzeniem w populacji kobiet w wieku reprodukcyjnym, szczególnie u młodych, aktywnych seksualnie kobiet w wieku 15-24 lat. Częstość występowania cerwicytu wśród kobiet zgłaszających się do poradni chorób przenoszonych drogą płciową wynosi od 20% do 40%, a w warunkach ambulatoryjnych od 14% do 37%. Cerwicyt nierzeżączkowy, zwłaszcza chlamydialny, jest cztery do pięciu razy częstszy niż cerwicyt rzeżączkowy. W populacjach wysokiego ryzyka, takich jak kobiety HIV-pozytywne (7 400/100 000) oraz pracownice seksualne (7 600-24 900/100 000), częstość występowania jest znacznie podwyższona. Etiologia cerwicytu pozostaje często nieokreślona, gdyż ponad połowa przypadków śluzowo-ropnego cerwicytu (MPC) nie wykazuje izolacji patogenów, mimo że Chlamydia trachomatis i Neisseria gonorrhoeae są najczęstszymi potwierdzonymi czynnikami zakaźnymi. Czynniki ryzyka obejmują młody wiek, aktywność seksualną, liczne partnerstwa, wcześniejsze infekcje przenoszone drogą płciową, nieregularne stosowanie prezerwatyw oraz historię opryszczki narządów płciowych.

<a href="#epidemiologia-cerwicytu”>Epidemiologia cerwicytu

Rozpowszechnienie cerwicytu w populacji ogólnej
Czynniki demograficzne i wiekowe
Rozpowszechnienie w grupach wysokiego ryzyka
Różnice geograficzne i socjoekonomiczne

Czynniki ryzyka cerwicytu
Konsekwencje i powikłania cerwicytu
Nadzór i badania przesiewowe
Trendy i oporność na antybiotyki
Badania i nowe kierunki
Podsumowanie epidemiologiczne

Kolejne rozdziały

cerwicytu”>Epidemiologia cerwicytu

Cerwicyt, określany jako zapalenie szyjki macicy, stanowi powszechny problem zdrowotny wśród kobiet w wieku reprodukcyjnym. Dokładna częstość występowania cerwicytu jest trudna do określenia ze względu na brak standardowej definicji, niedodiagnozowanie związane z brakiem objawów oraz zmienność występowania w różnych populacjach.¹ Jednak szacunki wskazują, że w zależności od badanej populacji, rozpowszechnienie cerwicytu może być znaczące.

Rozpowszechnienie cerwicytu w populacji ogólnej

Szacuje się, że cerwicyt może dotykać od 20% do 40% kobiet zgłaszających się do poradni chorób przenoszonych drogą płciową.¹² Niektóre badania sugerują, że nawet do połowy wszystkich kobiet doświadczy cerwicytu w pewnym momencie swojego życia.¹ W warunkach ambulatoryjnych obecność cerwicytu stwierdza się u 14-37% pacjentek.¹

Częstość występowania cerwicytu nierzeżączkowego jest wyższa niż cerwicytu rzeżączkowego, a cerwicyt chlamydialny jest cztery do pięciu razy częstszy niż cerwicyt rzeżączkowy.¹ Pomimo tego, że Chlamydia trachomatis lub Neisseria gonorrhoeae są najczęstszymi przyczynami cerwicytu potwierdzonymi diagnostycznie, w wielu przypadkach nie udaje się wyizolować żadnego organizmu.¹² Więcej niż połowa przypadków śluzowo-ropnego cerwicytu (MPC) ma nieznaną etiologię.¹

Czynniki demograficzne i wiekowe

Cerwicyt najczęściej występuje u młodych, aktywnych seksualnie kobiet. Najwyższa zachorowalność obserwowana jest wśród kobiet w wieku 15-24 lat.¹²³ Wzorzec wiekowy występowania cerwicytu zwykle pokrywa się z wzorcem występowania infekcji przenoszonych drogą płciową, co jest zgodne z faktem, że aktywność seksualna stanowi główny czynnik ryzyka dla przyczyn infekcyjnych.¹

Centrum Kontroli i Zapobiegania Chorobom (CDC) szacuje, że rocznie występuje ponad 19 milionów nowych infekcji przenoszonych drogą płciową (STI), z czego prawie połowa dotyczy osób w wieku 15-24 lat.¹ Chlamydioza jest najczęściej zgłaszaną chorobą zakaźną w Stanach Zjednoczonych, a większość przypadków występuje u osób w wieku 25 lat lub młodszych.¹ Rzeżączka zajmuje drugie miejsce pod względem częstości zgłaszanych chorób zakaźnych, z ponad 300 000 przypadków zgłoszonych w 2010 roku.¹

Rozpowszechnienie w grupach wysokiego ryzyka

Cerwicyt stosunkowo częściej występuje u kobiet HIV-pozytywnych niż u kobiet HIV-negatywnych. W tej populacji częstość występowania cerwicytu szacuje się na 7 400 na 100 000 kobiet ze zdiagnozowanym zakażeniem HIV.¹²

W populacji pracownic seksualnych (FSW) rozpowszechnienie cerwicytu waha się od 7 600 do 24 900 na 100 000 kobiet.¹ Badanie przeprowadzone wśród pracownic seksualnych w Peru wykazało, że cerwicyt wykryto u 99 (24,9%) spośród 397 FSW.¹ Podobnie badania prowadzone w Nigerii wśród pracownic seksualnych wykazały częstość występowania cerwicytu na poziomie 7,6%.¹

Warto zauważyć, że regularne wizyty kontrolne były związane z 46% redukcją ryzyka cerwicytu wśród pracownic seksualnych, prawdopodobnie ze względu na niższe wskaźniki STI i bakteryjnej waginozy (BV) odnotowywane u regularnie badanych kobiet.¹

Różnice geograficzne i socjoekonomiczne

Nie istnieje predylekcja rasowa do rozwoju cerwicytu.¹² Jednakże częstość występowania cerwicytu jest wyższa w społecznościach niedostatecznie obsługiwanych i krajach rozwijających się.¹² Znane czynniki ryzyka obejmują miejskie miejsce zamieszkania i niski status socjoekonomiczny.¹

Istnieją znaczące różnice geograficzne w częstości występowania cerwicytu. Na przykład, badanie porównujące częstość występowania cerwicytu wśród różnych populacji irańskich wykazało, że częstość występowania cerwicytu wynosiła 88% w plemieniu koczowniczym Qashgha’i, 85% w populacji Lor i 71% w populacji miejskiej.¹

W Ameryce Łacińskiej szacunki częstości występowania rzeżączki u kobiet w ciąży wskazywały, że częstość występowania wynosiła 0,5% w Argentynie, 2,0% na Bahamach, 1,0% w Brazylii, do 2,0% w Kolumbii i na Haiti oraz od 2,7% do 3,0% w innych regionach.¹

Czynniki ryzyka cerwicytu

Główne czynniki ryzyka rozwoju cerwicytu obejmują:

Młody wiek (poniżej 25 lat)¹²
Aktywność seksualną¹
Nowych lub wielu partnerów seksualnych¹
Partnerów z STI¹
Wcześniejszą historię lub obecność innych STI¹
Nieregularne używanie prezerwatyw¹²
Częstość stosunków płciowych w tygodniu¹²
Metodę porodu¹²
Historię opryszczki narządów płciowych¹²

Konsekwencje i powikłania cerwicytu

Cerwicyt, choć często bezobjawowy, może prowadzić do poważnych powikłań, jeśli pozostanie nieleczony. Główne powikłania obejmują:

Zapalenie endometrium¹²
Chorobę zapalną miednicy (PID)¹²³
Negatywne skutki w ciąży¹²
Niepłodność i przewlekły ból miednicy (jako następstwo PID)¹

U kobiet z zakażeniami dolnego odcinka dróg rodnych ryzyko rozwoju PID jest szacowane na poziomie od 20 do 80%, w zależności od opóźnienia w diagnozie, obecności współzakażenia i innych czynników zależnych od gospodarza.¹²

Co istotne, obecność zapalenia szyjki macicy może odgrywać rolę w transmisji HIV, zwiększając zarówno podatność na zakażenie wirusem, jak i jego wydzielanie.¹² Istnieją również dowody na udział przewlekłego zapalenia szyjki macicy w patogenezie raka szyjki macicy.¹²

Nadzór i badania przesiewowe

Definicja przypadku nadzoru to zestaw jednolitych kryteriów stosowanych do definiowania choroby na potrzeby nadzoru w zakresie zdrowia publicznego. Definicje przypadków nadzoru umożliwiają urzędnikom zdrowia publicznego klasyfikowanie i konsekwentne liczenie przypadków w różnych jurysdykcjach raportujących.¹

W wielu krajach choroby takie jak chlamydioza i rzeżączka podlegają obowiązkowemu zgłaszaniu do odpowiednich organów zdrowia publicznego.¹ Jednakże, na przykład w Brazylii, nie ma skonsolidowanych danych na poziomie krajowym na temat zakażeń wywołanych przez C. trachomatis lub N. gonorrhoeae, ponieważ nie są to choroby podlegające obowiązkowemu zgłaszaniu.¹

Ze względu na wysoką częstość występowania i potencjalne powikłania, rutynowe badania przesiewowe aktywnych seksualnie nastolatków i młodych dorosłych są zalecane.¹ Grupa Zadaniowa ds. Usług Profilaktycznych Stanów Zjednoczonych (USPSTF), Amerykańskie Towarzystwo Raka (ACS), Amerykańskie Kolegium Położników i Ginekologów (ACOG), Amerykańskie Towarzystwo Kolposkopii i Patologii Szyjki Macicy (ASCCP) oraz Amerykańskie Towarzystwo Patologii Klinicznej (ASCP) zalecają rutynowe badania przesiewowe w kierunku chlamydii u aktywnych seksualnie kobiet poniżej 25 roku życia, aby zapobiec konsekwencjom nieleczonego zakażenia chlamydią (np. PID, niepłodność, ciąża pozamaciczna, przewlekły ból miednicy).¹

Wdrażanie protokołów badań przesiewowych dla populacji wysokiego ryzyka może zmniejszyć niekorzystne skutki cerwicytu.¹ Dokładne lokalne dane epidemiologiczne są niezbędne do kierowania syndromicznym zarządzaniem cerwicytem, szczególnie w grupach wysokiego ryzyka, takich jak pracownice seksualne.¹

Trendy i oporność na antybiotyki

W przypadku N. gonorrhoeae, ze względu na rozwój wysokiej oporności na leki przeciwdrobnoustrojowe, Światowa Organizacja Zdrowia (WHO) prowadzi program globalnego nadzoru nad wrażliwością gonokoków na leki, tzw. Gonococcal Antimicrobial Surveillance Program (GASP).¹ Brazylia uczestniczy w tym programie poprzez projekt SenGono (Gonococcal Sensitivity), który prowadzi ten nadzór na poziomie krajowym na podstawie próbek męskiej wydzieliny cewki moczowej, zgodnie z zaleceniami WHO.¹

Zgłaszana częstość występowania zakażeń chlamydialnych stale wzrastała w ciągu ostatnich dwóch dekad, z 1,3 miliona przypadków zgłoszonych w 2010 roku.¹ Podobnie, liczba przypadków rzeżączki pozostaje znacząca, z 468 514 przypadkami zgłoszonymi do CDC w 2016 roku, przy czym 91,9% przypadków dotyczyło osób w wieku od 15 do 44 lat.¹

Badania i nowe kierunki

Trwają badania mające na celu lepsze zrozumienie związku między mikrobiotą pochwy a cerwicytem. Niektóre badania sugerują, że obecność określonych gatunków bakterii związanych z bakteryjną waginozą (BV) oraz gatunków Lactobacillus w pochwie może przyczyniać się do rozwoju cerwicytu.¹

Ponadto, istnieją dowody na to, że przewlekły cerwicyt (CC) może prowadzić do nawracającego PID nawet przy odpowiedniej terapii, a leczenie CC poprzez elektrokoagulację może zmniejszyć lub zapobiec rozwojowi nowych przypadków PID.¹²

Badania wykazały, że u krów mlecznych występowanie zapalenia szyjki macicy jest związane z zapaleniem endometrium i dłuższym okresem otwartym, co sugeruje istotną rolę tego schorzenia w chorobach macicy po porodzie.¹² Chociaż te wyniki nie mogą być bezpośrednio ekstrapolowane na ludzi, mogą dostarczyć cennych informacji na temat mechanizmów patogenetycznych.

Podsumowanie epidemiologiczne

Cerwicyt stanowi istotny problem zdrowia publicznego, szczególnie wśród młodych, aktywnych seksualnie kobiet. Jego częstość występowania jest znacząca, a nierozpoznany lub nieleczony cerwicyt może prowadzić do poważnych powikłań, w tym choroby zapalnej miednicy, niepłodności i przewlekłego bólu miednicy. Rutynowe badania przesiewowe populacji wysokiego ryzyka oraz dokładne dane epidemiologiczne są niezbędne do skutecznego zarządzania i zapobiegania cerwicytowi. Istnieje potrzeba dalszych badań w celu lepszego zrozumienia czynników ryzyka, patogenezy i optymalnych strategii leczenia cerwicytu, szczególnie w przypadkach o nieznanej etiologii.

Populacja	Częstość występowania cerwicytu	Źródło danych
Kobiety zgłaszające się do poradni STI	20-40%	Badania kliniczne
Kobiety z zakażeniem rzeżączkowym	18 000 na 100 000	Dane epidemiologiczne
Kobiety HIV-pozytywne	7 400 na 100 000	Badania kliniczne
Pracownice seksualne	7 600 – 24 900 na 100 000	Badania epidemiologiczne
Pracownice seksualne w Peru	24,9%	Badanie obserwacyjne
Pracownice seksualne w Nigerii	7,6%	Badanie epidemiologiczne
Plemię koczownicze Qashgha’i (Iran)	88%	Badanie porównawcze
Populacja Lor (Iran)	85%	Badanie porównawcze
Populacja miejska (Iran)	71%	Badanie porównawcze
Kobiety w ciąży (Argentyna)	0,5% (rzeżączka)	Dane regionalne
Kobiety w ciąży (Bahamy)	2,0% (rzeżączka)	Dane regionalne
Kobiety w ciąży (Brazylia)	1,0% (rzeżączka)	Dane regionalne

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Materiały źródłowe

#1 Cervicitis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562193/
Cervicitis, which is caused by infection, triggers an immune response. This triggers the release of proinflammatory cytokines, recruitment of neutrophils, and subsequent tissue damage, characterized by epithelial cell disruption, neutrophil infiltration, and cytokine release. This immune response disrupts the cervical mucus barrier, impairing its protective function against ascending infections. Noninfectious causes of cervicitis (eg, chemical or mechanical irritants) can also alter the local microenvironment, leading to epithelial injury and inflammation of the cervix. […] The exact prevalence of cervicitis is difficult to determine due to the lack of a standard definition, underdiagnosis due to lack of symptoms, and the variation of prevalence by population. Since sexual activity is the main risk factor for infectious causes, cervicitis may affect 30% to 40% of the patients seen in STI clinics. The highest incidence of cervicitis is seen in sexually active women aged 15 to 24.
#1 Cervicitis: Etiology, diagnosis and treatment | Enfermedades Infecciosas y MicrobiologÃa ClÃnica (English Edition)
https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-cervicitis-etiology-diagnosis-treatment-S2529993X19301790
Cervicitis is frequently asymptomatic and silent infection can cause complications of the upper genital tract. […] Despite the fact that there are not many studies which have evaluated the frequency of cervicitis, it is estimated that it is a common condition, with prevalences as high as 2040% in women seen in consultations for sexually transmitted infections (STIs). […] The main complications of cervicitis are endometritis, PID and possible adverse effects in pregnancy. The clinical signs of cervicitis and/or endometritis may be the only ones present in patients with PID. In women with lower genital tract infections the risk of developing PID is estimated to be between 20 and 80% depending on the delay in the diagnosis, the presence of co-infection and other host-dependent factors. […] Furthermore, it is accepted that the presence of cervical inflammation may play a role in the transmission of HIV, increasing both the susceptibility to the infection by the virus and the excretion of it.
#1 Cervicitis: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/15360-cervicitis
Cervicitis is a common condition, and healthcare providers know it’s very common. Some studies suggest that up to half of all women will have cervicitis at some point in their lives. […] Not everyone gets symptoms of cervicitis or knows they have it. That’s why regular gynecological exams and testing for STIs (if necessary) are essential so that your healthcare provider can detect cervicitis. […] People who have multiple partners or who don’t use condoms or dental dams during sex are at a higher risk for cervicitis. Those with a history of sexually transmitted infections (STIs), or who have partners with a history of STIs, are also more likely to get cervicitis. […] Cervicitis is a common and treatable condition that goes away within a few weeks with proper treatment. Noninfectious causes may not need any treatment. Follow your healthcare provider’s treatment instructions, even if you don’t have symptoms or your symptoms go away. While receiving treatment, avoid having sex so that you don’t spread the infection to your partner. To prevent cervicitis in the future, practice safe sex and be diligent about visiting your gynecologist for routine exams and STI testing.
#1 Cervicitis, Ectropion, and True Erosion | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116119/1.0/Cervicitis__Ectropion__and_True_Erosion
Cervicitis: most commonly due to infectious etiologies, including, but not limited to, the following: Chlamydia: 1.7 million cases were reported to the CDC in 2017, with actual incidence estimated to be 3 million yearly. About 5% of sexually active women between the ages of 14 and 39 years have chlamydia infection with substantial variation by region and ethnicity/race. Gonorrhea: second most commonly reported notifiable disease after chlamydia in the United States; 468,514 cases reported to the CDC in 2016, with 91.9% of cases in persons aged 15 to 44 years; isolates showing elevated ceftriaxone MICS indicating resistance fluctuated between 0.05% and 0%. Herpes simplex virus (HSV): 700,000 new cases per year in the United States. Trichomonas: not routinely reported to CDC, but trend data show Trichomonas infection overall prevalence of 3.1% with specific prevalence of 13.3% among non-Hispanic black persons. Mycoplasma genitalium: increasingly common sexually transmitted pathogen among high-risk, sexually active women, detected in 10-30% of women with cervicitis. Human papillomavirus (HPV): the most common sexually transmitted infection (STI) in the United States with prevalence 42.5% among U.S. adults. […] Prevalence Present in 14-37% of outpatients.
#1 Cervicitis overview – wikidoc
https://www.wikidoc.org/index.php/Cervicitis_overview
The incidence and prevalence of cervicitis depends on the study population. The prevalence of cervicitis is estimated to be 18,000 per 100,000 women diagnosed with gonococcal infection. The prevalence of cervicitis ranges from 7,600 to 24,900 per 100,000 female sex workers. […] Cervicitis is relatively more prevalent in HIV-positive women than non-HIV positive women. Among this population, the prevalence of cervicitis is estimated to be 7,400 per 100,000 women diagnosed with HIV infection. […] The overall prevalence of nongonococcal cervicitis is higher than gonococcal cervicitis. Chlamydia cervicitis is four to five times more prevalent than gonococcal cervicitis. […] Cervicitis commonly follows the pattern of age prevalence of sexually transmitted infections with the highest incidence among women aged 15-24. […] The prevalence of cervicitis is higher in under-served communities and developing countries.
#1 Urethritis and Cervicitis – STI Treatment Guidelines
https://www.cdc.gov/std/treatment-guidelines/urethritis-and-cervicitis.htm
C. trachomatis or N. gonorrhoeae is the most common etiology of cervicitis defined by diagnostic testing. […] However, in many cases of cervicitis, no organism is isolated, especially among women at relatively low risk for recent acquisition of these STIs (e.g., women aged 30 years) (769). […] Because cervicitis might be a sign of upper genital tract infection (e.g., endometritis), women should be assessed for signs of PID and tested for C. trachomatis and N. gonorrhoeae with NAAT on vaginal, cervical, or urine samples (553) (see Chlamydial Infections; Gonococcal Infections). […] Multiple factors should affect the decision to provide presumptive therapy for cervicitis. Presumptive treatment with antimicrobials for C. trachomatis and N. gonorrhoeae should be provided for women at increased risk (e.g., those aged 25 years and women with a new sex partner, a sex partner with concurrent partners, or a sex partner who has an STI), if follow-up cannot be ensured, or if testing with NAAT is not possible.
#1 Prevalence and treatment outcome of cervicitis of unknown etiology – PubMed
https://pubmed.ncbi.nlm.nih.gov/23588127/
Mucopurulent cervicitis (MPC) is a clinical syndrome characterized by mucopurulent discharge from the cervix and other signs of inflammation. […] More than half of the cases of MPC were of unknown etiology. […] The overall clinical failure rate was 30% (10/33), and the clinical cure rate was only 24% (8/33). […] Rates were not significantly different between the arms. […] Gastrointestinal AEs were higher in the treatment arm.
#1 Cervicitis: Practice Essentials, Etiology, Epidemiology
https://emedicine.medscape.com/article/253402-overview
The Centers for Disease Control and Prevention (CDC) estimates that over 19 million new sexually transmitted infections (STIs) occur annually, almost half of them among persons aged 15-24 years. […] Chlamydia, however, is the most frequently reported infectious disease in the US, with the majority of cases occurring in individuals aged 25 years or younger. […] The reported incidence of chlamydial infections has steadily increased over the past 2 decades, with 1.3 million cases reported in 2010. […] Gonorrhea is the second most commonly reported infectious disease in the United States, with more than 300,000 cases reported in 2010. […] The annual rates of infection by herpes simplex virus (HSV) is difficult to estimate, because the vast majority of initial infections are asymptomatic or unrecognized.
#1 Cervicitis epidemiology and demographics – wikidoc
https://www.wikidoc.org/index.php/Cervicitis_epidemiology_and_demographics
The incidence and prevalence of cervicitis depends on the study population. The prevalence of cervicitis is estimated to be 18,000 per 100,000 women diagnosed with gonococcal infection. […] Cervicitis is relatively more prevalent in HIV-positive women than non-HIV positive women. Among this population, the prevalence of cervicitis is estimated to be 7,400 per 100,000 women diagnosed with HIV infection. […] The overall prevalence of nongonococcal cervicitis is higher than gonococcal cervicitis. […] Cervicitis commonly follows the pattern of age prevalence of sexually transmitted infections with the highest incidence among women aged 15-24. […] There is no racial predilection to developing cervicitis. […] The prevalence of cervicitis is higher in under-served communities and developing countries.
#1 Prevalence and predictors of cervicitis in female sex workers in Peru: an observational study | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/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. […] Cervicitis was detected in 99 (24.9%) of 397 FSW. […] Cervicitis was common in FSW working Peru and was predominantly nongonococcal and non-chlamydial in etiology. […] Cervicitis is a common condition in FSW, with prevalences as high as 20%. […] Although cervicitis has been reported in Peruvian FSW, detailed data regarding the prevalence, etiologies and risk factors for cervicitis in FSW working in Peru or other Latin American countries is lacking.
#1 Cytopathology and epidemiology of cervicitis in commercial sex wo | 6360
https://www.walshmedicalmedia.com/proceedings/cytopathology-and-epidemiology-of-cervicitis-in-commercial-sex-workers-csws-in-enugu-nigeria-6360.html
Cytopathology and epidemiology of cervicitis in commercial sex workers (CSWs) in Enugu, Nigeria […] This study aimed at examining the cytopathology, patterns, prevalence and burden of cervicitis in CSWs in Enugu metropolis, Nigeria. […] The epidemiology revealed that acute cervicitis are predominant 7 (5.9%) and 2 (1.7%) are chronic cervicitis. […] The prevalence of CSWs living with cervicitis in Enugu, Nigeria (7.6%) is significantly affected by age and working duration as CSWs. […] C. trachomatis infection is the prevalent etiologic agent of cervicitis in this study.
#1 Prevalence and predictors of cervicitis in female sex workers in Peru: an observational study | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-195
Accurate local epidemiological data is essential for guiding syndromic management of cervicitis in FSW. […] Regular clinic attendance was associated with a 46% reduced risk of cervicitis, possibly due to the reduced rates of STI and BV noted in the regular clinic attendees. […] 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.
#1 Cervicitis: Practice Essentials, Etiology, Epidemiology
https://emedicine.medscape.com/article/253402-overview
Worldwide, 448 million adults (aged 15-49 years) become infected with a curable STI (trichomoniasis, chlamydia, syphilis, or gonorrhea) every year. […] A review of more than 27,000 women from 48 published reports found an overall global prevalence of 7.3% M genitalium urogenital infection in high-risk populations and 2.0% in low-risk populations. […] No race predilection exists for cervicitis. Known risk factors include urban residence and low socioeconomic status. […] Routine screening of sexually active adolescents and young adults is therefore recommended. […] Routine chlamydia screening of sexually active women younger than 25 years is recommended by the US Preventive Services Task Force (USPSTF), American Cancer Society (ACS), American College of Obstetricians and Gynecologists (ACOG), American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP) to prevent the consequences of untreated chlamydial infection (eg, PID, infertility, ectopic pregnancy, chronic pelvic pain).
#1
https://link.springer.com/article/10.1023/A:1010935723248
In 1990, a study of the reproductive habits and cervical pathology in women of the Qashgha’i nomadic tribe, resulted in a high prevalence of cervicitis. […] The prevalence of cervicitis was 88% in the Qashgha’i, 85% in the Lor and 71% in the urban population. […] BV was strongly associated with cervicitis, with a relatively high attributable risk. Both sexual and childbirth exposures may be associated with cervicitis in these populations.
#1 SciELO Brazil – Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis
https://www.scielo.br/j/rsbmt/a/BxQ8NJZXSfK45RFwVBDFvPd/
Infections that cause cervicitis are a topic presented in the „Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections”, published by the Brazilian Ministry of Health in 2020. […] This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. […] It discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. […] In 2016, estimates of the incidence of gonorrhea in Latin-America Countries indicated that the incidence in pregnant women was 0.5% in Argentina, 2.0% in the Bahamas, 1.0% in Brazil, up to 2.0% in Colombia, and Haiti, from 2.7% to 3.0%.
#1 SciELO Brazil – Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis
https://www.scielo.br/j/rsbmt/a/BxQ8NJZXSfK45RFwVBDFvPd/
In Brazil, there is no consolidated data at national level on the infections caused by C. trachomatis or N. gonorrhoeae, as they are not diseases with compulsory notification. […] Seventy to 80% of cervicitis cases are asymptomatic. […] The risk factors are sexually active women younger than 25 years old, new or multiple sexual partners, partners with STI, previous history or presence of other STI, and irregular use of condoms. […] As cervicitis is usually caused by an IST, it is essential to reinforce using condoms in all sexual intercourses. […] Patients with positive tests must be advised to refrain from sexual contact for seven days after the treatment and resolve possible symptoms. […] The tests for control of cure of non-complicated urogenital or rectal C. trachomatis and N. gonorrhoeae infections are not routinely recommended for people treated with first-line schemes.
#1 Prevalence and Risk Factors of Cervicitis in Married Women in Shahroud Northeast of Iran – Journal of Clinical and Basic Research
https://jcbr.goums.ac.ir/article-1-133-en.html
Prevalence and Risk Factors of Cervicitis in Married Women in Shahroud, Northeast of Iran. […] In this study, we evaluated the prevalence and risk factors of MPC in married women referred to health centers of Shahroud (northeast of Iran) in 2016. […] Logistic regression was used to evaluate association of sociodemographic, behavioral and sexual health related variables with prevalence of cervicitis. […] In addition, 38.2% of the subjects were with less than a high school diploma and 72.8% were housekeeper. […] Coital frequency per week (P=0.004) and method of delivery (P=0.02) were significantly associated with the prevalence of cervicitis. […] Our findings suggest that weekly coital frequency, method of delivery, vaginal discharge and history of genital herpes may be associated with the risk of cervicitis.
#1 Cervicitis – Symptoms, diagnosis and treatment | BMJ Best Practice US
https://bestpractice.bmj.com/topics/en-us/662
Cervicitis is common and often asymptomatic, but if left undiagnosed or untreated can result in pelvic inflammatory disease, which can lead to substantial long-term ill effects such as infertility and chronic pelvic pain. […] Implementing screening protocols for high-risk populations may reduce adverse outcomes from cervicitis. […] While Neisseria gonorrhoeae and Chlamydia trachomatis are the most commonly isolated organisms, in most cases no organism is identified.
#1 Cervicitis: Etiology, diagnosis and treatment | Enfermedades Infecciosas y MicrobiologÃa ClÃnica (English Edition)
https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-cervicitis-etiology-diagnosis-treatment-S2529993X19301790
There is also evidence of the involvement of chronic inflammation of the cervix in the pathogenesis of cervical cancer. Some genotypes of the human papillomavirus (HPV), particularly 16 and 18, are involved in the development of most of the genital cancers. The role of these viruses in cervicitis is more uncertain.
#1 Mucopurulent Cervicitis (MPC) 1996 Case Definition | CDC
https://ndc.services.cdc.gov/case-definitions/mucopurulent-cervicitis-1996/
A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. […] Mucopurulent cervicitis (MPC) is a clinical diagnosis of exclusion. […] An illness in a female that meets the case definition of MPC and C. trachomatis infection should be classified as chlamydia.
#1 07. Cervicitis & PID | Hospital Handbook
https://hospitalhandbook.ucsf.edu/07-cervicitis-pid/07-cervicitis-pid
Cervicitis and PID are most common among young ( age 25) sexually active women and adolescents […] Gonorrhea and chlamydia cases are reported to the public health department.
#1 SciELO Brazil – Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis
https://www.scielo.br/j/rsbmt/a/BxQ8NJZXSfK45RFwVBDFvPd/
However, they can be conducted during pregnancy, in cases of complicated infections or persistence of symptoms. […] Regarding N. gonorrhoeae, due to the development of high resistance to antimicrobial drugs, WHO has a program for worldwide surveillance of the gonococcal susceptibility to drugs, the Gonococcal Antimicrobial Surveillance Program (GASP). […] Brazil participates in this program, through the SenGono (Gonococcal Sensitivity) Project, which carries out this surveillance at the national level from samples of male urethral discharge, as recommended by WHO.
#1 Associations between Vaginal Microbiota and Cervicitis | Department of Epidemiology
https://epi.washington.edu/epi_research/associations-between-vaginal-microbiota-and-cervicitis/
Cervicitis is defined as the inflammation of the cervix. Many cases of cervicitis are caused by sexually transmitted infections (STIs); however, a substantial portion of cervicitis cases have no known etiology. […] In the analysis adjusting for sexually transmitted infections, vaginal washing, and condom use, certain BV-associated bacteria had one or more tertiles that were associated with an increased detection of cervicitis, including BVAB1, Megasphaera species, and Mageeibacilus indolicus. […] Conclusions: Presence of certain BV-associated species and Lactobacillus species in the vagina may contribute to cervicitis. This analysis was limited to Kenya and the US, and given differences of vaginal microbiota by region, additional studies are needed to understand if these associations are present in other regions. Further study is also needed to explore the role of lactobacilli in cervicitis.
#1 Impact of chronic cervicitis on recurrent pelvic inflammatory disease – MedCrave online
https://medcraveonline.com/OGIJ/impact-of-chronic-cervicitis-on-recurrent-pelvic-inflammatory-disease.html
Pelvic inflammatory disease (PID) is a sexually-transmitted infection (STI); and, as such, sometimes it is difficult to treat because of partner(s) issues. PID generally is accompanied by chronic cervicitis (CC). […] We observed that in spite of complying with indications and taking preventative measures against STIs, patients may present with PID again. This may be related to the presence of chronic cervicitis, in which case some response to antibacterial agents could have been documented, but finally they may need some form of invasive therapy. […] On the basis of this observation, we proposed the following hypothesis: CC may lead to PID even with proper therapy and in its recurrent form; and therapy of CC may reduce or prevent the development of new cases of PID. […] We presented in the introduction the following hypothesis: chronic cervicitis (CC) might be the cause of properly treated and recurrent pelvic inflammatory disease (PID); and treating CC with electrocauterization would reduce or prevent a new episode of PID.
#1 Diagnosis of clinical cervicitis and vaginitis in dairy cows in relation to various postpartum uterine disorders
https://clinicaltheriogenology.net/index.php/CT/article/download/10309/17223?inline=1
Clinical cervicitis was diagnosed in 36.0, 40.1, and 31.1% of cows in 1w, 3w, and 5w postpartum, respectively. […] Approximately 64% of cows with clinical endometritis in 5w postpartum also had clinical cervicitis (p 0.05). […] Contrary to vaginitis, high prevalence of clinical cervicitis and its association with clinical endometritis and longer average days open suggested a substantial role of the condition in postpartum uterine diseases. […] Cervicitis has a prevalence of 11 – 30% in dairy cows, and ~ 75% of cows with cervicitis also exhibit clinical or subclinical endometritis. […] Clinical cervicitis occurred in conjunction with various PUDs and our final model revealed that CC cases increased (OR = 3.8 p = 0.05) when cows had a positive culture for T. pyogenes. […] Cows with clinical endometritis in 5w postpartum (64.2%, n=9) had clinical cervicitis (p = 0.002).
#2 Cervicitis: Etiology, diagnosis and treatment | Enfermedades Infecciosas y MicrobiologÃa ClÃnica (English Edition)
https://www.elsevier.es/en-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-cervicitis-etiology-diagnosis-treatment-S2529993X19301790
Cervicitis is frequently asymptomatic and silent infection can cause complications of the upper genital tract. […] Despite the fact that there are not many studies which have evaluated the frequency of cervicitis, it is estimated that it is a common condition, with prevalences as high as 2040% in women seen in consultations for sexually transmitted infections (STIs). […] The main complications of cervicitis are endometritis, PID and possible adverse effects in pregnancy. The clinical signs of cervicitis and/or endometritis may be the only ones present in patients with PID. In women with lower genital tract infections the risk of developing PID is estimated to be between 20 and 80% depending on the delay in the diagnosis, the presence of co-infection and other host-dependent factors. […] Furthermore, it is accepted that the presence of cervical inflammation may play a role in the transmission of HIV, increasing both the susceptibility to the infection by the virus and the excretion of it. […] There is also evidence of the involvement of chronic inflammation of the cervix in the pathogenesis of cervical cancer.
#2 Cervicitis – Symptoms, diagnosis and treatment | BMJ Best Practice US
https://bestpractice.bmj.com/topics/en-us/662
Cervicitis is common and often asymptomatic, but if left undiagnosed or untreated can result in pelvic inflammatory disease, which can lead to substantial long-term ill effects such as infertility and chronic pelvic pain. […] Implementing screening protocols for high-risk populations may reduce adverse outcomes from cervicitis. […] While Neisseria gonorrhoeae and Chlamydia trachomatis are the most commonly isolated organisms, in most cases no organism is identified.
#2 Cervicitis overview – wikidoc
https://www.wikidoc.org/index.php/Cervicitis_overview
The incidence and prevalence of cervicitis depends on the study population. The prevalence of cervicitis is estimated to be 18,000 per 100,000 women diagnosed with gonococcal infection. The prevalence of cervicitis ranges from 7,600 to 24,900 per 100,000 female sex workers. […] Cervicitis is relatively more prevalent in HIV-positive women than non-HIV positive women. Among this population, the prevalence of cervicitis is estimated to be 7,400 per 100,000 women diagnosed with HIV infection. […] The overall prevalence of nongonococcal cervicitis is higher than gonococcal cervicitis. Chlamydia cervicitis is four to five times more prevalent than gonococcal cervicitis. […] Cervicitis commonly follows the pattern of age prevalence of sexually transmitted infections with the highest incidence among women aged 15-24. […] The prevalence of cervicitis is higher in under-served communities and developing countries.
#2 Cervicitis: Practice Essentials, Etiology, Epidemiology
https://emedicine.medscape.com/article/253402-overview
Worldwide, 448 million adults (aged 15-49 years) become infected with a curable STI (trichomoniasis, chlamydia, syphilis, or gonorrhea) every year. […] A review of more than 27,000 women from 48 published reports found an overall global prevalence of 7.3% M genitalium urogenital infection in high-risk populations and 2.0% in low-risk populations. […] No race predilection exists for cervicitis. Known risk factors include urban residence and low socioeconomic status. […] Routine screening of sexually active adolescents and young adults is therefore recommended. […] Routine chlamydia screening of sexually active women younger than 25 years is recommended by the US Preventive Services Task Force (USPSTF), American Cancer Society (ACS), American College of Obstetricians and Gynecologists (ACOG), American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP) to prevent the consequences of untreated chlamydial infection (eg, PID, infertility, ectopic pregnancy, chronic pelvic pain).
#2 07. Cervicitis & PID | Hospital Handbook
https://hospitalhandbook.ucsf.edu/07-cervicitis-pid/07-cervicitis-pid
Cervicitis and PID are most common among young ( age 25) sexually active women and adolescents […] Gonorrhea and chlamydia cases are reported to the public health department.
#2 Cervicitis: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/15360-cervicitis
Cervicitis is a common condition, and healthcare providers know it’s very common. Some studies suggest that up to half of all women will have cervicitis at some point in their lives. […] Not everyone gets symptoms of cervicitis or knows they have it. That’s why regular gynecological exams and testing for STIs (if necessary) are essential so that your healthcare provider can detect cervicitis. […] People who have multiple partners or who don’t use condoms or dental dams during sex are at a higher risk for cervicitis. Those with a history of sexually transmitted infections (STIs), or who have partners with a history of STIs, are also more likely to get cervicitis. […] Cervicitis is a common and treatable condition that goes away within a few weeks with proper treatment. Noninfectious causes may not need any treatment. Follow your healthcare provider’s treatment instructions, even if you don’t have symptoms or your symptoms go away. While receiving treatment, avoid having sex so that you don’t spread the infection to your partner. To prevent cervicitis in the future, practice safe sex and be diligent about visiting your gynecologist for routine exams and STI testing.
#2 Prevalence and Risk Factors of Cervicitis in Married Women in Shahroud Northeast of Iran – Journal of Clinical and Basic Research
https://www.jcbr.goums.ac.ir/article-1-133-en.html
Prevalence and Risk Factors of Cervicitis in Married Women in Shahroud, Northeast of Iran. […] In this study, we evaluated the prevalence and risk factors of MPC in married women referred to health centers of Shahroud (northeast of Iran) in 2016. […] Logistic regression was used to evaluate association of sociodemographic, behavioral and sexual health related variables with prevalence of cervicitis. […] Coital frequency per week (P=0.004) and method of delivery (P=0.02) were significantly associated with the prevalence of cervicitis. […] Our findings suggest that weekly coital frequency, method of delivery, vaginal discharge and history of genital herpes may be associated with the risk of cervicitis.
#2 Impact of chronic cervicitis on recurrent pelvic inflammatory disease – MedCrave online
https://medcraveonline.com/OGIJ/impact-of-chronic-cervicitis-on-recurrent-pelvic-inflammatory-disease.html
However, this study has proven that there is a significant success rate in patients with recurrent PID in whom electrocauterization was performed. […] When analyzing the results, we observed during follow-up an important 3.5-fold reduction in PID recurrence up to one year after therapy, compared to those women who did not undergo electrocauterization. This result is intuitively statistically significant, and it shows that the aforementioned procedure works and is quite useful. […] Uterine cervix electrocauterization in cases of chronic cervicitis within a pelvic inflammatory disease context significantly reduces recurrence of treated PID.
#2 Diagnosis of clinical cervicitis and vaginitis in dairy cows in relation to various postpartum uterine disorders
https://clinicaltheriogenology.net/index.php/CT/article/download/10309/17223?inline=1
Prevalence of CC and CYTOc in 5 weeks postpartum dairy cows was 31.1 and 6.6%, respectively. […] High prevalence of CC with its association with clinical endometritis and longer average days open suggested that it would be advantageous to conduct a visual vaginal examination during 5 weeks postpartum as part of a complete reproductive examination.
#3 Cervicitis epidemiology and demographics – wikidoc
https://www.wikidoc.org/index.php/Cervicitis_epidemiology_and_demographics
The incidence and prevalence of cervicitis depends on the study population. The prevalence of cervicitis is estimated to be 18,000 per 100,000 women diagnosed with gonococcal infection. […] Cervicitis is relatively more prevalent in HIV-positive women than non-HIV positive women. Among this population, the prevalence of cervicitis is estimated to be 7,400 per 100,000 women diagnosed with HIV infection. […] The overall prevalence of nongonococcal cervicitis is higher than gonococcal cervicitis. […] Cervicitis commonly follows the pattern of age prevalence of sexually transmitted infections with the highest incidence among women aged 15-24. […] There is no racial predilection to developing cervicitis. […] The prevalence of cervicitis is higher in under-served communities and developing countries.
#3 Cervicitis – Symptoms, diagnosis and treatment | BMJ Best Practice US
https://bestpractice.bmj.com/topics/en-us/662
Cervicitis is common and often asymptomatic, but if left undiagnosed or untreated can result in pelvic inflammatory disease, which can lead to substantial long-term ill effects such as infertility and chronic pelvic pain. […] Implementing screening protocols for high-risk populations may reduce adverse outcomes from cervicitis. […] While Neisseria gonorrhoeae and Chlamydia trachomatis are the most commonly isolated organisms, in most cases no organism is identified.