Abstract
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. This led us to explore the likely infectious agents responsible for a such high prevalence; to assess the difference in cervicitis rates between nomadic and non-nomadic populations in the same area; and to determine the risk factors for and the relationship between cervicitis and bacterial vaginosis (BV). In 1996–1997 a study was carried out of 839 married women of the Qashgha'i, 274 of the Lor nomadic tribes, and 388 non-nomadic urban women. A gynaecological examination, Pap smear and vaginal secretion for assessing BV by gram staining were performed. Data was analysed by logistic regression. Backward stepwise regression was used to assess multivariable effects on risk of cervicitis. The prevalence of cervicitis was 88% in the Qashgha'i, 85% in the Lor and 71% in the urban population. In the multivariate backward stepwise regression analysis for predictors of cervicitis in the Qashgha'i, significant factors were decreased association with those over 40 (p < 0.004) and postpartum bleeding. In the Lor tribe the predictors were an increased risk after more than four pregnancies (p < 0.01) and the use of contraception. Among the urban population, the risk of cervicitis was increased with the use of oral contraceptive previously (p < 0.03) or currently (p < 0.01). 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.
Similar content being viewed by others
References
Singh V, Sehgal A, Satynarayana L. Clinical presentation of gynecologic infections among Indian women. Gynecolog Infect 1995; 85: 215-219.
Chacko MR, Kozinetz CA, Hill R, et al. Leukocyte esterase dipstick as a rapid screening test for vaginitis and cervicitis. J Pediatr Adolese gynecol 1996; 9: 185-189.
Singh V, Sehgal A, Satynarayana L, et al. Association between reproductive tract infections and cervical inflammatory epithelial changes. Sexually Transmitt Dis 1995; 22: 25-30.
Hay PE, Taylor-Robinson D, Lamont RF. Diagnosis of bacterial vaginosis in a gynecology clinic. Br J Obstet Gynaecol 1992; 99: 63-66.
Nugent RP, Krohn MA, Hillier SH. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol 1991; 29: 297-301.
Keshavarz H, Duffy SW, Sotodeh-Maram E, et al. Factors related to cervicitis in Qashgha'i nomadic women of southern Iran. Rev Epidem et Sante Publ 1997; 45: 279-285.
Duffy SW, Keshavarz H, Sadeghi-Hassanabadi A, et al. Prevalence of cervicitis in women living in southern Iran. Rev Epidem et Sante Publ 1999; 47: 86.
Kiviat NB, Paavonen JA, Brockway J, et al. Cytologic manifestations of cervical and vaginal infections I epithelial and inflammatory cellular changes. JAMA 1985: 253: 989-996.
Lawley TB, Lee RB, Kapela R. The significance of moderate and severe inflammation on class I papanicolaou smear. Obstet Gynecol 1990; 76: 997-999.
Rantala I, Kivinen S. Demonstration of Chlamydia trachomatis in Papanicolaou-stained gynecological smears. Eur J Clin Microbiol Infect Dis 1998: 17: 46-48.
Martin HL, Richardson BA, Nyange PM, et al. Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. J Infect Dis 1999; 180: 1863-1868.
Breslow NE, Day NE. Statistical methods in cancer research. Lyon: International Agency for Research on Cancer, 1980.
Paavonen J, Critchlow CW, DeRouen T, et al. Etiology of cervical inflammation. Am J Obstet Gynecol 1986; 134(3): 556-564.
Parashari A, Singh V, Gupta MM, et al. Significance of inflammatory cervical smears. APMIS 1995; 103: 273-278.
Larsson PG, Platz-Christensen JJ. Bacterial vaginosis and the vaginal leucocyte/epithelial cell ratio in women attending an outpatient gynaccology clinic. Eur J Obstet Gynecol Reproduct Biol 1991; 42: 217-220.
Peipert JF, Montagono AB, Cooper AS, et al. Bacterial vaginosis as a risk factor for upper genital tract infection. Am J Obstet Gynecol 1997; 177: 1184-1187.
Eschenbach A. Bacterial vaginosis and anaerobes in obstetric infection. Clin Infectious Dis 1993; 16: S282-S287.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Keshavarz, H., Duffy, S., Sadeghi-Hassanabadi, A. et al. Risk factors for and relationship between bacterial vaginosis and cervicitis in a high risk population for cervicitis in Southern Iran. Eur J Epidemiol 17, 89–95 (2001). https://doi.org/10.1023/A:1010935723248
Issue Date:
DOI: https://doi.org/10.1023/A:1010935723248