Relationship of cervical ectopy to chlamydia infection in young women

Abstract

Objective Genital Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection (STI) in the UK. Behaviours including multiple sex partners and inconsistent condom use, and biological factors such as cervical ectopy, may increase susceptibility to STIs. Cervical ectopy is thought to increase risk of chlamydia infection by exposing columnar epithelium to a potential infectious inoculum. This study aimed to determine whether chlamydia was more prevalent in young women with cervical ectopy.Methods Clinical notes of women aged 16-24 years attending the Portsmouth Genitourinary Medicine Clinic for an STI screen during the period May-July 2003 were reviewed retrospectively. Information collected included the presence or absence of cervical ectopy, smoking habits, methods of contraception, number of sexual partners in the previous 3 months, and previous STIs. Chlamydia infection was diagnosed by using strand displacement amplification on cervical swabs.Results A total of 231 women were included in the study. The mean age was 19.8 years. Evidence of cervical ectopy was found in 107 women. Chlamydial infection was detected in 37.4% (40/107) of those women with cervical ectopy and 21.8% (27/124) in those without cervical ectopy. This difference was statistically significant (p = 0.009). The significance remained even when accounting for confounding variables.Conclusions Cervical ectopy is a common physiological process in young women. Recognition of cervical ectopy should alert the clinician to the possibility of a genital chlamydia infection. Opportunistic screening for chlamydia in young people should be offered to reduce the prevalence of infection and its sequelae. G A diagnosis of chlamydia is more likely in young women with cervical ectopy.G Opportunistic screening for chlamydia in young people should be offered to reduce the prevalence of infection and its sequelae.

Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy

“…Although most women are asymptomatic, the condition can present with irregular discharge and postcoital and intermenstrual bleeding. 6,7 It has been suggested that cervical ectopy may be a potential risk factor for various sexually transmitted diseases, including Chlamydia trachomatis, 8 HIV, 9 and HPV infection. [10][11][12] In a previous work we showed that the detection of HPV DNA was more common in cervical ectopy than in cytology normal controls.…”

Generation C: Prevalence of and Risk Factors forChlamydia trachomatisamong Adolescents and Young Women in Lima, Peru

“…Adolescent girls and young women do not yet have fully mature reproductive and immune systems, so they may be unable to mount a strong defense against infection; 15 specifically, they are more likely to have cervical ectopy, which has been shown to be associated with CT across most studies. 7,[16][17][18][19] Ectopy is thought to increase the risk of infection by allowing exposure of more susceptible columnar epithelial cells. In addition to biologic considerations, there may also be social and contextual factors that broadly increase the vulnerability of this age group to CT infection.…”

Chlamydia in Canada, 2010–2015

“…Chlamydia rates are also higher among females than among males in the USA, England and Australia (11, [16][17]. Several studies have indicated that females may be more biologically susceptible to chlamydia than males (18,19). Furthermore, they are also more likely to seek health care (19,20).…”