@article {Lusk175, author = {M Josephine Lusk and Frances L Garden and William D Rawlinson and Zin W Naing and Robert G Cumming and Pam Konecny}, title = {Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics}, volume = {92}, number = {3}, pages = {175--181}, year = {2016}, doi = {10.1136/sextrans-2015-052332}, publisher = {The Medical Society for the Study of Venereal Disease}, abstract = {Objectives Studies examining cervicitis aetiology and prevalence lack comparability due to varying criteria for cervicitis. We aimed to outline cervicitis associations and suggest a best case definition.Methods A cross-sectional study of 558 women at three sexually transmitted infection clinics in Sydney, Australia, 2006{\textendash}2010, examined pathogen and behavioural associations of cervicitis using three cervicitis definitions: {\textquoteleft}microscopy{\textquoteright} (\>30 pmnl/hpf (polymorphonuclear leucocytes per high-powered field on cervical Gram stain)), {\textquoteleft}cervical discharge{\textquoteright} (yellow and/or mucopurulent cervical discharge) or {\textquoteleft}micro+cervical discharge{\textquoteright} (combined {\textquoteleft}microscopy{\textquoteright} and {\textquoteleft}cervical discharge{\textquoteright}).Results Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV) and Neisseria gonorrhoeae (NG) had the strongest associations with cervicitis definitions {\textquoteleft}micro+cervical discharge{\textquoteright}: CT adjusted prevalence ratio (APR)=2.13 (95\% CI 1.38 to 3.30) p=0.0006, MG APR=2.21 (1.33 to 3.69) p=0.002, TV APR=2.37 (1.44 to 3.90) p=0.0007 NG PR=4.42 (3.79 to 5.15) p\<0.0001 and {\textquoteleft}cervical discharge{\textquoteright}: CT APR=1.90 (1.25 to 2.89) p=0.003, MG APR=1.93 (1.17 to 3.19) p=0.011, TV APR=2.02 (1.24 to 3.31) p=0.005 NG PR=3.88 (3.36 to 4.48) p\<0.0001. Condom use for vaginal sex {\textquoteleft}always/sometimes{\textquoteright} reduced cervicitis risk: ({\textquoteleft}micro+cervical discharge{\textquoteright}) APR=0.69 (0.51 to 0.93) p=0.016. Combined population attributable risk \% (PAR\%) of these four pathogens was only 18.0\% with a protective PAR\% of condoms of 25.7\%. Exposures not associated with cervicitis included bacterial vaginosis, Mycoplasma hominis, Ureaplasma urealyticum, herpes simplex virus 1\&2, cytomegalovirus, Candida, age, smoking and hormonal contraception.Conclusions Cervicitis was associated with CT, MG, TV and NG with combined PAR\% of these pathogens only 18\% in this setting, suggesting other factors are involved. Condoms significantly reduced cervicitis risk. Cervicitis definitions with best clinical utility and pathogen prediction were {\textquoteleft}cervical discharge{\textquoteright} and {\textquoteleft}micro+cervical discharge{\textquoteright}.}, issn = {1368-4973}, URL = {https://sti.bmj.com/content/92/3/175}, eprint = {https://sti.bmj.com/content/92/3/175.full.pdf}, journal = {Sexually Transmitted Infections} }