Risk factors for and relationship between bacterial vaginosis and cervicitis in a high risk population for cervicitis in Southern Iran

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 cerviciti s. This led us to explore the likely infectious agents responsible for a su ch high prevalence; to assess the difference in cervicitis rates between no madic and non-nomadic populations in the same area; and to determine the ri sk factors for and the relationship between cervicitis and bacterial vagino sis (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 regressi on. Backward stepwise regression was used to assess multivariable effects o n 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 backw ard stepwise regression analysis for predictors of cervicitis in the Qashgh a'i, significant factors were decreased association with those over 40 (p < 0.004) and postpartum bleeding. In the Lor tribe the predictors were an in creased risk after more than four pregnancies (p < 0.01) and the use of con traception. Among the urban population, the risk of cervicitis was increase d 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.