Cervical tuberculosis masquerading as cancer cervix: A report of three cases.

Summary: Tuberculosis is still frequently observed in third world countries like Africa and Asia. Here we report three cases of genital tuberculosis with variable presentations. First case was a lady of reproductive age group who presented with polymenorrhea and post-coital bleeding with unhealthy cervix. Histopathology of cervical tissue revealed tubercular cervicitis. Second and third cases presented with different complaints like discharge per vaginum, post-coital bleeding and pain in lower abdomen with growth over the cervix. Cervical biopsy was inconclusive of tuberculosis but endometrial tissue sampling for TB PCR was positive. This shows that newer diagnostic marker test can help us to detect secondary genital tuberculosis.

Perinatal morbidity and mortality associated with chlamydial infection: a meta-analysis study

OBJECTIVE: To evaluate the effect of Chlamydia trachomatis infection during pregnancy on perinatal morbidity and mortality. METHODS: Systematic review and meta-analysis in an electronic database and manual, combining high sensitivity specific descriptors seeking to answer the research objective. The articles considered to be of high methodological quality (score above 6 on the Newcastle-Ottawa Scale) were assessed by meta-analysis. RESULTS: Summary estimates of 12 studies were calculated by means of Mantel-Haenszel test with 95 percent confidence interval. It was observed that Chlamydia infection during pregnancy increased risk of preterm labor (relative risk (RR) = 1.35 [1.11, 1.63]), low birth weight (RR = 1.52 [1.24, 1.87]) and perinatal mortality (RR = 1.84 [1.15, 2.94]). No evidence of increased risk was associated with Chlamydia infection in regard to premature rupture of membranes (RR = 1.13 [0.95, 1.34]), abortion and postpartum endometritis (RR = 1.20 [0.65, 2.20] and 0.89 [0.49, 1.61] respectively). CONCLUSION: The diagnosis and treatment of Chlamydia cervicitis during pregnancy can reduce perinatal morbidity and mortality associated with this infection. However, clinical trials are needed to confirm these findings.

Infección por Chlamydia trachomatis en mujeres consultantes en Maracaibo, Venezuela / Chlamydia trachomatis infection in females consulting health centres in Maracaibo, Venezuela

Objetivo Evaluar la prevalencia de infecciones por Chlamydia trachomatis en un grupo de mujeres sintomáticas y asintomáticas que asistieron a control en servicios de ginecología en centros de salud de Maracaibo, estado Zulia. Métodos Se incorporaron al estudio 168 pacientes que asistieron a dos centros de salud de Maracaibo. Se llevó a cabo evaluación ginecológica basada en examen pélvico, de áreas profundas de la vagina y cuello uterino. Las pacientes fueron clasificadas en grupos etarios y de acuerdo a la presencia de manifestaciones clínicas. Para investigar C. trachomatis, se aplicaron dos ensayos de amplificación de ADN del plásmido endógeno y del gen OMP1, a partir de hisopados endocervicales. Resultados Se evaluaron 168 pacientes, 81 (48,2 por ciento) sintomáticas y 87 (51,8 por ciento) asintomáticas. Se encontró una prevalencia de 7,7 por ciento en la población total evaluada. La prevalencia fue de 9,9 por ciento y 5,8 por ciento para las pacientes sintomáticas y asintomáticas, respectivamente (p>0,05). El grupo de pacientes de 18-28 años exhibió la más alta prevalencia (13,7 por ciento) (p=0,0322). Las manifestaciones clínicas predominantes fueron secreción mucopurulenta (35,8 por ciento) y cervicitis (21 por ciento). C. trachomatis fue detectada en 7,1 por ciento pacientes con secreción mucopurulenta y 23,5 por ciento casos de cervicitis, pero no se demostró asociación significativa entre infección y manifestaciones clínicas individuales (p>0,05). Conclusión Se encontró una mediana prevalencia de infecciones por C. trachomatis en la población evaluada, exhibiendo mayor frecuencia en mujeres jóvenes. Este microorganismo debería ser investigado en mujeres jóvenes sexualmente activas, independientemente de su condición sintomática o asintomática.

Objective Evaluating Chlamydia trachomatis infection prevalence in a group of symptomatic and asymptomatic females attending gynaecology services in health centres in Maracaibo in the state of Zulia in Venezuela. Methodology 168 patients attending two health centres in Maracaibo were included in this study. Gynaecological evaluation was based on examining the pelvis, deep areas of the vagina and the cervix. Patients were classified into groups according to age and the presence of clinical manifestations. Two DNA amplification assays of endogenous plasmid and the omp1 gene taken from endocervical swabs were used for investigating C. trachomati. Results 168 patients were evaluated; 81 (48,2 percent) were symptomatic and 87 (51,8 percent) asymptomatic, A 7,7 percent prevalence (p>0.05) was found in the total population (9,9 percent prevalence for symptomatic patients and 5,8 percent for asymptomatic ones). The 18- 28 year old patient group exhibited the highest prevalence (13,7 percent) (p=0.0322). The predominant clinical manifestations were mucopurulent secretion (35,8 percent) and cervicitis (21 percent). C. trachomatis was detected in 7,1 percent of patients having mucopurulent secretion and 23,5 percent of cervicitis cases; however, no significant association between infection and individual clinical manifestations was shown (p>0.05). Conclusion Medium C. trachomatis infection prevalence was found In the population being assessed here, the highest frequency being exhibited in young females. This microorganism should be investigated in sexually-active young women, regardless of their symptomatic or asymptomatic status.

Prevalencia de infección cervical por Chlamydia trachomatis en mujeres de la Región Metropolitana / Prevalence of cervical infection by Chlamydia trachomatis among Chilean women living in the Metropolitan Región

Background: Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) worídwide. In women, chlamydia infections are 75 percent asymptomatic and can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. Infants exposed to the microorganism at birth also have a high risk to develop conjunctivitis and pneumonía. Aim: To determine the prevalence of C trachomatis in women in the Metropolitan área of Santiago (Chile). Patients and methods: Cervical specimens were collected from 403 women attending three gynecological outpatient settings from Apríl 2003 to June 2005. These included one public hospital (n =100), a prívate medical center (n =268), and a clinic for adolescents (n =35). Mean ages ofeach group of patients were 35.6±8,2, 33.4±8.1 and 16.9±4.2 years, respectively. The diagnosis of C trachomatis was performed by the amplification byPCRofa 517-base pair segment of the cryptic plasmid on specimens extracted by a commercial procedure. Positive specimens were conñrmed by nested PCRs targeting the ompl gene. The presence of vaginal infections and its association with C trachomatis was investigated in a subset of 223 women ofthe prívate center. Residís: C trachomatis was detected in the cervix of 19 out of 403 women, resulting in a prevalence of 4.7 percent. The distribution of positive cases among different age groups was not significantly different. Women presenting with bacterial vaginosis had a significantly higher prevalence of C trachomatis infection (p <0.01). Conclusions: This study found a high prevalence of C trachomatis among gynecologic patients that should prompt preventive strategies.

Detection of chlamydia trachomatis in endocervical specimens by an enzyme- linked polymerase chain reaction assay

Chlamydia trachomatis [CT] is the most common cause of sexually transmitted infections [STI] worldwide and its early detection and treatment can reduces the high morbidity associated with this infection. In this study a sensitive diagnostic polymerase chain reaction [PCR]-based enzyme immunoassay [PCR-EIA] method was developed which detects CT in women with cervicitis. Endocervical swabs collected from 123 women [20-55 years] with cervicitis were tested by both conventional PCR, and PCR-EIA assays, using identical sets of primers to amplify a CT-specific plasmid. For the conventional PCR, amplicons were detected by agarose gel electrophoretic analysis and the PCR-EIA assay used biotin-labeled primers, strepavidin-coated plates, a digoxigenin-labeled probe, and a final enzyme-linked colorometric analysis [405 nm] was used to measure the CT amplicon. The frequency of positive CT infection by conventional PCR and PCR-EIA assay was 7% and 17%, respectively. The highest frequencies of CT infection were among women of 31-40 years old group [25%]. The PCR-EIA limit of detection, calculated by linear regression analysis, was10 pg of CT DNA [r[2]=0.9642]. The degree of agreement [Kappa] between the conventional PCR and PCR-EIA method was 0.556 [p<0.0001]

Subclinical infection of the genital tract with Neisseria meningitidis

We report the isolation of Neisseria meningitidis, characterized as B:NT:P1.7, from a female patient's genital tract in an outpatient clinic for HIV care. The gynecology clinic, as part of the follow up, collects specimens from all patients with HIV infection for routine exams and for early laboratory detection of sexually transmitted diseases . A Gram-negative diplococcus was isolated from the cervix of a heterosexual patient with AIDS. Based on this and other reported cases, urogenital infection with N. meningitidis can no longer be considered uncommon. The rising incidence of N. meningitidis isolated from this and similar sites has significant medical and diagnostic implications.

Etiologic agents of cervicovaginitis in Turkish women

To investigate the distribution of microbiologic agents causing cervicovaginitis. We conducted the study between October 2002 and December 2004 in Abant Izzet Baysal University, Duzce School of Medicine Hospital, Turkey. The samples were obtained from the posterior vaginal fornix and cervix by swabs in 828 patients. Direct microscopic examination, culture and enzyme immune assay [EIA] methods were performed in all patients for diagnosis of microbiologic agents. Gardnerella vaginalis [G. vaginalis] were diagnosed in 254 [30.7%] patients, Candida albicans [C. albicans] in 152 [18.4%], Candida glabrata [C. glabrata] in 36 [4.3%], Candida species in 52 [6.3%], Staphylococcus aureus [S. aureus] in 62 [7.5%], Streptococcus group B in 28 [3.4%], Escherichia coli [E. coli] in 42 [5.1%], Klebsiella species in 24 [2.9%], and Streptococcus group D in 8 [1%] patients in culture. Less frequent enterobacteria in 30 [3.6%] were: Pseudomonas species, Proteus species Enterobacter species, Hafnia alvei and Nonfermenter species. Neisseria gonorrheae [N. gonorrheae] was detected in one patient [0.1%] in culture. The Chlamydia trachomatis [C. trachomatis] antigen was detected by EIA methods in 130 [15.7%] patients and Trichomonas vaginalis [T. vaginalis] was observed in 8 [1%] patients by direct microscopic examination. Performing the etiologic diagnosis of cervicovaginitis is necessary in order to take appropriate therapeutic and preventive measures. Therefore, we recommend G. vaginalis, C. albicans and C. trachomatis should be investigated in patients having a diagnosis of cervicovaginitis in our population, since these were detected in a considerable number of cases. Additionally, C. glabrata and T. vaginalis should be kept in mind as possible pathogens

Etiología de la infección cérvico vaginal en pacientes del Hospital Juárez de México / Etiology of cervicovaginal infection in Mexican women

OBJETIVO: Conocer la etiología de la infección cérvico vaginal, con el fin de establecer un diagnóstico acertado que permita ofrecer a las pacientes el tratamiento más apropiado. MATERIAL Y MÉTODOS: De enero de 1995 a diciembre de 1999 se realizó un estudio bacteriológico a 6 811 muestras de exudado cérvico vaginal de pacientes del Hospital Juárez de México, de la Ciudad de México, con edades comprendidas entre los 13 y los 65 años, que referían leucorrea, prurito, hiperemia y dolor abdominal bajo. RESULTADOS: La frecuencia de infección por cada germen fue G vaginalis, 22.65 por ciento, Candida spp, 19.13 por ciento, C albicans, 7.8 por ciento, T vaginalis, 1.5 por ciento, Streptococcus del grupo D, 11.78 por ciento, Streptococcus b haemolyticus, 4.59 por ciento, E coli, 13.46 por ciento, Klebsiella ssp, 2.0 por ciento, además de otras enterobacterias menos frecuentes como Citrobacter spp, Enterobacter spp, Pseudomonas spp, M morganii y P mirabilis. El 2.9 por ciento presentó anaerobios siempre asociados con G vaginalis. Se aislaron Neisseria spp y N weaveri en 0.15 por ciento de las muestras. La N gonorrhoeae no se encontró en ningún caso. Datos comparativos indican que, tanto Streptococcus hemoliticos como E coli tuvieron un marcado incremento en los dos últimos años, siendo el de esta última estadísticamente significativo (p<0.001). El método de ji cuadrada se aplicó para la evaluación de los datos. CONCLUSIONES: Considerando la diversidad de la etiología de la infección se recomienda realizar cultivos de la secreción cérvico vaginal a todas las pacientes con sintomatología sugestiva de ella.

Chlamydia and fertility

Chlamydia trachomatis infection is the most common sexually transmitted disease all around the world. For a long time, Chlamydia trachomatis has been recognized as the common cause of urethritis, cervicitis, and other complications such as pelvic inflammatory disease [PID], ectopic pregnancy, etc. However, today there is more concern on its role in male and female fertility and infertility and many studies have concentrated on this issue all over the world. There is good evidence based on seroepidemiologic studies on relationship between serum Chlamydial antibodies and infertility due to tubal factor in women with or without PID. However, there are many questions about Chlamydia trachomatis and its influence on IVF outcome and the exsisting information is controversial. The impact of Chlamydia trachomatis on male infetility is under investigation and it seems able to cause destruction of different parts of male genital tract in addition to high rate of transmission to women. With regard to these data, it seems that prevention, early diagnosis and treatment of Chlamydial infections are importart and cost effective

Role of the male partner in the lower genitourinary tract infection of female.

We studied the relationships of selected microbes and the role of consorts in the causation of vaginal discharge which may be due to cervicitis or vaginitis. A total of 93 consecutive patients in the reproductive age group with symptoms of vaginal discharge along with their sexual partners were studied. Samples were collected from the cervix and posterior fornix of the female patients and from the urethra and sub-prepucial area of the male partner for culture of Neisseria gonorrhoeae, Gardnerella vaginalis, Mycoplasma hominis, ureaplasma, candida, aerobic and anaerobic organisms. Apart from cultures, KOH and Gram stain of the discharge were made. Predominant pathogen isolated was Ureaplasma urealyticum from 40 (43.01%) females and 23 (24.7%) males. The next common pathogenic organisms isolated were candida species from 11 (11.8%) females and 5 (5.4%) males and Chlamydia trachomatis in 3 (3.2%) females and 1 (1.1%) male. Various organisms were more frequently isolated from the 29 of 43 (67.4%) couples who had had sexual intercourse 7 days prior to the recruitment as compared to 14 of 43 (32.6%) who had had coitus more than 7 days prior to their recruitment. This may be due to the spontaneous disappearance or decrease in the number of organisms to the level that they could be detected by culture. In our study, 6 (6.5%) of male partners carrying pathogenic organisms were asymptomatic, indicating that their screening and treatment is vital.

Enfermedades infecciosas del cérvix uterino, vagina y vulva: prevencion, diagnóstico y tratamiento / Infectious diseases of the uterine cervix, vagina and vulva: prevention, diagnosis and treatment

Las enfermedades infecciosas inflamatorias del cérvix uterino, vagina y vulva se encuentran entre las patologías con mayor frecuencia en la práctica clínica cotidiana; forman parte de los 12 motivos principales de demanda de consulta en medicina familiar en el Instituto Mexicano del Seguro Social (IMSS). La cérvico-vaginitis de origen infeccioso se asocia con incremento en la frecuencia de parto pretérmino secundario a ruptura prematura de membranas amnióticas durante el embarazo y con enfermedad inflamatoria pélvica crónica, esterilidad de origen tubario y carcinoma cérvico-uterino. Todas estas patologías impactan en forma desfavorable la salud de las mujeres en edad reproductiva y dan lugar a secuelas de alto costo social y económico. En virtud de lo anterior, en el presente trabajo se efectúa la revisión y síntesis de los factores de riesgo, las medidas preventivas y los criterios más aceptados para el diagnóstico y tratamiento de los tipos más frecuentes de cérvico-vaginitis infecciosas, con el fin de contribuir a su difusión y a la utilización de protocolos actualizados y uniformes por parte del personal médico familiar y ginecoobstetra de nuestra institución

Chlamydia in pelvic inflammatory disease

Pelvic inflammatory disease is one of the major public health problems in the world, both in the developing as well as developed countries. Genitourinary tract infections caused by Chlamydia trachomatis are most common sexually transmitted diseases. Fifty to seventy per cent of women suffering from chlamydial infection of the genital are symptom free and 25-30% of chlamydial urethritis is silent. Clinical presentation is varied. Laparoscopy is the gold standard in the diagnosis of Chlamydia associated pelvic infections. Treatment depends on the severity of the disease. Early diagnosis, prompt, accurate, aggressive and appropriate chemotherapy is essential to prevent its sequelae

Azitromicina en el tratamiento de uretritis agudas: primer estudio multicéntrico nacional de eficacia clínico-microbiológica / Azythromycin in the treatment of acute urethritis: first national multicentric study of clinico-microbiologic effectiveness

Objetivos: evaluar la actividad de los antibióticos recomendados contra N. gonorrhoeae; concomitantemente realizar un estudio de eficacia clínico microbiológica y seguridad con azitromicina (monodosis 1 g) en el tratamiento de uretritis aguda no complicada en hombres con diagnóstico etiológico conocido. Material y método: fueron estudiadas 46 cepas de N. gonorrhoeae aisladas de pacientes sin tratamiento previo durante el período de setiembre de 1994 a julio de 1995. Además se estudiaron 48 pacientes hombres que consultaron en policlínicas del Hospital Policial y Laboratorio Montevideo con uretritis. Se investigaron C. trachomatis; U. urealyticum y N. gonorrhoeae con valoración de su concentración inhibitoria mínima (CIM) para los distintos antibióticos. Los pacientes fueron evaluados clínico-microbiologicamente a los 7, 15, 21 y 28 días del inicio del antibiótico. Resultados: en las 46 cepas, 25 fueron N. gonorroheae de penicilina sensibles (PEN sensibles).Para azitromicina la CIM 90 fue de 0,25 mg/l, para eritromicina la CIM 90 fue de 1 mg/l y para tetracilina la CIM 90 fue de 1,5 mg/l;no se encontró determinante de resistencia para ciprofloxacina, ceftriaxona, cefixime y espectinomicina. De los 48 pacientes, 40 fueron incluidos en el análisis de eficacia. Las etiologías fueron: N. gonorrhoeae en 17 con CIM 90 de 0,38 mg/l para azitromicina; C. trachomatis en 16, N. gonorrhoeae más C. trachomatis en 5 y U. urealyticum en 2. En el primer control se encontró erradicación microbiológica y cura clínica en 40/40 de los pacientes. La azitromicina fue bien tolerada; sólo tres pacientes presentaron efectos colaterales leves. Conclusiones: N. gonorrhoeae presentó CIM baja para azitromicina no existiendo determinantes de resistencias para ésta. La dosis de 1 g, fue bien tolerada, efectiva y práctica para el tratamiento de uretritis gonocóccica y no gonocóccica

Cervicitis: riesgo epidemiológico y clínico para infección por chlamydia trachomatis en estudiantes universitarias / Cervicitis: epidemiological and clinical risk for chlamydia trachomatis infection in universitary students

Se encuestaron y examinaron 50 estudiantes universitarias sexualmente activas, asintomáticas y voluntarias, a fin de determinar factores de riesgo predictivos de infección por chlamydia trachomatis. Se encontró que los factores epidemiológicos y conductuales eran similares a lo descrito para estudiantes norteamericanas, en cuanto a edad, número de parejas sexuales, uso de anticonceptivos orales y antecedentes de enfermedad de transmisión sexual previa. Había diferencia en el uso de métodos anticonceptivos de barrera. Un 22 por ciento de la muestra presentaba cervicitis clínica y un 30 por ciento cervicitis subclínica. Si se hubiera aplicado los criterios de screening propuestos por los diferentes autores norteamericanos, entre un 32 por ciento y 73 por ciento de las estudiantes debieran haber sido sometidas a estudio selectivo para pesquisa de Chlamydia trachomatis, porcentaje similar al de los trabajos originales. Se concluye que existiendo similares factores de riesgo pudiera existir una similar prevalencia de infección y debieran adoptarse las sugerencias foráneas a pesquisas mientras no se cuente con estudios nacionales

Chlamydia trachomatis in cervical mucus in cases of chronic cervicitis abortion and pregnancy

Direct immunofluorescence technique was used for detecting the prevalence of Chlamydia trachomatis infection in 20 patients with chronic cervicitis, 20 women during abortion. 20 fullterm pregnant women and 20 normal healthy controls attending AI-Zahraa University Hospital. The results revealed that the prevalence of C-trachomatis was 20%, 25%, 10% and 5% among the studied groups, respectively, with significant difference only between aborted Women and controls [P<0.05]. The results also revealed that mucopurulent discharge, dysuria and backache were the most frequent symptoms noted while cervical erosion and infertility were less common, and none were asymptomatic. Chlamydia trachomatis infection was found to be inversely related to age, parity and marital duration. From the forementioned results, it is clear that Chlamydia trachomatis has an important role, especially in abortion so that strategies for the treatment of women and mothers early in pregnancy must be carried out to prevent pregnancy loss

Prevalencia de chlamydia trachomatis y mycoplasma spp. en mujeres con DIU que asisten a la consulta de planificacion familiar en el modulo de la Candelaria, Tinaquillo, Estado Cojedes. 1992 / Prevalence of chlamydia trachomatis and mycoplast spp in women with div of the family plannino service in the Candelaria center, Tinaquillo Edo. Cojedes

Se realizó un estudio de 80 pacientes portadoras de DIU, provenientes de la consulta de planificación Familiar del Módulo la Candelaria, Tinaquillo, Estado Cojedes. A cada paciente le fue tomada muestra endocervical y se le hizo el estudio pertinentes para chlamydia trachomatis, por el método enzimoinmunoensayo (Elisa), y para mycoplasma spp. por Mycoplasma-Lyo. Los resultados arrojaron un alto porcenaje de positividad (45,2 por ciento) en aquellas mujeres cuyas edades oscilaban entre 17 y 26 años, con tiempo de DIU de 0-3 años, siendo el Uréaplasma urealyticum el género que más se aisló. En relación a Chlamydia trachomatis,nuestros resultados se ajustan a los reportados por otros autores, aunque nuestra muestra fue relativamente pequeña

A comparative study of PAP technique and in-situ molecular hybridization for identification of human papilloma viruses in cervical lesions.

The association of Human Papilloma Virus (HPV) with cervical lesions was correlated using peroxidase anti-peroxidase (PAP) technique and in-situ molecular hybridization (MH) with H3 labelled DNA probes (HPV type 6, 11, 16 and 18). The PAP technique to demonstrate capsid antigen and molecular hybridization for DNA sequences was studied in 30 cases. The correlation of HPV with cervical lesions was seen in 29.9% cases with PAP technique unlike 73.4% using M.H. technique, indicating the efficacy of the latter.

Microbiological evaluation of female patients in STD clinics.

A total of 215 women patients attending the STD clinic were evaluated in an attempt to isolate the different microorganisms in sexually transmitted diseases (STD). Mycoplasmas (30.22%), Candida species (20.00%), Trichomonas vaginalis (wet mount study; 15.81%), beta haemolytic streptococci (13.48%), Neisseria gonorrhoeae (9.30%), Staphylococcus aureus (13.95%), inclusion bodies of Chlamydia trachomatis (11.60%) and Gram negative organisms (9.30%) were isolated from these patients. Sera of all patients screened for HBsAg by ELISA showed a carrier rate of 12.5 per cent; 29.8 per cent sera were reactive in the VDRL test at the dilutions varying from 1:4 to 1:64.

Chlamydiazyme test for rapid detection of Chlamydia trachomatis.

Endocervical (120) and endourethral (104) swabs collected from patients attending the Gynaecological OPD and STD Clinic of a Hospital, in north India were subjected to the chlamydiazyme test to detect C. trachomatis antigen. This antigen was detected in 25 per cent (30 of 120) of cervical and 20.19 per cent (21 of 104) of urethral specimens. Of the 51 antigen positive cases, 30 (58.8%) presented with the clinical picture of cervicitis, 11 (21.5%) with urethritis, 6 (11.7%) were cases of primary infertility and 4 (7.8%) were healthy controls. The association of C. trachomatis and other sexually manifested microorganisms (Mycoplasma hominis, Ureaplasma urealyticum and Gardnerella vaginalis) was found more commonly in patients of cervicitis, especially those who were C. trachomatis antigen positive.

Role of chlamydia trachomatis in mucopurulent cervicitis

Endocervical chlamydia trachomatis was found in 4 of 80 women [5 per cent] attending the gynecology and Antenatal Clinic of Al-Zahraa University Hospital with clinical signs of mucopurlent cervicitis. A significant association was clearly demonstrated between infection and young age [P = 0.006], contact with partner with urethritis [P = 0.036]. No such association was demonstrated between infection and other historical correlates as years of intercourse and gravidity. Also a significant association was demonstrated between infection and cervical ectopy [P = 0.015], however, no such association was demonstrated for other cervical examination correlates as erythema, friability, discharge, colour and character and number of polymorphonuclear leukocytes. Finally a significant association was evident between chlamydial infection and the use of oral contraceptive versus the use of intrauterine contraceptive devices "I.U.Ds." [- = 0.026], but not between the use of I.U.Ds. and others [P = 0.533]