Phylogeny-based identification of Mycoplasma genitalium in a Nigerian population of apparently healthy sexually active female students.

Introduction: Mycoplasma genitalium is an emerging sexually transmitted pathogen. Sexually transmitted infection (STI) is still a burden for Nigerian women because it is asymptomatic. The lack of detection of M. genitalium in apparently healthy sexually active females in Nigeria is due to non-application of high throughput molecular approach. We conducted a study to identify M. genitalium in apparently healthy Nigerian female students using a phylogenetic approach. Methods: one hundred endocervical swab specimens were collected from a student population of sexually active females aged 15 - 39 years. The 16SrRNA gene V1-V3 region of M. genitalium were amplified directly from the specimens before sequencing. Maximum Likelihood (ML) phylogenetic analysis was carried out to determine genetic relatedness. Results: the prevalence of M. genitalium infection was 1% among students. The majority (59%) of them were between 20 - 24 years, with a mean age of 26.2 ± 2.66 years. High number of sexual partners, previous STI and irregular condom use were significantly associated (P < 0.05) with the prevalence of M. genitalium infection. There was extensive lack of knowledge (0%) about M. genitalium infection among the students. Phylogenetic analysis revealed three clades with different relatedness. Our study highlighted that 16SrRNA gene was a detector of M. genitalium, but it shared no phylogenetic relationship with other examined species from around the world. Conclusion: despite a low prevalence of M. genitalium infection among the understudied group, its cause was not established; consequently, prevention and control measures should be based on health education in the general population in order to limit the spread of this pathogen. To our knowledge, this is the first study to identify M. genitalium among the general population of Nigeria using a phylogenetic approach.

Predominance of cervicitis agents with minimal testing rate within the student population in Benin city, Nigeria.

Here, we aimed to investigate the predominance of cervicitis agents with minimal testing rates among asymptomatic students in a Tertiary Institution and its associated risk factors. Endocervical swabs were collected from randomly selected 133 female students (15-34 years of age) in Benin City, Nigeria and screened for six genital pathogens (Chlamydia trachomatis, Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum, U. parvum and Trichomonas vaginalis) using multiplex PCR. Out of the 133 subjects, 80 were positive for cervicitis with 46.3% of its agents. Five different species of the pathogens were identified with highest and lowest prevalence as: T. vaginalis (71.0%) and U. urealyticum (6.45%). Co-infection had predominance of 19.35 and 9.67% for three-organism and two-organism colonisation respectively. Strong associations were observed between the presence of cervicitis and co-infection with other genital pathogens, abortion, inconsistent condom use (p < .05). The high occurrence of cervicitis agents in our study combined with asymptomatic outcome among the subjects justifies screening for these pathogens in this population. Impact statement What is already known on this subject? Cervicitis is a genital condition among reproductive age women. It is characterised by inflammation of the uterine cervix which subsequently promotes the acquisition of certain genital conditions such as infertility and sexually transmitted infections. In various studies, there have been reports on 30-40% of cervicitis cases associated with known pathogens but left undetected within the general population. Studies have shown that majority of the cervicitis cases presents in an asymptomatic state. What the results of this study add? There may be some risk associated factors promoting the acquisition of cervicitis agents within the student population since the prevalence of these agents in this population which is underrated was relatively high. What the implication are of these findings for clinical practice and/or further research? Further investigation is needed to define the prospective influence of microbial load in colonisation of the organism and the association of new and higher sexual partners as their prevalence are not fully understood. Furthermore, our finding recommend inclusion of screening exercise for cervicitis agents within the student population which will control the infection, thereby improving female reproductive health, consequently limiting spread and serious sequelae.