Prevalence and associated factors of Chlamydia trachomatis and Neisseria gonorrhoeae among female commercial sex workers in Hawassa City, Southern Ethiopia

摘要

BackgroundNeisseria gonorrhoea and Chlamydia trachomatis are among the main pathogens causing sexually transmitted infections (STIs) [1, 2]. The World Health Organization (WHO) estimated that 50 million women worldwide were newly infected with C. trachomatis; of which, 34 million were in Sub-Saharan Africa and South/Southeast Asia [3]. With annual 82 million estimated cases globally, N. gonorrhoeae has been recognized as one of the major bacterial STIs. An estimated 17 and 27 million new cases annually occurred in Africa and in Southern Asia, respectively [1].In women, urogenital C. trachomatis and N. gonorrhoeae infections cause broad spectrum of clinical manifestations, including urethritis, cervicitis, and pelvic inflammatory disease. If untreated, these infections may lead to serious complications, including ectopic pregnancy and tubal infertility [4]. However, over 50% of women with gonorrhea and 75% of women with C. trachomatis remain asymptomatic during the entire infection process. Thus, they are unaware of their infection to seek treatment, which facilitates further spread to their sexual partners [5, 6].It was reported that chlamydial infection often occurred among women aged 15–29?years due tohost related factors such as the number of sexual partner, contraceptive use, sexual preference, and population mobility [5]. Female commercial sex workers (FCSWs) are at higher risk of contracting the infection [7], due to their social vulnerability and work related factors, like a history of having multiple sexual partners, inconsistent condom use, and a history of having STIs [8, 9]. FCSWs also link the spread of STIs to the general population through their clients [10].In Ethiopia, the epidemiology of C. trachomatis and N. gonorrhoeae infection is not well described due to the asymptomatic nature of the infection and lack of laboratory diagnostic facilities. However, a hospital-based study that investigated women of reproductive age (15–49?years) reported prevalence of C. trachomatis and N. gonorrhoeae was 18.9 and 0.31%, respectively [11]. It would be important to study FCSWs to emphasize the need of strengthening intervention strategies that address the risk group. Therefore, this study aimed to assess the prevalence and associated risk factors of C. trachomatis and N. gonorrhoeae infections among FCSWs. The findings from this study help public health experts and other concerned bodies to design and undertake evidence-based interventions.