title: Sexually transmitted infections among female sex workers in Tunisia: high prevalence of Chlamydia trachomatis.
abstract: OBJECTIVE
  The aim of this study was to determine the prevalence of Chlamydia trachomatis infection and other sexually transmitted infections (STI) in female sex workers (FSW) in Tunisia.
  
  
  METHODS
  188 prostitutes from three Tunisian towns were enrolled at their weekly medical visit. Demographic and sexual behaviour data were collected. C trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2 (HSV-2) and human papillomavirus (HPV) were detected by PCR. Blood samples were tested for the presence of HIV, hepatitis B core, hepatitis C virus (HCV), HSV-2, C trachomatis and syphilis antibodies and Hbs antigen.
  
  
  RESULTS
  The mean age of the FSW was 34&emsp14;years. They had worked in the sex industry for 6.6&emsp14;years on average. Nearly all FSW (98.9%) had at least one marker of STI. A current infection was found in 86.7% of cases. Only one STI was noted in 37.2% and two or more in 49.5% of FSW. C trachomatis, N gonorrhoeae, HPV and HSV-2 PCR were positive in 72.9%, 11.2%, 44.1% and 1.1% of cases, respectively. Syphilis, HCV antibodies and Hbs antigen were detected in poor percentages, 2.7%, 1.1% and 0.5% of cases, respectively. No case of HIV infection was noted. No epidemiological or clinical factors were associated with STI. Only disturbed bacterial vaginal flora was found to be associated with C trachomatis infection.
  
  
  CONCLUSIONS
  In this study, a high rate of C trachomatis infection was observed. The detection of this microorganism should be introduced in systematic surveillance of Tunisian FSW.
authors.affiliation: Laboratory of Microbiology, Habib Bourguiba University Hospital, Route el Ain Km 0.5, 3027 Sfax, Tunisia. abirznazen2001@yahoo.fr
authors.forename: Abir
authors.initials: A
authors.lastname: Znazen
authors.forename: Olfa
authors.initials: O
authors.lastname: Frikha-Gargouri
authors.forename: Lamia
authors.initials: L
authors.lastname: Berrajah
authors.forename: Sihem
authors.initials: S
authors.lastname: Bellalouna
authors.forename: Hela
authors.initials: H
authors.lastname: Hakim
authors.forename: Nabiha
authors.initials: N
authors.lastname: Gueddana
authors.forename: Adnene
authors.initials: A
authors.lastname: Hammami
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology*; D002692:Chlamydia trachomatis; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D014416:Tunisia / Q000453:epidemiology; D047568:Unsafe Sex