title: Clinical characteristics associated with Mycoplasma genitalium infection among women at high risk of HIV and other STI in Uganda.
abstract: BACKGROUND
  Mycoplasma genitalium is a common infection of the genitourinary tract, but its pathogenic effects have not been well described, especially in women. The increasing evidence that M. genitalium is associated with HIV infection calls for an urgent consensus on how best to control this infection. The aim of this study was to describe symptoms and signs associated with M. genitalium infection among high-risk women in Uganda.
  
  
  METHODS
  A cohort of 1027 female sex workers was recruited in Kampala in 2008. At enrollment, HIV testing was performed, genital specimens were tested for other sexually transmitted infection, and urogenital symptoms and signs were recorded. Endocervical swabs were tested for M. genitalium using a commercial Real-TM PCR assay (Sacace Biotechnologies, Como, Italy). The associations of clinical signs and symptoms with prevalent M. genitalium were investigated using multivariable logistic regression models.
  
  
  RESULTS
  Reported dysuria and presence of mucopurulent vaginal discharge were significantly associated with M. genitalium infection (OR: 1.85, 95% confidence interval: 1.13-3.03 and OR: 1.55, 95% confidence interval: 1.06-2.29, respectively). There was little evidence for an association with cervicitis or with pelvic inflammatory disease.
  
  
  CONCLUSIONS
  In this specific population, we found evidence that symptoms of urethritis and mucopurulent vaginal discharge were associated with M. genitalium infection. This supports earlier studies showing that M. genitalium may lead to clinically relevant genitourinary disorders and should be treated. In the absence of sensitive screening tests, further work is needed to validate clinical findings as possible indicators of M. genitalium infection to guide a possible syndromic approach for its control.
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. Judith.vandepitte@mrcuganda.org
authors.forename: Judith
authors.initials: J
authors.lastname: Vandepitte
authors.forename: Justine
authors.initials: J
authors.lastname: Bukenya
authors.forename: Peter
authors.initials: P
authors.lastname: Hughes
authors.forename: Etienne
authors.initials: E
authors.lastname: Muller
authors.forename: Anne
authors.initials: A
authors.lastname: Buvé
authors.forename: Richard
authors.initials: R
authors.lastname: Hayes
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.forename: Heiner
authors.initials: H
authors.lastname: Grosskurth
mesh_terms: D000328:Adult; D015331:Cohort Studies; D053159:Dysuria / Q000453:epidemiology; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D006801:Humans; D009175:Mycoplasma Infections / Q000175:diagnosis / Q000453:epidemiology*; D045704:Mycoplasma genitalium / Q000302:isolation & purification*; D015995:Prevalence; D060386:Sex Workers / Q000706:statistics & numerical data*; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology*; D014454:Uganda / Q000453:epidemiology; D019522:Vaginal Discharge / Q000453:epidemiology; D014626:Vaginal Smears