Utility of Vaginal pH as Point of Care Test for Detection of Bacterial Vaginosis

ABSTRACT

Background & objectives: Bacterial vaginosis (BV) is a Reproduc?ve tract infec?on (RTI) among young sexually ac?ve women with high prevalence. It is associated with complica?ons related to pregnancy and an increased risk of acquiring STDs. This poses a need for cost-effec?ve detec?on of BV in low resource se?ngs. Hence, we propose to study the u?lity of vaginal pH determina?on for the detec?on of BV. Material & Methods: This is a single center, 1 year cross-sec?onal study. Swabs were collected from 250 non-pregnant women a?ending the out-pa?ent department of Obstetrics and Gynecology with vaginal discharge as a predominant symptom with or without backache and abdominal pain. Vaginal pH determina?on, Gram stain, wet mount, Whiff test, and Amsel’s criteria were used for BV detec?on. Results: 250 study par?cipants with vaginal discharge sugges?ve of BV were analyzed. Vaginal pH was significantly higher in women with BV with the mean pH being 6.2. Vaginal pH >4.5 had a sensi?vity of 85% and specificity of 66% to detect BV. The Whiff test had the least sensi?vity. Clue cells and Amsel’s criteria of ? 3 were significant for BV. A combina?on of pH and Whiff test performed be?er had high sensi?vity and specificity. Conclusions: A combina?on of pH determina?on and the Whiff test serves as a low-cost alterna?ve in resource-poor se?ngs for detec?on of BV. Though Clue cells and Amsel’s criteria ? 3 were most sensi?ve and specific, they cannot be used in low resource se?ngs. Vaginal pH alone can be used to detect BV in areas of low prevalence.