Rapid clinical diagnostic tests for bacterial vaginosis and its predictive value

ABSTRACT

To determine the sensitivity and specificity of Amsel's criteria for diagnosis of bacterial vaginosis. This study was carried out at the Outdoor Department of Obstetrics and Gynaecology Fauji Foundation Hospital Rawalpindi from 20[th] Feb to 20[th] August 2008. A total of 556 pregnant patients were seen among which 208 patients had complaints of vaginal discharge. These patients were then scrutinized for the diagnosis of bacterial vaginosis by employing rapid clinical tests i.e. Amsel criteria, which was further confirmed by gram staining in laboratory. Among 208 symptomatic women bacterial vaginosis was diagnosed in 38.55% [n=80]. These women had 3 out of 4 Amsel's criteria fulfilled i.e. presence of milky white vaginal discharge, clue cells, Whiff test or alkaline pH. The specificity of each criterion was calculated which came out to be 96% while for the Amsel's criteria it was 96.8%.The sensitivity was 84% of milky white discharge, 87% of Whiff test, 82% of clue cells and 86% of pH while the overall sensitivity of Amsel criteria was 92%. Amsel's criteria is a sensitive method for the diagnosis of bacterial vaginosis when compared with gram staining. It provides us with a rapid clinical results with sensitivity of Whiff test being 87%