Reliability of self-collected versus provider-collected vaginal swabs for the diagnosis of bacterial vaginosis

Abstract

Women reluctant to undergo a per-speculum examination consider self-sampling more acceptable. The aim of this study was to compare self-collected vaginal swabs for detection of bacterial vaginosis (BV), candidiasis and trichomoniasis, with vaginal specimens obtained by the gynaecologist at per-speculum examination. Self-collected and provider-collected vaginal swabs were obtained from 50 women attending the gynaecological outpatients department. The Gram-stained smears and saline wet mounts prepared from the provider-collected vaginal swabs were examined by a microbiologist and a gynaecologist. We determined the validity and the inter-rater reliability of the overall BV score and the morphotype specific score using Kappa statistics. When compared with the provider-collected smear, the ability of the self-collected smear to diagnose BV had a sensitivity of 70% and a specificity of 97%. With specific instructions to help assure the depth of sampling, self-collected swabs can reasonably approximate specimens obtained by clinicians during speculum examination for the diagnosis of BV.

Vaginal microbiome in early pregnancy and subsequent risk of spontaneous preterm birth: a case–control study

“…In the first trimester of pregnancy (8+ 0 –13 +6 weeks), two vaginal swabs were self‐collected after instructions were provided by trained research staff. Studies have shown strong validity for the overall and morphotype‐specific scores comparing self‐collected swabs with those collected by trained health professionals and high intra‐rater and inter‐rater reliabilities . One vaginal swab was rolled onto glass slides, air‐dried, Gram‐stained and examined under oil immersion for vaginal microbiota assessment using the Nugent score .…”

“…Studies have shown strong validity for the overall and morphotype-specific scores comparing self-collected swabs with those collected by trained health professionals 19 and high intra-rater and inter-rater reliabilities. 20 One vaginal swab was rolled onto glass slides, air-dried, Gram-stained and examined under oil immersion for vaginal microbiota assessment using the Nugent score. 4 The other vaginal swab was placed in a tube without any buffer and immediately stored at À80°C until assayed.…”

Prevalence of Bacterial Vaginosis and Candida among Postmenopausal Women in the United States

“…It also broadens the population studied to include women who are uncomfortable having someone else examine their genital area. The self-collected vaginal swab remains an accepted and highly sensitive method for vaginal microbiology collection in clinical or field studies or for women without access to a gynecological clinic (Chernesky et al, 2005;Kashyap, Singh, Bhalla, Arora, & Aggarwal, 2008).…”

Evaluation of reliability of self-collected vaginal swabs over physician-collected samples for diagnosis of bacterial vaginosis, candidiasis and trichomoniasis, in a resource-limited setting: a cross-sectional study in India

“…Moreover, the samples were examined only by Gram’s stain for their sensitivity for the diagnosis of STIs and were not tested by other diagnostic techniques like wet mount and culture. Another study was performed in New Delhi,9 which showed that self-collected swabs can reasonably approximate physician-collected swabs for BV only. However, this study also was limited by a statistically small sample size.…”