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

Abstract

Background & objectives: Bacterial vaginosis (BV) is a Reproductive tract infection (RTI) among young sexually active women with high prevalence. It is associated with complications related to pregnancy and an increased risk of acquiring STDs. This poses a need for cost-effective detection of BV in low resource settings. Hence, we propose to study the utility of vaginal pH determination for the detection of BV. Material & Methods: This is a single center, 1 year cross-sectional study. Swabs were collected from 250 non-pregnant women attending the out-patient department of Obstetrics and Gynecology with vaginal discharge as a predominant symptom with or without backache and abdominal pain. Vaginal pH determination, Gram stain, wet mount, Whiff test, and Amsel’s criteria were used for BV detection. Results: 250 study participants with vaginal discharge suggestive 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 sensitivity of 85% and specificity of 66% to detect BV. The Whiff test had the least sensitivity. Clue cells and Amsel’s criteria of ≥ 3 were significant for BV. A combination of pH and Whiff test performed better had high sensitivity and specificity. Conclusions: A combination of pH determination and the Whiff test serves as a low-cost alternative in resource-poor settings for detection of BV. Though Clue cells and Amsel’s criteria ≥ 3 were most sensitive and specific, they cannot be used in low resource settings. Vaginal pH alone can be used to detect BV in areas of low prevalence.