Volume: 10 Issue: 1
Year: 2022, Page: 35-39, Doi: https://doi.org/10.47799/pimr.1001.06
Received: Nov. 14, 2021 Accepted: Feb. 5, 2022 Published: Feb. 5, 2022
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.
Keywords: Vaginal pH, Bacterial Vaginosis, Point of care test
Bhilwar, M, Lal, P, Sharma, N, Bhalla, P & Kumar, A . 2015. Prevalence of reproductive tract infections and their determinants in married women residing in an urban slum of North-East Delhi. India. J Nat Sci Biol 6(1):29–34.
Afroze, N, Shaik, M N & Jaffar, S . 2013. Identification Of Microbiological Profile Of Leucorrhoea In reproductive Age Group. An International Journal of Advances in Pharmaceutical Sciences 4(6):1464–78.
Gul, S, Qamar, H, Jawaid, W, Bukhari, U & Javed, Y . 2013. Women facing heavy vaginal discharge (Leucorrhea) by virtue of unhealthy life style. Int Res J Pharm 4(1):258–61.
Leela, K P, Ramana, K V & Madhuri, V L . 2013. Evaluation of various causes of leucorrhea in sexually active females. Int J Curr Pharm and Clin Res 3(2):93–99.
Khan, S A, Amir, F, Altaf, S & Tanveer, R . 2009. Evaluation of common organisms causing vaginal discharge. J Ayub med Coll 21(2):90–93.
Sarwat, F & Sharada, T . 2013. Evaluation of common etiological agents of leucorrhea. JMicrobiol Biotech. Res 3(3):111–116.
Rizwan, S A, Rath, R S, Vivek, G, Nitika, , Anant, G & Farhad, A . 2015. KAP Study on Sexually Transmitted Infections/Reproductive Tract Infections (STIs/RTIs) among married women in rural Haryana. (Vol. 6, pp. 9-12) Indian Dermatol Online:
Balamurugan, S S & Bendiger, N D . 2012. Community-Based Study of Reproductive Tract Infections Among Women of the Reproductive Age Group in the Urban Health Training Centre Area in Hubli, Karnataka. Indian J Community Med 37(1):34–38.
Bhargava, D, Kar, S, Saha, A & Saha, M . 2016. Prevalence of Vaginitis in Females Attending National Medical College and Teaching Hospital. Ind J of Med Res and Pharma Sci 3(7):39–43.
Thorsen, P, Jensen, I P, Jeune, B, Ebbesen, N, Arpi, M & Bremmelgaard, A . 1998. Few microorganisms associated with bacterial vaginosis may constitute the pathologic core: a population-based microbiologic study among 3596 pregnant women. Am J 178:580–587.
Hillier, S L, Nugent, R P, Eschenbach, D A, Krohn, M A, Gibbs, R S & Martin, D H . 1995. Association between bacterial vaginosis and preterm delivery of a low birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med 333:1737–1779.
Rizwan, S A, Rath, R S, Vivek, G, Nitika, , Anant, G & Farhad, A . 2015. KAP Study on Sexually Transmitted Infections/Reproductive Tract Infections (STIs/RTIs) among married women in rural Haryana. (Vol. 6, pp. 9-12) Indian Dermatol Online:
2005. World Health Organization. Sexually transmitted and other reproductive tract infections. Geneva: WHO 11–21.
Amsel, R, Totten, P A, Spiegel, C A, Chen, K C S, Eschenbach, D A & Holmes, K K . 1983. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations. Am. J. Med 74:14–22.
Nugent, R P, Krohn, M A & Hillier, S L . 1991. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J. Clin. Microbiol 29:297–301.
Hemalatha, R, Ramalaxmi, B A, Swetha, E, Balakrishna, N & Mastromarino, P . 2013. Evaluation of vaginal pH for detection of bacterial vaginosis. Indian J Med Res 138(3):354–363.
Posner, S F, Kerimova, J, Aliyeva, F & Duerr, A . 2005. Strategies for diagnosis of bacterial vaginosis in a resource-poor setting. Int J STD AIDS 16:52–57.
Schwebke, J R, Hillier, S L, Sobel, J D, Mcgregor, J A & Sweet, R L . 1996. Validity of the vaginal gram stain for the diagnosis of bacterial vaginosis. Obstet Gynecol 88:73–79.
Metgud S, Gangigute S, Metgud S. Utility of Vaginal pH as Point of Care Test for Detection of Bacterial Vaginosis. Perspectives in Medical Research. 2022;10(1):35-39 DOI: 10.47799/pimr.1001.06