阴道pH值作为检测细菌性阴道病的护理点试验的应用

Shridevi Metgud, Spurthi Gangigute, S. Metgud
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摘要

摘要背景与目的:细菌性阴道病(BV)是一种生殖道感染(RTI),在性活跃的年轻女性中发病率较高。它与妊娠相关的并发症和获得性传播疾病的风险增加有关。这提出了在低资源设置中对BV的成本效益检测的需求。因此,我们建议研究阴道pH值测定在BV检测中的作用。材料和方法:这是一项单中心、1年的横断面研究。从250名在妇产科门诊就诊的非孕妇身上采集拭子,这些妇女的主要症状是阴道分泌物,伴有或不伴有背痛和腹痛。阴道pH值测定、革兰氏染色、湿贴、Whiff试验和Amsel标准用于BV检测。结果:对250名阴道分泌物提示BV的研究参与者进行了分析。BV患者阴道pH值显著升高,平均pH值为6.2。阴道pH>4.5检测BV的敏感性为85%,特异性为66%,Whiff试验的敏感性最低。线索细胞和Amsel标准≥3对BV有显著意义。pH和Whiff试验联合应用表现较好,具有较高的敏感性和特异性。结论:在资源匮乏的环境中,pH测定和Whiff试验相结合是检测BV的一种低成本的替代方法。尽管Clue细胞和Amsel标准≥3是最敏感和特异的,但它们不能在资源不足的环境中使用。阴道pH值可以单独用于低流行地区的BV检测。
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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.
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