COMPARATIVE STUDY TO CHECK THE EFFICACY OF pH STRIP & pH GLOVES FOR DETECTION OF BACTERIAL VAGINOSIS IN A TERTIARY CARE HOSPITAL
Keywords:Bacterial Vaginosis, Cross-sectional study, pH Strip, pH Gloves, Nil
Objectives: Comparative study to check the efficacy of pH Strip & pH Gloves for Detection of Bacterial Vaginosis in a Tertiary Care Hospital.
Methods: It was a duly approved, cross-sectional study in which 50 subjects were enrolled from Tertiary care hospital, New Delhi, India. Written informed consent was obtained from all women. Vaginal swabs were collected for vaginal pH measurement. Vaginal pH was evaluated immediately with the pH strips and vaginal pH glove simultaneously.
Results: The study was done on to check the efficacy of pH strip & pH gloves in pregnant as well as non-pregnant women by regularly visiting the tertiary care hospital. Among 50 subjects 8(16%) were Pregnant and 42(84%) were Non-pregnant. The mean age of the patients included in the study was found to be 26.1Â±19.5 years. After a Gram stain and microscopic examination of samples obtained from 50 women, those with intermediate flora and Candida infection were excluded and the final analysis was done on 40 samples. Among 40, 15 were diagnosed with BV and 25 had normal vaginal flora based on Nugents' score.
Conclusions: Our findings show that vaginal pH determination is relatively sensitive, but less specific in detecting women with BV. Both pH glove and pH strip are equally suitable for screening women with BV on an outpatient basis. Further studies are required to explore the possibility of self-evaluation of vaginal pH with pH glove at community level.
Gorodeski GI, U Hopfer, CC Liu, E Margles. Estrogen acidifies vaginal pH by up-regulation of proton secretion via the apical membrane of vaginal-ectocervical epithelial cells. Endocrinol 2005;146:816-24.
Verstraelen H. Bacterial vaginosis: a sexually enhanced disease. Int J STD AIDS 2008;19:575-6.
Cauci S, S Driussi, D De Santo, P Penacchioni, T Iannicelli, P Lanzafame, et al. Prevalence of bacterial vaginosis and vaginal flora changes in peri-and postmenopausal women" J Clin Microbiol 2002;40:2147-52.
Manetta A, Pinto JL, Larson JE, Stevens CW, Pinto JS, Podczaski ES. Primary invasive carcinoma of the vagina. Obstet Gynecol 1988;72(1):77â€“81.
Martin R, JE Suarez. Biosynthesis and degradation of H2O2 by vaginal lactobacilli. Appl Environ Microbiol 2010;76:400-5.
Simoes JA, Discacciati MG, Brolazo EM, Portugal PM, Dini DV, Dantas MCM. Clinical diagnosis of bacterial vaginosis. Int J Gyncol Obstet 2006;94:28-32.
Davidson KM. Detection of premature rupture of the membranes. Clin Obstet Gyncol 1991;34(4):715-22.
World Health Organization, Geneva. Sexually transmitted and other reproductive tract infections; 2005. p. 11â€“21.
Thorsen P, Jensen IP, Jeune B, Ebbesen N, Arpi M, Bremmelgaard A, et al. Few microorganisms associated with bacterial vaginosis may constitute the pathologic core: a population-based microbiologic study among 3596 pregnant women. Am J Obstet Gynecol 1998;178:580â€“7.
Gillet E, Meys JFA, Verstraelen H, Bosine C, Sutter DP, Temmerman M, et al. Bacterial vaginosis is associated with uterine cervical human papillomavirus infection: a meta-analysis. BMC Infect Dis 2011;11:10-6.
Cherpes TL, Meyn LA, Krohn MA, Lurie JG, Hillier SL. Association between acquisition of Herpes simplex virustype 2 in women and bacterial vaginosis. Clin Infect Dis 2003;37:319â€“25.
Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983;74:14â€“22.
Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improving by a standardized method of Gram stain interpretation. J Clin Microbiol 1991;29:297â€“301.
World Health Organization, Regional Office for the Western Pacific, Manila. Syndromic case management of STD; 1997.
Eschenbach DA, Hillier S, Critchlow C, Stevens C, DeRouen T, Holmes KK. Diagnosis and clinical manifestations of bacterial vaginosis. Am J Obstet Gynecol 1988;158(4):819â€“28.
Choncleying V, Skor S, Kemapunmans M, Law M, Creator A, Rowe P. Evaluation of two clinical protocols for the management of woman with vaginal discharge in Southern Thailand. Sexually Transmitted Infections 1998;74:194â€“201.
Posner SF, Kerimova J, Aliyeva F, Duerr A. Strategies for diagnosis of bacterial vaginosis in a resource-poor setting. Int J STD AIDS 2005;16:52â€“5.
Schwebke JR, Hillier SL, Sobel JD, McGregor JA, Sweet RL. Validity of the vaginal gram stain for the diagnosis of bacterial vaginosis. Obstet Gynecol 1996;88:573â€“6.
Thomason JL, Gelbart SM, Anderson RJ, Walt AK, Osypowski PJ, Broekhizen FF. Statistical evaluation of diagnostic criteria for bacterial vaginosis. Am J Obstet Gynecol 1990;162:155â€“60.
Thulkar J, Kriplani A, Agarwal N. Utility of pH test & Whiff test in syndromic approach of abnormal vaginal discharge. Indian J Med Res 2010;131:445â€“8.
Pavletic AJ, Hawes SE, Geske JA, Bringe K, Polack SH. Experience with routine vaginal pH testing in a family practice setting. Infect Dis Obstet Gynecol 2004;12:63â€“8.
Pramanik JM, Kerkar SC, Mehta PB, Potdar S, Salvi VS. Use of vaginal pH in diagnosis of infections and its association with reproductive manifestations. J Clin Lab Anal 2008;22:375â€“9.
Forrest S, Mc Caffery K, Waller J, Desai M, Szarewski A, Cadman L, et al. Attitudes to self-sampling for HPV among Indian, Pakistani, African, African-Caribbean and white British women in Manchester, UK. J Med Screening 2004;11:85â€“8.
Ferris DG, Francis SL, Dickman ED, Miler-Miles K, Waller JL, McClendon N. Variability of vaginal pH determination by patients and clinicians. J Am Board Family Med 2006;19:368â€“73.