title: Strategies for diagnosis of bacterial vaginosis in a resource-poor setting.
abstract: This study evaluated Amsel's criteria, the FemExam card and pH plus amine methods for the diagnosis of bacterial vaginosis (BV) in a resource-poor setting. Two hundred Azerbaijani women participated in a study about reproductive health that included a gynaecological examination and an interviewer-administered survey. Using the WHO syndromic diagnosis algorithm, nearly all women (99%) had abnormal vaginal discharge. The prevalence of BV by Gram stain was 35%; using pH plus amine, the FemExam card and Amsel's criteria, prevalence ranged from 29% to 49%. No behavioural or demographic characteristics were associated with BV as diagnosed by Gram stain. The sensitivity ranged from 0.59 to 0.74 and specificity from 0.65 to 0.92 using the three methods. The pH plus amine test is better than syndromic management protocols, and although it is not the most sensitive or specific of the three methods it will be easiest to implement in resource-poor settings.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Mail Stop K-34, Atlanta, GA 30341, USA. SHPS@CDC.GOV
authors.forename: S F
authors.initials: SF
authors.lastname: Posner
authors.forename: J
authors.initials: J
authors.lastname: Kerimova
authors.forename: F
authors.initials: F
authors.lastname: Aliyeva
authors.forename: A
authors.initials: A
authors.lastname: Duerr
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000588:Amines / Q000032:analysis; D001382:Azerbaijan; D003906:Developing Countries; D005260:Female; D005840:Gentian Violet; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008875:Middle Aged; D010619:Phenazines; D015995:Prevalence; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D019522:Vaginal Discharge; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D000588:Amines; C035863:Gram's stain; D010619:Phenazines; D011933:Reagent Kits, Diagnostic; D005840:Gentian Violet