title: [Abnormal vaginal secretion: sensitivity, specificity and concordance between clinical and cytological diagnosis].
abstract: OBJECTIVE
  To estimate the prevalence of bacterial vaginosis (BV), candidiasis and trichomoniasis and compare the findings of physical examination of the vaginal secretion with the microbiological diagnosis obtained by cytology study of a vaginal smear using the Papanicolaou method.
  
  
  METHODS
  A cross-sectional study of 302 women aged 20 to 87 years, interviewed and submitted to a gynecology test for the evaluation of vaginal secretion and collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses were carried out and specificity, positive predictive value (PPV) and negative predictive value (NPV) with their respective 95%CI were determined to assess the accuracy of the characteristics of vaginal secretion in relation to the microbiological diagnosis of the cytology smear . The kappa index (k) was used to assess the degree of agreement between the clinical features of vaginal secretion and the microbiological findings obtained by cytology. RESULTS The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%, respectively. The sensitivity, specificity, PPV and NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of BV were 74, 78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation between the clinical evaluation of vaginal secretion and the microbiological diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was 0.47, 0.23 and 0.28, respectively. CONCLUSION The most common cause of abnormal vaginal secretion was BV. The clinical evaluation of vaginal secretion presented amoderate to weak agreement with the microbiological diagnosis, indicating the need for complementary investigation of the clinical findings of abnormal vaginal secretion.
authors.affiliation: Secretaria Municipal de Saúde de Goiânia, Goiânia, GO, Brasil.
authors.forename: Kélvia Cristina
authors.initials: KC
authors.lastname: de Camargo
authors.affiliation: Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brasil.
authors.forename: Rosane Ribeiro Figueiredo
authors.initials: RR
authors.lastname: Alves
authors.affiliation: Secretaria Municipal de Saúde de Goiânia, Goiânia, GO, Brasil.
authors.forename: Luciano Augusto
authors.initials: LA
authors.lastname: Baylão
authors.affiliation: Departamento de Biomedicina, Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brasil.
authors.forename: Andrea Alves
authors.initials: AA
authors.lastname: Ribeiro
authors.affiliation: Faculdade de Farmácia, Universidade Federal de Goiás, Goiânia, GO, Brasil.
authors.forename: Nadja Lindany Alves de Souza
authors.initials: NL
authors.lastname: Araujo
authors.affiliation: Faculdade de Farmácia, Universidade Federal de Goiás, Goiânia, GO, Brasil.
authors.forename: Suelene Brito do Nascimento
authors.initials: SB
authors.lastname: Tavares
authors.affiliation: Faculdade de Farmácia, Universidade Federal de Goiás, Goiânia, GO, Brasil.
authors.forename: Sílvia Helena Rabelo
authors.initials: SH
authors.lastname: dos Santos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D015995:Prevalence; D012680:Sensitivity and Specificity; D014247:Trichomonas Vaginitis / Q000175:diagnosis* / Q000453:epidemiology*; D014621:Vagina / Q000378:metabolism* / Q000382:microbiology / Q000469:parasitology; D016585:Vaginosis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology*