Screening for abnormal vaginal microflora by self-assessed vaginal pH does not enable detection of sexually transmitted infections in Ugandan women.
OBJECTIVE
Is self-assessed vaginal pH measurement to detect abnormal vaginal bacterial microflora (AVF) an adequate prescreening method for detection of genital sexually transmitted infections (STIs)?


METHODS
A total of 360 Ugandan women tested themselves with a gloved finger and a pH color strip. PCR for bacterial vaginosis (BV)-associated bacteria was tested by PCR for Mycoplasma hominis, Ureaplasma urealyticum, and/or Atopobium vaginae, while the STIs were diagnosed by positive PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and/or Trichomonas vaginalis.


RESULTS
A strong correlation was found between self-assessed pH values and BV-associated bacteria (P<0.0001), but not with STIs, not as single infections, nor in general.


CONCLUSIONS
Self-measured vaginal pH correlated well with markers of high-risk microflora types such as BV or aerobic vaginitis, but not with STIs. Hence, in a screening program addressing AVF in low-resource countries, extra specific tests are required to exclude STIs.
Femicare vzw, Clinical Research for Women, Tienen, Belgium; Department of Obstetrics and Gynaecology, University Hospital Antwerpen, Antwerp, Belgium; Department of Obstetrics and Gynaecology, General Hospital H Hart, Tienen, Belgium. Electronic address: gilbert.donders@femicare.net.
Gilbert G G
GG
Donders
Faculty of Medicine, University of Leuven, Leuven, Belgium. Electronic address: Francesca.donders@gmail.com.
Francesca
F
Donders
Femicare vzw, Clinical Research for Women, Tienen, Belgium. Electronic address: gert.bellen@femicare.net.
Gert
G
Bellen
Department of Molecular Diagnostics, Algemeen Medisch Laboratorium (AML), Sonic HealthCare Benelux, Antwerp, Belgium. Electronic address: christophe.depuydt@aml-lab.be.
Christophe
C
Depuydt
Faculty of Medicine, University of Ghent, Ghent, Belgium. Electronic address: natalie.eggermont@ugent.be.
Natalie
N
Eggermont
Faculty of Medicine, University of Leuven, Leuven, Belgium. Electronic address: thirsa.michiels@uzleuven.be.
Thirsa
T
Michiels
Department Obstetrics and Gynaecology, Mulago University Hospital, Kampala, Uganda. Electronic address: lulejc@yahoo.co.uk.
John
J
Lule
Department Obstetrics and Gynaecology, Mulago University Hospital, Kampala, Uganda. Electronic address: byamugishar@yahoo.co.uk.
Jacobat
J
Byamughisa
D000328:Adult; D064806:Dysbiosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008403:Mass Screening / Q000379:methods*; D011247:Pregnancy; D012646:Self Administration; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D013048:Specimen Handling / Q000379:methods*; D014454:Uganda; D014621:Vagina / Q000737:chemistry*
Abnormal vaginal flora; Aerobic vaginitis; Bacterial vaginosis; C. trachomatis; Lactobacillary grades; M. genitalium; N. gonorrhoeae; PCR; Screening; T. vaginalis