Mayaud P, Cook K, Demba E, West B, Ekpo G, Scherf C, Morison L, Walraven G; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. MoPeA2105.
P. Mayaud, London School of Hygiene and Tropical Medicine, Keppel street,, London WC1E 7HT,, United Kingdom, Tel.: +44 171 927 2291, Fax: +44 171 637 4314, E-mail: philippe.mayaud@lshtm.ac.uk
Background: Bacterial vaginosis (BV) could increase susceptibility to HIV, but is not currently diagnosed in many developing country (DC) settings owing to the lack of practical, affordable and reliable methods of diagnosis. Objective: to evaluate the performance of a new commercial rapid diagnostic test kit for BV in DC setting. Methods: 477 women were enrolled in a reproductive morbidity community survey in a rural area of The Gambia. BV was diagnosed using Nugent's vaginal gram stain score 3 7. Amsel's clinical criteria for BV (3 or more of : vaginal pH > 4.5; amine odour; clue cells; abnormal vaginal discharge) were also evaluated. Two vaginal swabs were collected for the evaluation of the FemExamO card tests for pH and detection of trimethylamine (card 1) and proline iminopeptidase (PIP) activity indicative of G vaginalis (card 2). Results: The prevalence of BV was 38% (182/477); further 22% and 39% of women had intermediate and normal vaginal flora patterns, respectively. Only 71 (39%) women with BV complained of a vaginal discharge. The use of FemExam card 1 or card 2 individually gave sensitivities of 45% and 65%, respectively, with specificities of 90% and 77%, respectively. The use of the 2 cards together gave a sensitivity of 36% and a specificity of 94%. Amsel clinical criteria had a sensitivity of 39% and specificity of 94%, whilst use of pH paper alone had a sensitivity of 92% and a specificity of 46%. The FemExam tests were simple and rapid to use (2 minutes), with perceived easier interpretation by users. The cost per true BV case-detected-and-treated ranged from $1.25 using Gram stain, $2.0 using pH paper, $7.2 using FemExam card 1, and $15.8 using the 2 cards. Conclusions: Asymptomatic BV was common in this population of rural Gambian women. FemExam tests did not appear superior to cheaper but not always readily available alternative methods.
Publication Types:
Keywords:
- Africa
- Bacteria
- Bacteriological Techniques
- Developing Countries
- Female
- Gambia
- Gentian Violet
- Gram's stain
- HIV
- HIV Infections
- Humans
- Phenazines
- Prevalence
- Proto-Oncogene Proteins c-kit
- Sensitivity and Specificity
- Vagina
- Vaginal Discharge
- Vaginosis, Bacterial
- diagnosis
- immunology
- methods
Other ID:
UI: 102237652
From Meeting Abstracts