Epidemiology and Infection

Research Article

Vaginal symptoms and bacterial vaginosis (BV): how useful is self-report? Development of a screening tool for predicting BV status

D. B. NELSONa1 c1, S. BELLAMYa2, A. ODIBOa3, I. NACHAMKINa4, R. B. NESSa5 and L. ALLEN-TAYLORa2

a1 Department of Public Health and Ob/Gyn, Temple University, Philadelphia, PA, USA

a2 Department of Biostatistics and Clinical Epidemiology, University of Pennsylvania School of Medicine, PA, USA

a3 Washington University Medical Center, Department of Ob/Gyn, St Louis, MO, USA

a4 Clinical Microbiology Laboratory, University of Pennsylvania School of Medicine, Philadelphia, PA, USA

a5 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

SUMMARY

Vaginal complaints compel an evaluation of bacterial vaginosis (BV), however, many cases of BV are asymptomatic. We evaluated the sensitivity and specificity of vaginal symptoms in the diagnosis of BV and examined the utility of creating a BV screening tool using clinical, behavioural and demographic characteristics. A total of 1916 pregnant women were included in this analysis. In total, 757 women screened positive for BV and over one third of BV-positive women presented without any lower genital tract symptoms (39·4%). African American race, abnormal vaginal odour, and smoking were independently related to BV positivity. A BV screening tool including these three factors was fairly predictive of BV status with the area under the ROC curve equal to 0·669. This three-item prediction rule may be useful in identifying high- risk pregnant women in need of BV screening and, given the high specificity, accurately identify the group of BV-negative pregnant women.

(Accepted November 22 2006)

(Online publication February 05 2007)

Correspondence:

c1 Author for correspondence: D. B. Nelson, Ph.D., Assistant Professor, Department of Public Health and Ob/Gyn, Temple University, 1700 North Broad Street – Room 304F, Philadelphia, PA 19122, USA. (Email: dnelson@temple.edu)

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