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Accuracy of Nugentís Score and Each Amselís Criteria in the Diagnosis of Bacterial Vaginosis

1270

Kantida Chaijareenont MD*, Korakot Sirimai MD*,
Dittakarn Boriboonhirunsarn MD, MPH, PhD*, Orawan Kiriwat MD*

* Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University

Abstract


Objective : To determine the diagnostic accuracy of Nugentís score and each Amselís criterion in the diagnosis of bacteria vaginosis (BV), considering Amselís criteria as the gold standard.
Design : Cross-sectional, descriptive study (diagnostic test)
Setting : Family planning clinic, Siriraj Hospital, Mahidol University
Subjects : A total of 217 women who attended the Family Planning Clinic at Siriraj Hospital between August and December 2003
Method : Pelvic examination was performed on each participant. Samples of vaginal discharge was tested for BV infection using both Amselís criteria and Nugentís score. Interpretation was made blinded without knowledge of each test result. Using Amselís criteria as a gold standard, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Nugentís score and each of Amselís criteria were estimated.
Results : Considering Amselís criteria as the gold standard, Nugentís score showed a sensitivity of 65.6% (95%CI 46.8%, 80.8%), specificity of 97.3% (95%CI 93.5%, 99.0%), positive predictive value (PPV) of 80.8% (95%CI 60.0%, 92.7%), negative predictive value (NPV) of 94.2% (95%CI 89.7%, 96.9%) and accuracy of 92.6% (95%CI 88.1%, 95.6%). Both vaginal pH and whiff test demonstrated 100% sensitivity. However, vaginal pH showed lower specificity than the whiff test (58.9% and 97.3% respectively).
Conclusion : Nugentís score might not be suitable to use as a screening test for diagnosis of BV due to its low sensitivity. The whiff test is the best clinical criteria of Amselís criterion in the diagnosis of BV due to its high sensitivity and specitivity.

Keyword : Bacteria vaginosis, Diagnosis, Amselís criteria, Nugentís score



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