RT Journal Article
SR Electronic
T1 Self-taken vaginal swabs versus clinician-taken for detection of candida and bacterial vaginosis: a case-control study in primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e824
OP e829
DO 10.3399/bjgp17X693629
VO 67
IS 665
A1 Pam Barnes
A1 Rute Vieira
A1 Jayne Harwood
A1 Mayur Chauhan
YR 2017
UL http://bjgp.org/content/67/665/e824.abstract
AB Background Vaginal discharge and vulvitis are common presenting symptoms in general practice. Few studies have specifically looked at the validity of self-taken low vulvovaginal swabs (LVS) for the diagnosis of vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV).Aim To assess if patient self-taken LVS are a valid alternative to clinician-taken high vaginal swabs (HVS) for the detection of VVC and BV.Design and setting Case-control study with the patient acting as their own control in an urban sexual health centre in Newcastle upon Tyne, UK.Method Females aged 16–65 years attending with symptomatic vaginal discharge, vulval irritation, genital pain, and an offensive genital smell were recruited into the study. Participants took a self-taken LVS before vaginal examination, during which a clinician took an HVS (reference standard). Main outcome measures were the diagnosis of BV or VVC infection.Results A total of 104 females were enrolled. Of those, 45 were diagnosed with VVC and 26 with BV. The sensitivities of self-taken LVS for VVC and BV were 95.5% and 88.5% respectively. Cohen’s κ coefficient showed ‘strong agreement’ for the detection of both VVC and BV. Vulval itching was the most common symptom associated with VVC (69%), whereas 50% of females diagnosed with BV presented with an offensive discharge. Both symptoms had poor positive predictive values (0.63 and 0.50, respectively).Conclusion Self-taken LVS appears to be a valid alternative to clinician-taken HVS for detecting VVC and BV infections. Symptoms were found to be a poor indicator of underlying infection.