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Bacterial vaginosis (BV) is a clinical syndrome associated with altered vaginal ecology and a spectrum of vulvovaginal symptoms, including malodorous discharge and elevated pH. It is common among pre-menopausal women and has been implicated in adverse sexual and reproductive outcomes.1–3 Traditionally, BV has been diagnosed by Amsel’s clinical criteria or laboratory-based Nugent scoring method. However, due to realistic constraints in clinical practice, either syndromic case management is favoured or modified clinical criteria are used, leading to misdiagnosis and unfavourable health outcomes. We therefore sought to evaluate the concordance between the standard diagnostic tests – Amsel’s criteria and the Nugent scoring method. Additionally, we evaluated the accuracy of individual and combinations of two Amsel’s criteria for BV diagnosis.
A prospective, longitudinal study was conducted from August 2018 to February 2021 in the Sexually Transmitted Diseases (STD) and Obstetrics and Gynaecology out-patient departments at the All India Institute of Medical Sciences, New Delhi, India. Women who were pregnant, lactating, menstruating, or had received oral antibiotics in the preceding 4 weeks were excluded. The study was approved by the Institute Ethics Committee, All India Institute of Medical Sciences, New Delhi and informed consent was obtained from all participants.
A total of 293 participants were enrolled in the study and vaginal swabs were collected. Additionally, BV-positive women were treated and repeat swabs were collected at week 1, week 4 and thereafter quarterly...