Background/introduction Vaginal discharge and vulvitis are common presenting symptoms in both sexual health services and general practice. Due to various constrains particularly in general practice, examination of a patient may not be possible. Syndromic management is often practiced but can be unreliable. Few studies to date have specifically looked at the validity of self-collected vulvovaginal swab for the diagnosis of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC)
Aim(s)/objectives To describe agreement between self-collected vulvovaginal swabs and clinician taken high vaginal swabs for the detection of BV and VVC.
Design Case controlled study with the patient acting as her own control.
Setting An urban sexual health centre. Participants: Women aged 16–65 years attending with symptomatic vaginal discharge, vulval irritation or an offensive genital smell. Interventions: Participants took a vulvovaginal swab prior to speculum insertion and vaginal examination during which a clinician took a high vaginal swab. Main outcome measure: Diagnosis of BV or VVC infection with samples analysed in a microbiology department using both microscopy and culture.
Results 104 women were enrolled in the study. Of these 45 were diagnosed with VVC. 26 were diagnosed with BV. Using the reference standard of laboratory testing, the sensitivities of self-collected vulvovaginal swabs for BV and VVC were 88.5% and 95.5% respectively. The Cohen Kappa score showed strong agreement for the detection of both BV and VVC (k = 0.842 and k = 0.878 respectively).
Discussion/conclusion Self-collected vulvovaginal swabs appear to be a valid alternative to clinician taken high vaginal swabs for detecting BV and VVC infections.