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PURPOSE:

To estimate the prevalence of bacterial vaginosis (BV), candidiasis and
trichomoniasis and compare the findings of physical examination of the vaginal
secretion with the microbiological diagnosis obtained by cytology study of a
vaginal smear using the Papanicolaou method.

METHODS:

A cross-sectional study of 302 women aged 20 to 87 years, interviewed and
submitted to a gynecology test for the evaluation of vaginal secretion and
collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses
were carried out and specificity, positive predictive value (PPV) and negative
predictive value (NPV) with their respective 95%CI were determined to assess the
accuracy of the characteristics of vaginal secretion in relation to the
microbiological diagnosis of the cytology smear . The kappa index (k) was used to
assess the degree of agreement between the clinical features of vaginal secretion
and the microbiological findings obtained by cytology.

RESULTS

The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%,
respectively. The sensitivity, specificity, PPV and NPV of the clinical
characteristics of vaginal secretion for the cytological diagnosis of BV were 74,
78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV
of the clinical characteristics of vaginal secretion for the cytological diagnosis
of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation
between the clinical evaluation of vaginal secretion and the microbiological
diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was
0.47, 0.23 and 0.28, respectively.

CONCLUSION

The most common cause of abnormal vaginal secretion was BV. The clinical
evaluation of vaginal secretion presented amoderate to weak agreement with the
microbiological diagnosis, indicating the need for complementary investigation of
the clinical findings of abnormal vaginal secretion.