Whiff Test and Vaginal pH >4.5 as Rapid and Accurate Bed-side Screening Test for Vaginal Infection

Bacterial vaginosis and Trichomonas virginals infection have been associated with adverse pregnancy and health outcomes. Aims of the study :evaluate the diagnostic yield of determination of vaginal pH considering pH>4.5 as diagnostic for vaginal infection and positive Whiff test as rapid bed-side diagnostic tests and their applicability as screening tests for vaginal infection in women apparently free of symptomsMaterials & method:current study included 120 women; 60 women were complaining of vaginal discharge (Patient group) and another 60 women have no complaint of vaginal discharge (Screening group).  An un-lubricated Cusco’s vaginal speculum was inserted into the vagina and characteristics of the discharge with respect to amount, odor and type of discharge were evaluated. Two samples of the vaginal discharge collected on dry sterile cotton wool tipped swabs. Secretions from the second swab were placed on pH indicator strips with a pH range of 3.5 to 6 to determine vaginal pH. Two drops of 10% KOH solution were added to the second and release of fishy amine odor signified a positive whiff test.Results:-three patients (55%) complained of vaginal discharge, 5 patients (8.3%) had itching and 14 patients (23.3%) had history of recurrent discharge and past history of treatment. Thirty-nine patients 39 (65%) had positive whiff test and 43 swabs (71.7%) had pH>4.5. Twenty-seven patients  were missed on reliance on clinical data only, while 21 patients were missed in case of whiff test and only 17 patients in case of pH>4.5. Thus, both tests improved the diagnosis of vaginal infection with sensitivity rate of 85% and accuracy rate of 65% compared to sensitivity rate of 58.9% and accuracy rate of 46.7% for clinical alone.Conclusion:of vaginal pH >4.5 and positive Whiff test are rapid, simple and easy to perform as bed-side diagnostic tests and could be used as screening tests for vaginal infection in women apparently free