Background: Bacterial vaginosis (BV), a disturbance of vaginal microflora, is a common cause of vaginal symptoms and is associated with an increased risk of acquisition of sexually transmitted infections, HIV, and with adverse pregnancy outcomes.

Objectives: We studied the overall prevalence of BV in symptomatic women, compared the efficacy of Gram stain and Papanicolaou (Pap) smear and determined the sensitivity and specificity of clinical criteria.

Material and Methods: The present prospective and analytical study was a part of ICMR funded project done over a period of 2 months. This study included 150 non pregnant women attending   gynaecological outpatient department. High vaginal smears were Gram-stained and examined and characterized into 5 grades of vaginal flora and diagnose BV.Smears were PAP-stained and examined. The results of the 2 methods were compared.

Results: In our study, prevalence of BV was 23.3% using clinical criteria as gold standard. Considering the clinical criteria as gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of Gram stain for diagnosis of bacterial vaginosis were 80.0%, 98.3%, 93.3% and 94.2%, respectively. Considering the clinical criteria as gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of Pap stain for diagnosis of bacterial vaginosis were 60.0%, 94.8%, 77.8% and 88.6%, respectively.

Conclusions: Given the high prevalence, it is critical to diagnose and treat women, affected by BV appropriately. If Amsel’scriteria is accepted as the gold standard for diagnosis of BV, Gram stain has greater sensitivity and specificity.