Secreção vaginal anormal: fatores de risco e associação entre diagnóstico clínico e citológico
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2014-06-18
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Universidade Federal de Goiás
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INTRODUCTION. The balance of the vaginal microbiota is related to a woman's hormonal
status, microbial metabolism, sexual stimulation and immune response. The imbalance of
vaginal flora, induces elevation of pH, favoring infections and abnormal vaginal secretion.
OBJECTIVES. Estimating the prevalence of the bacterial vaginosis (BV), vulvovaginal
candidiasis (VVC) and trichomoniasis in cervical cytology smears, stained by the method of
Papanicolaou; studying the association between sociodemographic and behavioral variables
and microbiological findings; assessing the degree of agreement between the clinical
characteristics of vaginal secretion and microbiological findings. METHODS. Crosssectional
study performed in 302 women aged 20 to 87, referred to the Gynecology Outpatient
Clinic of the Integrated Healthcare Center Chácara do Governador, in Goiânia, Goiás, from
June 2012 to May 2013. All were patients interviewed and underwent a gynecology test.
Cervical smear was also collected for cytology. The samples were analyzed at the Rômulo
Rocha Clinical Analysis Center of the School of Pharmacy of the Federal University of Goiás
- UFG. A multiple logistic regression analysis was performed to identify sociodemographic
and behavioral factors associated to the microbiological findings from the cytology smear.
The odds ratio (OR) and adjusted OR were calculated and the confidence interval was set at
95% (CI 95%). The kappa index was used to evaluate the degree of agreement between the
characteristics of the vaginal secretion and microbiological findings. RESULTS. The
prevalence of BV, VVC and trichomoniasis was 25.5%, 9.3% and 2.0%, respectively. The
report of a previous STI (OR=2.27; CI 95%=1.15-4.49; p=0.018) and the use of vaginal
douching were associated to the diagnosis of BV (OR=4.71; CI 95%: 2.65-8.38; p=<0.001).
None of the variables studied presented a significant association with the microbiological
findings of VVC and trichomoniasis. The degree of agreement between the clinical evaluation
of vaginal secretion and the microbiological diagnosis of BV, candidiasis and trichomoniasis,
as analyzed by the kappa index was 0.47, 0.23 and 0.28, respectively. CONCLUSION. The
most prevalent microbiological diagnosis was BV. The association found between the use of
vaginal douching and BV indicated that it may be a triggering factor. The clinical evaluation
of vaginal secretion presented a moderate to weak degree of agreement with the
microbiological diagnosis, indicating the need for complementary investigation.
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CAMARGO, Kelvia Cristina de. Secreção vaginal anormal: fatores de risco e associação entre diagnóstico clínico e citológico. 2014. 66 f. Dissertação (Mestrado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2014.