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BioMed Research International
Volume 2013 (2013), Article ID 365194, 5 pages
Clinical Study

Comparison of Hay’s Criteria with Nugent’s Scoring System for Diagnosis of Bacterial Vaginosis

1Centre of AIDS and Related Diseases, National Centre for Disease Control, 22 Shamnath Marg, New Delhi 110054, India
2Department of Microbiology, Maulana Azad Medical College, Delhi University, Bahadur Shah Zafar Marg, New Delhi 110002, India
3Department of Community Medicine, Maulana Azad Medical College, Delhi University, Bahadur Shah Zafar Marg, New Delhi 110002, India

Received 30 April 2013; Accepted 28 May 2013

Academic Editor: Sohinee Bhattacharya

Copyright © 2013 Rohit Chawla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Although Nugent’s criterion is considered as the gold standard for the diagnosis of bacterial vaginosis (BV), the method requires an experienced slide reader and considerable time and skill. In this study, we compared the method of Hay and Ison with Nugent’s scoring criteria. Vaginal specimens were collected from a total of 213 women, presenting with or without the symptoms of vaginitis. Diagnosis of BV was done using Nugent’ and Hay’s method. Sensitivity, specificity, and predictive values for positive and negative test were calculated for Hay’s method using Nugent’s method as the gold standard. We diagnosed 70 cases (32.86%) of BV by Nugent’s method and 87 (40.85%) cases by the Hay’s method. Sensitivity, specificity, predictive value of positive result, predictive value of negative result, and Kappa value when evaluating Hay’s criteria using Nugent’s criteria as the gold standard were ≥97.2%, ≥88.1%, ≥80.4%, ≥97.1%, and ≥0.830, respectively, when Hay’s grade II and/or Nugent’s intermediate score were considered either as negative or positive or excluded. Using Nugent score for the intermediate group is the most difficult. Hay’s method shows good agreement with the gold standard method of Nugent et al. and can be used as an alternative to Nugent’s criteria in busy tertiary care hospitals.