Abstract

Vulvovaginal candidiasis (VVC) is an opportunistic fungal of the female lower genital tract, the vulva and the vagina caused by candida spp (Sobel et al, 2007).Candida species are among important opportunistic pathogens causing candidiasis in human worldwide. These yeast species are of public health concern nowadays.

The study was aimed at evaluating the prevalence of candidiasis among single and married women at the BUEA REGIONAL HOSPITAL. Clean catch midstream urine were collected from the enrolled subjects, the samples were inoculated onto Sabouraud Dextrose Agar (SDA) incubated at 37oC for 48h and gram’s staining technique was performed.

Out of the 543 samples analysed, a prevalence of 27.6% was obtained. Two different Candida species were isolated; Candida albicans 1016(67.3) and the rest of the candida spp  49(32.7). According to age groups, 21-40 had highest infection rate 362(66.7%) compared to other age groups.

CHAPTER ONE

INTRODUCTION

The genital tract is the portal of entry for numerous sexually and non-sexually transmitted diseases (Dodson  et al. 1997.Psychosomatic vulvovaginitis. Jour. Obstet.Gynecol 51(23), 94-98. Different Kinds of bacterial and non-bacterial infections exist that affect the female reproductive tract and cause vaginal D discharge.

Vaginal discharge is a common symptom in primary health care and is often the second most common gynecological problem after menstrual disorders. Most women regard any secretion from the vagina as abnormal discharge and the first task for primary health care providers is to ascertain whether it is pathological or physiological.

There are few women who complain of vaginal discharge, discomfort or odour without any objective finding (Dodson et al. 1997.j. Obstet. Gynecol.51(23):98). Candida albicans is the most frequently isolated invasive fungal Pathogen in humans, with the majority of infections being localized to the urogenital or oropharyngeal tracts of the patient (Fidel et al 1996, immunopathogenesis of recurrent Vulvovaginal Candidiasis.

Microbiol Rev 9(1): 335-348).In addition to localized infections, Candida albicans is also able to establish a systemic Infection in its host. Vaginal candidiasis is a common gynecological problem among women of child bearing age worldwide (Anderson et al (2004) .Are vaginal symptoms ever normal.

A review of literature Med Gen J 6(4) 49-55,  Naglik et al; (2003) Candidiasis albican secrète aspartyl proteinase in virulence and pathogens. Microbiol Mol Bio Rev 67(3): 400- 428). It has been reported that up to 75% of sexually active women will have experienced symptomatic vaginal candidiasis (Schroppei et al .(1994) J.clin microbiol 32(11): 2646-2654, Lisiak et al. (2003), Ginekol pol 71).

Candida species are part of the lower genital tract flora in 20-50 % of healthy asymptomatic women (McClelland et al., (2009). J Infect Dis 15: 1883-1890), Akah et al., 2010. J. Med, Med. Sci 1(10):447-452. It is reported that Carrier rates are higher in women treated with broad spectrum antibiotics (Singh, (2003).

Clin.Rev.CPJ/RPC. 136(9):26-30), pregnant and diabetic women (Donders (2002). Curr Infect Dis Rep 4(6):536-539); de Leon et al., 2002) and women with HIV/AIDS (Reed et al., (2003); Duerr et al., (2003); Akah et al., (2010).).

Several factors can be associated with increased rate of vaginal colonization by C. albicans: these Include pregnancy, use of high oestrogen content drugs and oral contraceptives (Akah et al., 2010; Alli et al.(2011).), uncontrolled diabetes mellitus (CDC, 2002; Alli et al., 2011), prolonged use of broad spectrum antibiotics (Mardh et al. (2002), Alli et al.,( 2011).) which kill the good and beneficial bacteria, allowing yeast overgrowth, Poor dietary habits and poor personal hygiene.

Many practitioners believe that nylon underwear and tight insulating clothing predispose to vaginal candidiasis by the temperature and moisture of the perineum (Nwankwo et al., (2010), Alli et al.(2011).). A study among women wearing tight clothes reported a higher prevalence of Candida albicans in Vulvovaginal candidiasis than thosewearing loose clothing (Alli et al., (2011).).The aim of this research work was to determine the incident of candidiasis among women of different age groups.

 Research Question

1. What is the awareness about the incidence of candidiasis among married and single women of different age groups?
2. What are the risk factors associated with candidiasis among women of different age groups?
3. What local measures have been put in place to prevent this infection?

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