Abstract

The purpose of the study was to determine the prevalence, incidence and associated risk factors of vulvovagina candidiasis among female youths in the Muea community. Permission was sought from the school, Delegation of Public health and CMA Muea.  The study is a cross sectional and laboratory base study design that was be carried out  at the Muea health Centre with a sample size of 370 youths from January 2023 to  March 2023 at CMA Muea.

The prevalence of vaginal candidiasis in youths was analyzed using Micro soft excel 2010.  In this study, the prevalence was found to be 14%. This relatively low prevalence of vaginal candidiasis among women of the Muea community may be attributed to adequate knowledge, good personal hygiene, and normal levels of estrogens and corticoids.

The study showed that the  young ladies between 15- 20 were more infected with candidiasis by 1%, and ladies aged 21-25  with 8.5% followed by the middle-aged women between 26- 30 with 3.5% and the least were the  elderly youths between 31-35 with 1. 0%. The prevalence of 21-25 may be due to high sexual activity, poor personal hygiene, the use of contraceptives.

CHAPTER ONE

INTRODUCTION

1.1 Background

The first description of a fungus as the causative agent of an oropharyngeal and oesophageal candidosis was by Bernhard von Langenbeck in 1839.(Knoke et al, 2006) Vulvovaginal candidiasis was first described in 1849 by Wilkinson. (Lynch DP, 1994). In 1875, Haussmann demonstrated the causative organism in both vulvovaginal and oral candidiasis is the same.( Lynch DP, 1994) With the advent of antibiotics following World War II, the rates of candidiasis increased. The rates then decreased in the 1950s following the development of nystatin. (Obladen M, 2012)

Vaginal candidiasis; is a yeast infection of the vulva and/or vagina caused by Candida species with Candida albicans being the major culprit, has been reported by researchers including (Foxman et al., 2006) as one of the common infections among women. Consistently, (Emeribe et al., 2009) revealed that about 90% of this infection is caused by Candida albicans and 10% by other species of Candida. This infection has been reported as the commonest cause of vaginitis, second to bacterial vaginosis and generally, the infections occur when there is an imbalance in the pH of the vagina.

The over-growth of this fungus in the vagina leads to a burning sensation in the vagina vulva, the production of heavy white/yellow curd-like discharge and/or an itchy vulva, puritus, dyspareunia, dysuria, irritation, soreness of the vulva and other discomforting symptoms that will ensure frequent hospital visits. Vaginal candidiasis sometimes referred to as vulvo-vaginitis can be recurrent or relapsing and its prevalence has been observed to be on the increase. (Emeribe et al., 2009), asserted that about 75% of females experience at least one episode of vaginal candidiasis during their life time.

They added that most healthy women have at least 1-2 episodes of vaginal candidiasis during their reproductive years. Similarly, (Eckert et al., 2000 and Emeribe et al., 2009) proposed that about 50%of college women will by the age 24- 25 years have had at least one episode of vaginal candidiasis investigated by a physician.

Vagina candidiasis has been reported to globally affect women. (According to Rathod et al., 2014) most of the reported epidemiological data available only revealed a lack of laboratory confirmation of the infection which further compounds the problem.

In line with this, (Rathod et al., 2014)  reported 5% prevalence among women in India.( Klufio et al., 2012) reported 25% prevalence among pregnant women in New Guinea, while (Toua et al., 2002) recorded 55.4% among pregnant women in Cameroon. In Nigeria, (Umeh and Umeakanne, 2016) reported that about 28 million of women are affected annually.

Consistently, the prevalence among female student in Buea was 26% . This increase has been suggested to be due to multiple interacting risk factors for the infection. Extended use of broad spectrum antibiotics, pregnancy and underlying diseases such as poorly managed diabetes mellitus and HIV/Aids, contraceptives, tight fitting clothing, poor female hygiene as well as the use of tampons and vaginal douching have been observed by researchers as risk factors or socio-economic factors associated with vaginal candidiasis.

Poorly associated risk factors including the use of intrauterine devices (IUDS), diaphragms, sponge, orogenital sex, condoms, intercourse and diet with high glucose content has been mentioned. Though, evidence in favour of sexual transmission exists but has not been proven beyond doubt. However, 12-15% of men have been reported to develop symptoms including itching and rash on the genital area following sexual relation with infected women. (Joy Nkeiruka et al, 2021)

Vaginal candidiasis is an endemic problem globally. In Cameroon , little data is available on the prevalence especially among apparently healthy females. Most reported studies are limited to patients seen in hospital settings. This study is therefore, aimed at contributing to existing understanding of the incidence, risk factors and prevalence of candidiasis among female youths of the Muea community.

A cross sectional study was conducted to determine the prevalence of vulvo-vaginal candidiasis (VVC) in pregnant women at Bafoussam Regional hospital and the susceptibility of isolates to some commonly used antifungal agents. 143 vaginal swabs was collected and were used to culture for isolation on chromagar candida medium. Susceptibility testing was carried out with the isolates. Mycological examination revealed that out of 143 vaginal swabs, 47 were positive to Candida spp culture.

The antifungal susceptibility of the isolates showed high resistance ketoconazole. The isolation revealed Candida albicans was a major species (44.15%) followed by Candida parapsilosis and women in their third trimester of pregnancy were the most affected by vulvovaginal candidiasis. ( Cyrille Levis et al., 2021)

1.2 Statement of Problems

Vulvovaginal candidiasis causes a lot of problems and insecurities to women in our societies because the nature of the disease vulvovagina candidiasis such as the discomfort it causes to people like itching around the genitals which leads to a lot of embarrassment to people publicly. Secondly candidiasis causes people that are suffering from the disease to find it difficult to stay in public places for a long time without being disgraced by this infection.

Another main problem with this infection is it causes the people suffering from the disease to emit odour or smell if the person stays long (like 6hours) without a shower this is due to severe discharge.( Soll Dr, 1988)

During my community internship I noticed that ladies had vagina itches and constant scratching of their privates and some termed it “sugar sugar” and they complaint of a burning sensation around the vagina.

1.3 Objectives

1.3.1 General Objective

To determine the incidence, risk factors and prevalence of vulvovaginal candidiasis among female youths of the Muea community.

1.3.2 Specific Objectives

1. To determine the incidence of vulvovaginal candidiasis.
2. To determine the prevalence of candidiasis among female youths of the Muea community.
3. To determine the risk factors of vagina candidiasis in Muea.

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