Prevalence of Vulvovaginal Candidiasis in Ahvaz, Southwest Iran: A Semi-Large Scale Study

Abstract

Background: Candida vaginitis or vulvovaginal candidiasis (VVC) is the most common mucosal infection of the female genital tract caused by different species of Candida. Despite several antifungal therapies and personal hygiene practices, VVC has remained an important public health problem affecting millions of women worldwide. Objectives: The aim of this study was to determine the prevalence of VVC and the frequency of causative agents in women of different age groups referring to the midwifery clinics in Ahvaz, Iran, from January 2017 to March 2018. Methods: Samples were obtained from 493 women aged 15 - 64 years with signs and symptoms of VVC using endocervical swabs. All collected samples were cultured on CHROMagar Candida plates and incubated at 35°C for 24 - 72 h. Various Candida sp. were initially identified using morphologic characteristics and physiologic features, and finally confirmed with PCR-RFLP. Results: Totally 196 (39.76%) cases were diagnosed as VVC, of which nine (4.6%) were as recurrent vulvovaginal candidiasis. More than half of the cases were in the age group of 21 - 30 years. Candida albicans was the most commonly identified species (71.1%), followed by C. glabrata (20.4%) and other non-C. albicans species (8.6%). Infection in pregnant women decreased in the third trimester compared to the first and second trimesters of pregnancy. Conclusions: Vulvovaginal candidiasis is a relatively common gynecologic problem in Ahvaz. Although the frequency of non-C. albicans species in VVC has increased, C. albicans is still the predominant species.