Vulvovaginal candidiasis in patients attending the Buea Regional Hospital-Cameroon: Prevalence and risk factors

Abstract

Introduction: Infection of the female vulva and vagina due to Candida species results in Vulvovaginal candidiasis (VVC). Indiscriminate drug use causing drug resistance and varying lifestyle factors have led to increased spread of the infection. If early laboratory identification and confirmation is not done, this may evolve to serious genital abnormalities and the main reason for increase hospital consultations. Objective: To determine the prevalence of VVC in reproductive age women at Buea regional hospital and possible predisposing factors for its cause. Materials and Methods: We carried out a cross-sectional descriptive study from February to May 2023 in women between the ages 15-45 years attending the Buea Regional Hospital. Sterile vaginal swabs were employed to collect samples and then culture was done using Sabouraud Dextrose Agar. Gram staining and microscopy were conducted to isolate Candida. CHROMagar differential agar and germ tube tests, were used to differentiate the various species of Candida. Pre-tested questionnaires were used to collect socio-demographic and clinical data. Management and analyses of data were done using the SPSS version 22.0 and a significant relationship among variables was obtained when P<0.05. Results: Out of a total of 190 samples analyzed from symptomatic cases of VVC, Candida species were present in 102 (54%) and all the positive cases of VVC were due to Candida albicans. The average age of study participants was 30 years and VVC was mostly frequent in patients >35 years (77.8%). Participants who were single, married and students, had a prevalence of 63.2%, 39.5%, 67.5%, respectively (P<0.05). Clinical presentation, such as, burning sensation while urinating and itches were significantly (P<0.05) associated to high prevalence of VVC (46.1% and 53.9% respectively). Laboratory-confirmed VVC showed significant association to the practice of douching (OR: 3.71, 95%CI: 1.2-14.01, P<0.05) and sexually active (OR: 2.87, 95%CI: 1.3-12.46, P <0.05). Conclusion: Vulvovaginal candidiasis occurred more in women above 35 years, single and who presented with abnormal discharges. The use of antiseptic soap during douching and being sexually active were significantly associated to VVC. Women, especially those of child bearing age should be sensitized on the importance of practicing and maintaining good personal hygiene, safe sex, which will help to prevent and curb the prevalence of vulvovaginal candidiasis.