Prevalence Of Vulvovaginal Candidiasis Research Articles

A systematic review and meta-analysis on the prevalence of vulvovaginal candidiasis in Southeast Asian countries

Vulvovaginal candidiasis (VVC) is a disease caused by pathogenic Candida species. This disease typically affects women of reproductive age with high sexual activity (i.e., sex workers), poor educational attainment and economic status, and infrequent hygiene practices. VVC remains a major public health concern. VVC prevalence across Southeast Asian countries remains poorly understood. To address this concern, the current study estimated the current prevalence of VVC infections among women in Southeast Asian countries by conducting a systematic review and meta-analyses. All studies reporting the prevalence of VVC in Southeast Asia were obtained from Ovid Medline, Scopus, and CINAHL. A review of titles and abstracts was done independently by three reviewers. The quality of the studies was assessed using the Newcastle-Ottawa scale. Meta-analysis was performed in R v.4.1,1 using the ‘meta’ package (version 4.19-0). Based on the results of the current study, the pooled estimated prevalence of VVC among Southeast Asian women is 23.0% (95% CI: 18.0% to 28.0%). Across countries, Laos had the highest estimated prevalence at 33.0% (95% CI: 22.0% to 46.0%). Subgroup analysis based on pregnancy status and occupation revealed a higher estimated prevalence among non-pregnant women (32.0%, 95% CI: 25.0% to 40.0%) and non-sex workers (33.0%, 95% CI: 20.0% to 48.0%). Based on the diagnostic method, the prevalence was higher for the combinatorial approach using microscopy, a culture-based approach, and molecular techniques (51.0%) and lowest when solely based on clinical diagnosis (9.0%, 95% CI: 1.0% to 22.0%) or an exclusively culture-based approach (11%, 95% CI: 6.0% to 18.0%). Overall, further study is necessary to accurately characterize the current distribution of VVC across Southeast Asian countries. Developing more effective diagnostic and management strategies is to improve the health of affected women.

Candidiasis in Pregnancy: Relevant Aspects of the Pathology for the Mother and the Fetus and Therapeutic Strategies.

Vulvovaginal candidiasis (VVC) is a common condition that can lead to significant discomfort, affecting approximately 70-75% of women at least once in their lives. During pregnancy, the prevalence of VVC is estimated to be around 20%, peaking at about 30% in the third trimester, with a number of specific risk factors predisposing to yeast infection being identified and needing elucidation. This review aims to provide updated knowledge on candidiasis during pregnancy, addressing risk factors and maternal and neonatal outcomes, as well as discussing optimal therapeutic strategies to safeguard mothers and newborns. The bibliographic search involved two biomedical databases, PubMed and Embase, without imposing time limits. Among all Candida spp., Candida albicans remains the most frequent causative species. The hyperestrogenic environment of the vaginal mucosa and reduced immune defenses, physiological effects of pregnancy, create conditions favorable for Candida spp. vaginal colonization and hence VVC. Recent evidence shows an association between VVC and adverse obstetric outcomes, including premature membrane rupture (PROM), chorioamnionitis, preterm birth, and puerperal infections. Prompt and effective management of this condition is therefore crucial to prevent adverse obstetric outcomes, maternal-fetal transmission, and neonatal disease. Additional studies are required to confirm the benefits of systemic treatment for maternal candida infection or colonization in preventing premature birth or neonatal systemic candidiasis.

Vulva Candidiasis among HIV Patients and Healthy Female Volunteers in Port Harcourt

Vulvo-rectal the most prevalent species of candida, Candida albicans, is the cause of candidiasis, a fungal infection of the vagina that affects the genital system as an adaptive and opportunistic pathogen.
 This study was aimed at examining the prevalence and risk factors of vulvo-vaginal candidiasis among HIV positive women and healthy volunteers in Port Harcourt. A total of 200 urine and HVS samples, 100 from each of the two groups, were collected. The samples were examined using culture, microscopy, and the germ tube identification method. The overall prevalence of Vulvo-vaginitis in HIV and healthy volunteers using urine and HVS was (32%), (34%), and (76%) and (54%) respectively. HIV recorded a higher of (76%) compared to that of healthy volunteers with (54%). There was no statistically significant difference in the two groups’ prevalence (p>0.05). The age group of 15–25 years old had the highest prevalence of (33%), while the age group of 40–45 had the highest prevalence of 80% for HIV. HIV-positive workers and retirees had higher rates of vulvo-vaginitis in urine samples (21% and 75%, respectively) than did healthy workers and retirees (15% and 25%, respectively). Individuals with tertiary education had the highest prevalence of (32%) and (14%) in HIV and healthy volunteers respectively. It was also reported that married individuals who are HIV positive had a higher incidence of (50%) while for healthy volunteers, single individuals recorded a higher frequency of (29%). Prevalence of vulvo-vaginal candidiasis was greater in HIV patients in Port Harcourt. To help combat fungal infections, it is proposed that antifungal medications be added to antiretroviral medications prescribed to HIV patients.

Using Artificial Neural Network to Predict Predisposing to Vulvovaginal Candidiasis among Vaginitis Cases

Background: Vulvovaginal candidiasis (VVC) is a common fungal infection caused by Candida species in the female genital tract. Objectives: This study attempts to predict predisposition to VVC related to risk factors and clinical symptoms among vaginitis cases using the artificial neural network (ANN) model. Methods: This cross-sectional study was performed on 250 women referred to gynecology clinics in Birjand, Iran. A questionnaire was used to record participants' demographic information. Swabs were used for wet mounts and culture. Candida species were identified by morphological and physiological methods. The performance of the optimal neural network model was assessed by the sensitivity, specificity, and accuracy area under the ROC curve (AUC). Descriptive statistics were used for the statistical description of data, and chi-square test, t-test, and ANN analysis using SPSS application tools (Statistical Product and Service Solutions) version 22 software at 0.05 significant level. Results: The prevalence of vulvovaginal candidiasis was 41.0%, and Candida albicans was the most frequently identified species (55.9%). The descriptive statistics (chi-square test and t-test) revealed no significant difference between the frequencies of Candida infection with demographic factors and clinical presentations. However, factors such as abortion history, number of sexual intercourse, dyspareunia, education, natural vaginal delivery (NVD), and lower abdominal pain included in our ANN model had significant differences (P < 0.05). Conclusions: The result of the ANN model revealed that using demographic factors and clinical symptoms can predict VVC infection. Therefore, this model can identify the effect of the clinical presentations and symptoms of infection.

VULVOVAGINAL CANDIDIASIS- PREVALENCE AND ANALYSIS OF ASSOCIATED RISK FACTORS AMONG WOMEN OF REPRODUCTIVE AGE GROUP IN VINDHYA REGION

Background: Although it can affect all groups, vaginitis remains one of the most common ambulatory problems to occur in women of reproductive age group. It accounts for 5-10 million office visits per year throughout world. In India prevalence of vaginitis is approximately 30%. Vaginitis has substantial impact on various aspects of female reproductive health, mental health, work ability and routine physical activity. It is also associated with various obstetrical and gynecological complications. Vulvovaginal candidiasis is common form of vaginitis. So, we aim to find out prevalence and analyze risk factors associated with vulvovaginal candidiasis at tertiary care hospital in Rewa, Madhya Pradesh India. Method: An observational cross-sectional study was conducted at Department of Obstetrics and Gynecology, Shyam Shah Medical College Rewa for 18 months from January 2021 to June 2022 on 1000 women of reproductive age group, visiting routine Gynae OPD of department of Obstetrics & Gynecology. Results: Prevalence of vulvovaginal candidiasis in present study was found to be 12%. Various associated risk factors were OCP use, use of cloth during menses, douching/cleanliness habit, rural area of residence, middle and lower socioeconomic class and various occupations like factory workers and farmers. Conclusion: As it is evident that vaginitis will never be completely prevented, but incidence can be reduced. Much of the morbidity and complications can be reduced by identification and prevention of modifiable risk factors and interventional strategies directed mainly on high-risk behaviors in day-to-day life.

Prevalence of vaginal infection by candida subtypes in women with HIV compared to the control group and influence of immune status

Introduction: Vulvovaginal candidiasis (VVC), caused by Candida sp, may present with increased frequency and symptoms in immunocompromised patients, and there is concern about the diagnosis and adequate treatment of these patients. Objective: The aim of this study was to evaluate the prevalence of VVC compared to the immune status and species present in the microbiota of patients with HIV. Methods: This cross-sectional study was conducted from January 2017 to January 2018, including 97 women with HIV compared to a control group (n=112). For data collection, interviews were conducted, vaginal pH was measured, CD4+ T cells and viral load (VL) were evaluated, and vaginal secretions were collected for microscopy and culture. Results: The prevalence of VVC was 41.2% in seropositive patients and 3.6% in the control group (p<0.001). Of the patients with CD4+<200 T, 54.3% had Candida sp, while in those with CD4+ T 200 cells/mm³, the prevalence was 33.9% (p=0.057). Regarding viral load, the prevalence of VVC was 24.1% in those with undetectable VL or <20, 50% in those with VL between 20 and 9999, and 46.9% in VL above 10000 copies/mL (p=0.08). The most prevalent species were Candida albicans, followed by C. parapsilosis, C. krusei, and C. glabrata. The mean vaginal pH was 4.6 in the control group and 5.2 in the case group. Conclusion: HIV-positive women have a higher prevalence of candida. Lower T CD4+ values and increased VL seem to be associated with a higher prevalence of infection.

Microbiological and molecular screening of Candida spp. isolated from genital tract of asymptomatic pregnant women.

Introduction. Candida spp. may cause opportunistic infections called vulvovaginal candidiasis (VVC), which is estimated to be the second most common cause of vaginitis worldwide.Gap Statement. Under various circumstances, VVC could compromise pregnancy outcomes. Emerging data suggests that VVC during pregnancy may be associated with increased risk of complications and congenital cutaneous candidiasis.Aim. To assess the prevalence of Candida spp. in asymptomatic pregnant women and determine the susceptibility of the isolates to antifungal drugs.Methodology. In a prospective cohort, 65 high vaginal swab samples of consented pregnant women. Candida isolates were identified using both microbiological and molecular tools and drug susceptibilities were profiled.Results. The prevalence of VVC among our study participants was 37 %, 24 of the 65 asymptomatic pregnant women show Candida spp. colonization. C. albicans was the most common species 61 %, followed by C. glabrata 39 %. In addition, a significant fraction of the isolated colonies showed resistance to Fluconazole, with a ratio of 63 % for C. albicans isolates and 16 % for Candida glabrata isolates. Moreover, relative quantification of genes related to resistance to fluconazole, CDR1, ERG11 as well as HWP1, showed a significant change compared to controls.Conclusion. Monitoring of vaginal Candida colonization before the third trimester of pregnancy, that could reduce congenital Candida colonization and risk of pregnancy complications.

Prevalence of vulvovaginal candidiasis among pregnant women in Africa: A systematic review and meta-analysis.

Vulvovaginal candidiasis (VVC) is a yeast infection of the vulva, which is caused by Candida species and affects women worldwide. Pregnant women are more vulnerable to VVC due to certain risks. Moreover, their offspring are also exposed to the risk of preterm birth. In this context, ascertaining the burden of VVC is of paramount importance and this meta-analysis was conducted to estimate the occurrence of VVC among pregnant women in Africa. Database search was carried out through PubMed, Scopus, Science-Direct, and Google Scholar from the date of inception until December 2020. All the studies on the prevalence of VVC among African pregnant women were included in the analysis. The pooled prevalence was estimated based on the Random-effect model DerSimonian-Laird approach with Freeman- Tukey double arcsine transformed proportion. Heterogeneity was assessed using I2 test and subsequently explored using subgroup and meta-regression analysis. A total of Sixteen records having a sample size 4,185 were included in this study. The overall prevalence of VVC was pooled at 29.2% (CI 95%: 23.4 - 33.0). Subgroup analysis revealed a higher prevalence in Eastern Africa, followed by Western Africa and North Africa (35%, 28%, and 15% respectively). Moderator analysis indicated that the studies that used advanced methods of detection had a higher prevalence (p = 0.048). In addition, the large sample size was associated with higher prevalence (p ≤ 0.001). No other moderators were found to be statistically significant. The overall prevalence of VVC among African pregnant women is comparable to other studies worldwide. However, appropriate identification techniques and larger sample size could likely be associated with an increased prevalence. Our findings necessitate the need for further investigations to determine the geographical distribution of VVC across African regions.

Vulvovaginal candidiasis: Epidemiology, treatment and prevention strategies

Vulvovaginal candidiasis (VVC) is a commonly encountered clinical condition. At least three-fourth women experience one episode of VVC in their lifetime. In India, the prevalence of VVC is 10 to 35%. Laboratory methods often supplement clinical diagnosis. VVC should be confirmed with culture and other investigative techniques, especially in complicated and recurrent cases. Topical and intravaginal azoles remain the mainstay of therapy. In women who have predisposing risk factors or develop recurrent VVC, oral antifungal agents are used. Topical steroids may be used in women having vulvar symptoms along with pruritus. Pregnancy is a significant risk factor. Intravaginal azoles remain the standard of treatment and can be offered from the second trimester onwards. The emergence of non-albicans species has caused difficulties in the management of VVCs. Thus, all women with vaginal discharge should be correctly diagnosed to tailor the therapy.

Epidemiological evaluation of risk factors associated with vaginal candidiasis in a cross section of pregnant women in Trinidad and Tobago.

Vaginal Candidiasis and associated epidemiological risk factors prevalent among a cross section of pregnant women attending tertiary hospital in Trinidad and Tobago was evaluated. Standardized questionnaire was used to survey 492 pregnant women over a period of 10 months in 2019. Vaginal swab was collected and processed using standard microbiological laboratory methods for phenotypic identification. Data were analyzed using SPSS to identify potential risk factors. Chi-squared (ꭓ2) test and logistic regression tests examined associations and odds ratios with corresponding 95% confidence intervals. Prevalence of vulvovaginal candidiasis was 44.9% with Candida albicans as predominant species identified (62%, N=492). Vaginal candidiasis was statistically significant for several risk factors, including second trimester (p = 0.03), age group 26 - 34 years (p=003), history of masturbation especially during the last 48hours prior to the swabbing (p=0.05), and wearing of pants as opposed to skirt clothes (p=0.04). In conclusion, several epidemiological risk factors are associated vaginal candidiasis among cross section of pregnant women in the country. Patient education, microbiological investigations and appropriate treatment will improve antenatal healthcare delivery in the country.

A study on vaginitis among pregnant and non-pregnant females in Alexandria, Egypt: An unexpected high rate of mixed vaginal infection.

BackgroundMany infectious and noninfectious triggers lead to inflammation of the vagina.AimWe investigated the prevalence of causative vaginitis microorganisms in 516 pregnant and nonpregnant female volunteers. Vaginal samples were examined microscopically, cultured and tested for different pathogens.ResultsOf the participants, 310 (60.1%) were pregnant, whereas 206 (39.9%) were nonpregnant. Using Amsel's criteria and Nugent's scores, bacterial vaginosis (BV) was diagnosed in 59.1%, and the prevalence of vulvovaginal candidiasis (VVC) was 50.2% in the population. Candida infections were significantly higher in nonpregnant females (p value ≤ 0.01), and 24% of females had mixed infections. The most common mixed infection was BV and Candida spp., detected in 21% of the cases.ConclusionsBacterial vaginosis is the most common cause of vaginitis. We observed that 24% of females experienced mixed infections, and Candida albicans was the most common fungal species causing VVC. Trichomonas vaginalis prevalence was underestimated using wet mounts.

Characterization of Candida species isolated from vulvovaginal candidiasis by MALDI-TOF with in vitro antifungal susceptibility profiles.

Background and Purpose: Vulvovaginal candidiasis (VVC) is an opportunistic infection due to Candida species, one of the most common genital tract diseases among reproductive-age women. The present study aimed to investigate the prevalence of VVC among non-pregnant women and identify the epidemiology of the involved Candida species with the evaluation of antifungal susceptibilities.Materials and Methods: Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed to identify Candida species isolated from the genital tract of 350 non-pregnant women. Moreover, antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute broth microdilution method guidelines (M27-A3 and M27-S4).Results: Vaginal swab cultures of 119 (34%) women yielded Candida species. Candida albicans was the most frequently isolated species (68%), followed by Candida glabrata (19.2%). Voriconazole was the most active drug against all tested isolates showing an MIC50/MIC90 corresponding to 0.016/0.25 µg/mL, followed by posaconazole (0.031/1 µg/mL). Overall, resistance rates to fluconazole, itraconazole, and voriconazole were 2.4%, 4.8% and, 0.8% respectively. However, posaconazole showed potent in vitro activity against all tested isolates.Conclusion: Results of the current study showed that for the effectual therapeutic outcome of candidiasis, accurate identification of species, appropriate source control, suitable antifungal regimens, and improved antifungal stewardship are highly recommended for the management and treatment of infection with Candida, like VVC.

Prevalence and Antimicrobial Susceptibility Profiles of Microorganisms Associated with Lower Reproductive Tract Infections in Women from Southern Poland-Retrospective Laboratory-Based Study.

Objective: Female infections affecting the genital tract include sexually transmitted diseases, endogenous infections such as vulvovaginal candidiasis, bacterial vaginosis (BV) or aerobic vaginitis (AV) and healthcare-associated infections. The aim of the study was to analyze the etiological factors of the vaginal dysbacteriosis, and the antimicrobial susceptibility of the dominant bacterial and fungal infections in different age groups of outpatient women from the Silesian Region. Materials and methods: A retrospective laboratory-based multi-center study encompassed 4994 women of different ages in Silesian Voivodeship, in the south of Poland; patients who had vaginal swabs collected as per physicians’ orders during the period from 1 January 2017 until 30 June 2018 were included in the study. The inclusion criteria were: non-hospitalized female, aged ≤80, with suspected vulvovaginal candidiasis or bacterial vaginosis and clinical sings of infections. Results: Gram-positive cocci were the ones most often isolated: Enterococcus faecalis (29.2%) and Streptoccoccus agalactiae (13.1%), followed by bacilli from the Enterobacteriaceae group, including Escherichia coli (26.3%). The presence of Streptococcus agalactiae was confirmed in 13.1%, slightly more often in the 45–80 age group, and Gardnerella vaginalis in 6.4%, most often in women aged 15–24. The prevalence of yeast-like infections was 24.3%, Candida albicans accounted for 78.3%, whereas among C. non-albicans spp.—C. glabrata dominated (14.9%) followed by C. parapsilosis (3.8%). The highest resistance was observed only in Streptococcus agalactiae as the MLSB mechanism (Macrolide-lincosamide-streptogramin B) was identified in 38.6% of strains. The prevalence of vulvovaginal candidiasis was 24.3%, the highest in women aged 15–44. Conclusions: Drug resistance in studied vulvovaginitis was associated only with Streptococcus agalactiae. A high proportion of yeast-like aetiology was found, probably associated with recurrent infections. In the analyzed cases only the Amsel criteria and culture methods were used for diagnosis without preparations and microbiological Nugent criteria.

Relationship between Vulvovaginitis in Women with the Candida Species

Background: Vulvovaginal candidiasis refers to the vaginal infection that is caused most commonly by candida species, especially candida albicans, women in their lifetime at risk to infect by candida species. The objectives of this study were to determine the relationship of Vulvovaginal infection with Candidiasis and its association with some risk factors and the incidence of different species of Candida among patients with vulvovaginitis. Methods: 300 samples from high vaginal swabs obtained from females attending maternity teaching hospital in Erbil City complained from signs and symptoms of valvovaginitis from the period September 2019 to February 2020. A questionnaire form prepared for each patient, who includes: age, clinical presentation and history of pregnancy, diabetes, and history of using contraceptives and the type of contraceptives. High vaginal swabs collected from patients and direct microscopic examination performed, cultured onto Sabouraud Dextrose Agar (SDA), Blood agar and Macconkey agar and species identification done by using an automated VITEK 2 compact system. Results: From the total of 300 high vaginal swabs collected at Maternity hospital in Erbil city and prevalence of vulvovaginal candidiasis was (57%). The highest prevalence of positive cases were in the age range (30-34) years and the positive culture among pregnant women was 73(63.4%) and also the incidence of vulvovaginal candidiasis was higher among diabetic females 49(80.3%), The incidence of positive cultures of Candida spp. in the antibiotic users group were 61(64.4%) and also the positive culture for candida spp was higher among the contraceptive pills 40(60.6%) however for IUCD user the positive culture was 31(68.9%). The species of Candida species which identified by using Vitek system were distribute as follow: Candida albicans was 147(86%) Candida glabrata16 (9.4%),CandidaParapsilosis 6(3.5%)and, Candida krusei 2(1.2%). Conclusion: In the present study, vulvovaginal candidiasis is more in the young age group and more frequent in the pregnant ladies and the diabetic patients and those using antibiotic and contraceptives, either the pills or Intrauterine contraceptive device. Candida albicans had the highest percentage among other positive isolated from high vaginal swab and there was a significant relation between clinical presentation of the patient with the result of culture.

Vaginitis in women of reproductive age group: A hospital-based study from North India

Background: Vaginal discharge is a common problem faced by women of the reproductive age group seeking consultation in the gynecology outpatient department (GOPD). If not treated, it can lead to pelvic inflammatory disease, infertility and further complicate pregnancy. Objective: The present study explores the etiology and clinical presentations of vaginal discharge among women of reproductive age presenting to the GOPD of our tertiary care hospital. Materials and Methods: The study group comprised of 200 sexually active women of age group ?18 years attending our GOPD. Four vaginal swabs were taken from the posterior fornix under aseptic condition. Direct wet mount microscopy, gram stain, and culture on Sabaroud’s dextrose agar and Kupferberg media were carried out. Results: Prevalence of vulvovaginal candidiasis, bacterial vaginosis, trichomoniasis, and mixed infection was 30%, 20%, 2%, and 2%, respectively. Candida albicans were present in 55% patients and non-albicans Candida in 45%. The most common associated presenting symptom of patients presenting with the discharge was lower abdominal pain. Conclusion: Simple diagnostic techniques such as microscopy and culture help in diagnosis and the precise managementprocess of such women presenting with discharge and thus circumvent impending complication.

Prevalence of vulvovaginal candidiasis among pregnant women in the Ho municipality, Ghana: species identification and antifungal susceptibility of Candida isolates

BackgroundCandida is the leading cause of vaginitis, and 75% of women have at least one episode of infection in their lives, with pregnancy being a predisposing factor. If left untreated, vulvovaginal candidiasis (VVC) can lead to chorioamnionitis with subsequent abortion, prematurity and congenital infection of the neonate. We aimed to determine the prevalence of VVC, identify the recent and most frequently occurring species of Candida in pregnant women, and determine the most effective antifungal drug of choice for treatment.MethodA prospective cross-sectional study in which 176 high vaginal swab samples of consented pregnant women visiting the antenatal clinic from February 2018 to April 2018 were subjected to direct gram smear and culture for Candida isolation. Candida isolates were identified using a germ tube test and HiCrome Candida differential agar. Candida isolates were then subjected to a disk diffusion method using fluconazole (25 μg), nystatin (100 units), and voriconazole (1 μg) on Mueller-Hinton agar supplemented with 2% (w/v) glucose and 0.5 μg/ml methylene blue dye to determine the susceptibility pattern as per the guidelines of the Clinical Laboratory Standard Institute (CLSI). Chi-square analysis was used to ascertain the significant association of participants’ sociodemographics and clinical presentations to VVC. A univariate logistic regression model was used to identify potential risk factors of VVC.ResultsThe prevalence of VVC among our study participants was 30.7%. Non-albicans Candida (NAC) and Candida albicans had a prevalence of 74.1 and 25.9%, respectively. Candida glabrata was the most common species, followed by Candida albicans, Candida krusei, and Candida parapsilosis. 50.0, 18.5 and 3.7% of Candida species were susceptible to voriconazole, fluconazole and nystatin, respectively, whereas 37.0, 48.1 and 9.3% of Candida species were resistant to voriconazole, fluconazole and nystatin, respectively. The majority of isolates were susceptible dose dependent to all three antifungal agents, with voriconazole being the most efficacious antifungal agent. There was no significant association between participants’ socio-demographic information and clinical presentations to VVC.ConclusionThe prevalence of VVC was high in the study area. C. glabrata was found to be the most common cause of VVC among the pregnant women attending antenatal clinics, in the Ho Municipality region of Ghana. The majority of the Candida isolates were susceptible and resistant to voriconazole and fluconazole, respectively.

Prevalence of Candida spp. from in women with vulvovaginal infection in Maternity teaching hospital in Erbil, Iraq

Objectives: This study aimed to determine the prevalence of Vulvovaginal candidiasis and its association with some risk factors and the incidence of different species of Candida attending the Maternity hospital in Erbil city.Methods: A cross-sectional carried out at Maternity teaching hospital, over a period that conducted from July 2019 to January 2020 on females Patient who complained of itching and erythema, vaginal discharge, swelling. A questionnaire form prepared for each patient, which includes: age, clinical presentation and history of pregnancy, diabetes, and history of using contraceptives and the type of contraceptives. High Vaginal Swabs were collected from patients and subjected to direct microscopy, cultured onto Sabouraud Dextrose Agar (SDA) and, Blood agar. The results, determined by standard microbiological methods, species identification done by using an automated VITEK 2 compact system.Results: From the total of 246 high vaginal swabs collected at Maternity hospital in Erbil city and prevalence of vulvovaginal candidiasis was(54.66%). The highest number of positive cases found to be in the age group(30-34) years and the positive culture was among pregnant women was 71(63.4%) also the prevalence of vulvovaginal candidiasis was higher among diabetic women 44(67.7%), frequency of culture positive for Candida spp. in the antibiotic users group was 85(64.4%) and also the positive culture for candida spp was higher among the contraceptive pills31(57.4%) however for IUCD user the positive culture was 22(66.7%). Conclusion: In this present study, vulvovaginal candidiasis is more in the young age group and more frequent in the pregnant ladies and the diabetic patients and those using antibiotic and contraceptives, either the pills or Intrauterine contraceptive device. Candida albicans had the highest percentage among other positive isolated from high vaginal swab and there was a significant relation between clinical presentation of the patient with the result of culture.

THE PREVALENCE OF VULVOVAGINAL CANDIDIASIS IN PREGNANT WOMEN ATTENDING SEVERAL HOSPITALS IN SANA’A, YEMEN

Candida species are opportunistic yeasts affecting the genitourinary tract which causes the vulvovaginal candidiasis in the most female especially in developing countries. This study aims to determine the prevalence of vulvovaginal candidiasis caused by Candida species causing among pregnant women in Sana'a City, Yemen. This study was carried out at the department of microbiology of AL-Kuwait University Hospital. 250 vaginal swabs were collected and cultured on Sabouraud dextrose agar. Candida species identification and antifungal susceptibility testing were determined according to standard microbiological methods. The results showed that out of 250 samples, 63(25.2%) were positive for Candida species. It was found that the C. albicans (68.3%) was the most common species isolated followed by non-albicans species that are C. tropicalis (20.6%), C. glabrata (6.3%), and C. kefyr (4.8%). Also, it was recorded that the highest prevalence of Candida species was within group aged of 36-46 year. Susceptibility tests revealed that the most isolated species of C. andida were sensitive to nystatin (95%). miconazole was the next effective drug with 64% sensitive followed by amphotericin B (29%) and clotrimazole (24%). But only 6% of the isolates were sensitive to fluconazole. It can be concluded that the vulvovaginal candidiasis are quite common in Yemen country with a high prevalence. Also, the nystatin remains the effective agent against all isolated of Candida species. In contrast, the increase resistance of Candida species to fluconazole that commonly used antifungal is an alarming increase of vaginal candidiasis caused by antifungal-resistant Candida species.
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 Name: Dr. Hassan A.H. Al-Shamahy
 Affiliation: Sana'a University, Yemen
 E-mail: shmahe@yemen.net.ye
 
 Name: Dr. Tamer Mohamed Ali El Habibi
 Affiliation: Suez Canal University, Egypt.
 E-mail: tamer_hassan@pharm.suez.edu.eg
 
 Name: Rola Jadallah
 Affiliation: Arab American University, Palestine
 E-mail: rola@aauj.edu
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Prevalence of Candida Species from Cases of Vulvovaginitis in Women using Contraceptives in Four Selected States of North Central Nigeria

Background: Vulvovaginal candidiasis affects millions of women every year and in most developing countries such as Nigeria, vulvovaginal candidiasis is still received with little attention since it is considered to be a trivial disease. 
 Aim: The aim of this study is to determine the prevalence of Candida species from cases of vulvovaginitis in women using contraceptives in four selected states of North Central Nigeria.
 Place and Duration of Study: The study was carried out in four selected states of North Central Nigeria and the Department of Microbiology, Federal University Lafia between the months of January to November 2018.
 Study Design: A cross-sectional study design was utilized.
 Material and Methods: One thousand six hundred samples of high vaginal swabs were collected in four States of North Central Nigeria. Four hundred samples were collected from women using contraceptive device in each state. Two high vaginal swabs were collected. Germ tube test, direct examination and lactophenol cotton blue examination was carried out. The high vaginal swabs was streaked on Sabouraud dextrose agar (SDA), and subsequently isolates from SDA were streaked on CHROM agar and incubated aerobically at 37ºC.
 Results: Five species of Candida were isolated from 710 women with vulvovaginal candidiasis. Candida albicans was the most frequent isolate which accounted for 43.23% of the species isolated. The prevalence of vulvovaginal candidiasis across the four selected states in the North Central zone is 44.37%. The prevalence of vulvovaginal candidiasis in relation to age in the study area shows that the lowest prevalence (32.67%) of candidiasis infection was recorded among women below 20 years. The distribution of contraceptive usage reveals that the use of injectables was the most predominant contraceptive method used in the study area. The cross tabulated results at 95% confidence interval showed a statistically strong significance at 0.001 level for demographic characteristics which include age, marital status, and educational status in the study area. A significant difference at 0.294, 0.351 was recorded for diabetes and HIV status respectively.
 Conclusion: The high prevalence rate of vulvovaginal candidiasis in this study poses a great threat to women’s reproductive health, hence the need for continuous epidemiological surveys among women in Nigeria.

Prevalence of vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis in pregnant women attending antenatal clinic in the middle belt of Ghana

BackgroundVaginal infections usually caused by Candida sp, organisms responsible for bacterial vaginosis and Trichomonas vaginalis are associated with considerable discomfort and adverse outcomes during pregnancy and child birth. The study determined the prevalence of vulvovaginal candidiasis (VVC), bacterial vaginosis (BV) and trichomoniasis (TV) in pregnant women attending antenatal clinic at the Kintampo Municipal Hospital.MethodsA study adopted a cross sectional design and recruited 589 pregnant women after seeking their informed consent from September, 2014 to March, 2015. Semi-structured questionnaire were administered to participants and vaginal swabs were collected. The samples were analysed using wet mount method and Gram stain (Nugent criteria) for vaginal infection. Univariate and multivariate analysis were used to investigate association of risk factors to vaginal infections.ResultsThe overall prevalence of at least one vaginal infection was 56.4%. The prevalence of vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis were 36.5, 30.9 and 1.4% respectively. Women with more than four previous pregnancies (OR: 0.27, 95% CI: 0.13–0.58) and those in the third trimester of pregnancy (OR: 0.54, CI: 0.30–0.96) were associated with a lower risk of bacterial vaginosis. Douching and antibiotic use were neither associated with VVC or BV.ConclusionThe prevalence of vaginal infections was high among pregnant women in the Kintampo area. There is the need for interventions such as adequate investigations and early treatment of vaginal infections to reduce the disease burden to avoid associated complications.