Prevalence of Candida Species from Cases of Vulvovaginitis in Women using Contraceptives in Four Selected States of North Central Nigeria

Abstract

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.