The Prevalence of Symptomatic Vulvo-vaginal Candidiasis and Trichomonas vaginalis Infection and Associated Risk Factors among Women in the Niger Delta Region of Nigeria

Abstract

Aims: This study aims to determine the prevalence of symptomatic vulvo-vaginal candidiasis and trichomoniasis and risk factors among women presenting at the outpatient departments of two tertiary health institutions in the Niger Delta region of Nigeria. Study Design:  A prospective cross-sectional study. Place and Duration of Study: The study was carried out at the Niger Delta University Teaching Hospital (NDUTH), Okolobiri and the Federal Medical Centre (FMC), Yenagoa, both in Bayelsa State, Nigeria between February 2012 and May 2013. Methodology: 1240 patients presenting with vaginal symptoms: discharge, itching, soreness or burning sensation were consecutively recruited for the study. High vaginal and endocervical swabs were taken from the women and examined microscopically for motile trichomonads and yeasts, and cultured on appropriate media. Gram staining and Germ tube test were used to identify the organisms. A structured questionnaire was used to obtain patient information relevant to the study. IBM SPSS 21 for Windows® was used for statistical analysis. Variables were compared using the Student’s t-test and Fisher’s Exact test. P values less than 0.05 were considered significant. Results: The prevalence of VVC was 25.7% (319 subjects), and only Candida albicans genus was isolated from the samples. Bacterial culture was positive in 34.3% of the subjects and Trichomonas vaginalis identified in 6.5% of the samples. Prevalence of co-infection with C. albicans and T. vaginalis was 2.6%.  Most of the subjects with VVC and T. vaginalis infection were in the 21 years to 30 years age group. Diabetes mellitus (p<0.01), being a student (p<0.01) and being single (p<0.01) were significantly associated with C. albicans infection and T. vaginalis infection. Pregnancy was significantly associated with C. albicans infection (p=0.04).  The use of low-oestrogen oral contraceptives had no significant association with C. albicans or T. vaginalis infection. Conclusion: Symptomatic VVC and T. vaginalis infection were found to be common in the Niger Delta region of Nigeria. Risk factors include diabetes mellitus, pregnancy, being single and being a student. Clearly defined clinical guidelines for symptomatic vulvovaginitis management are needed.