Vulvovaginal Candidiasis

^*1,2Okeke, P. C. U., ^1,2Nwafia, I. N., and ^1,2Emeribe,S. C.

¹Department of Medical Microbiology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria

²Department of Medical Microbiology, College of Medicine, Faculty of Basic Clinical Sciences, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria

*Correspondence to: princess.okeke@unn.edu.ng; Tel: +2348037117982; ORCID: https://orcid.org/0009 –0004 –2522 –2416

Abstract:

Vulvovaginal candidiasis (VVC) affects an estimated 70-75% of women at least once before menopause, and recurrent disease is estimated to affect approximately 138 million women annually worldwide. Within this global picture, sub-Saharan Africa carries a disproportionate share of non-albicans Candida infection and reported antifungal resistance, yet remains one of the least-studied regions for the mechanistic, immunological and therapeutic research now reshaping the field elsewhere. This mini-review summarizes the available African-specific evidence, identifies where that evidence stops short of matching the region’s disease burden, and proposes concrete regional research priorities. The central challenge is not simply a shortage of prevalence surveys, of which a reasonable number now exist, but the near-total absence of African data from every mechanistic and translational thread currently advancing VVC science elsewhere: host immunogenetics, vaginal and gut microbiome characterization, novel antifungal evaluation, and vagina-specific diagnostic standards.

Continue reading “The evidence gap: Vulvovaginal candidiasis research in African populations”

C. E Ejike, N. R Agbakoba, C. C Ezeanya, F. E Emele, C. B Oguejiofor, J. Dirisu

Abstract

Background: Antimicrobial resistance among Candida species is an intense public health concern. The aim of the study was to determine the antifungal susceptibility pattern and test for cure of Candida species among women of child bearing age who visited the General Hospital Onitsha, Nigeria with symptoms suggestive of Vulvovaginal Candidiasis (VVC).
Materials and Methods: Eight hundred and seventy six female patients participated in the study of which high vaginal swabs were collected and evaluated mycological by standard microbiological methods: microscopic examination and culture using sabouraud dextrose agar (SDA). Susceptibility of isolates to 4 antifungal agents was tested using agar dilution method. Clinicomycological evaluation was also performed among the patients.
Result: Higher minimum inhibitory concentration (MIC) to azole antifungals was observed predominantly among non-albicans Candida speciesincreasingly involved in VVC. The rate of mycological resolution was higher than symptomatic relief at 2 weeks after treatment with antifungal drug.
Conclusion: Efficacious treatment of VVC requires an adequate knowledge of the causative agents and more importantly the antimicrobial to which they exhibit high susceptibility.

Keywords: Vulvovaginal Candidiasis, Clinico- mycology, Antimicrobial resistance, Candida species

Susceptibilite antifonique et test pour la cure d’especes de candida entre les patients de candidases vulvovaginales dans un hopital de soins secondaires, Nigeria

Contexte: La résistance aux antimicrobiens chez les espèces de Candida est un problème de santé publique intense. L’objectif de l’étude était de déterminer le schéma de susceptibilité aux antifongiques et le test de guérison des espèces de Candida parmi les femmes en âge de procréer qui ont visité l’hôpital général de Onitsha, au Nigeria, avec des symptômes suggérant une candidose vulvovaginale (VVC).

Matériaux et méthodes: huit cent soixante-seize six patientes ont participé à l’étude des prélèvements vaginaux élevés collectés et évalués par mycologie par méthodes microbiologiques standard: examen microscopique et culture à l’aide de la gélose sabouraud dextrose (SDA). La susceptibilité des isolats à 4 agents antifongiques a été testée en utilisant une méthode de dilution en agar. Une évaluation clinico-mycologique a également été réalisée chez les patients.

Résultat: une concentration minimale minimale d’inhibition (MIC) en anatoxines azoliques a été observée principalement chez les espèces non-albicans Candida de plus en plus impliquées dans VVC. Le taux de résolution mycologique était plus élevé que le soulagement symptomatique à 2 semaines après le traitement par un médicament antifongique.

Conclusion: Un traitement efficace de la VVC nécessite une connaissance adéquate des agents causaux et, plus important encore, des antimicrobiens auxquels ils présentent une forte susceptibilité.

Mots-clés: Candidiase Vulvovaginale, Clinico-mycologie, Résistance Antimicrobienne, Espèces Candida

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Antifungal susceptibility and test for cure of candida species among vulvovaginal candidiasis patients in a secondary care hospital, Nigeria