Prevalence of Vulvovaginal Candidiasis among Outpatients Attending the Federal Medical Centre, Onitsha, Southeastern Nigeria

Abstract

Vulvovaginal candidiasis (VVC) is a prevalent gynecological infection causing significant morbidity among women of reproductive age. The emergence of non-albicans Candida (NAC) species, some of which exhibit intrinsic resistance to common antifungals such as fluconazole, complicates treatment and necessitates ongoing epidemiological surveillance and the search for alternative therapies. This study aimed to determine the prevalence of VVC and identify the causative Candida species, among outpatients attending the Federal Medical Centre, Onitsha, Southeastern Nigeria. A cross-sectional study was conducted involving 100 high vaginal swab (HVS) specimens collected aseptically from out-patients. The samples were transported in a cold chain to the laboratory, inoculated onto Sabouraud Dextrose Agar supplemented with chloramphenicol (50ug/ml), and incubated at 25°C for 24 hours. Isolates were purified and identified based on their macroscopic, microscopic, physiological, and molecular characteristics. The overall prevalence of vaginal candidiasis was 56%. The age-specific prevalence was highest among the 21-25 years age group (68.4%) and lowest among the 16-20 years group (37.5%). Four Candida species were identified: Candida albicans (2 different strains 50%), Candida krusei (25%), and Candida glabrata (25%).  The study revealed a high prevalence of VVC in Onitsha, with C. albicans as the predominant species. The isolation of NAC species, particularly C. krusei, highlights a critical public health challenge especially in managing VVC.