Epidemiology of Vaginal candidiasis and Its Antifungal Susceptibility Pattern at the Buea Regional Hospital in Cameroon

Abstract

Aims: This study aimed to assess the prevalence of Vulvovaginal candidiasis (VVC) and investigate the antifungal susceptibility patterns among both pregnant and non-pregnant women in Buea, Cameroon. Study Design:  Cross-sectional hospital-based design. Place and Duration of Study: The study was conducted at the Buea Regional Hospital, in the South West Region of Cameroon for a period of 3months. Methodology: The study included a total of 270 participants, comprising 135 pregnant women and 135 non-pregnant women. Vaginal swab samples were collected and cultured on Sabouraud Dextrose Agar supplemented with chloramphenicol and later sub-cultured on Chromogenic Candida Agar. A Germ tube test was carried out to confirm the presence of Candida albicans and served as a confirmatory test in classifying the species as pathogenic or not. Kirby-Bauer disk diffusion technique was used for antimicrobial susceptibility testing. Statistical analysis was performed where a P <0.05 was considered significant. Results: The overall prevalence of VVC was 20.7%. The prevalence was higher among pregnant women (23.7%) compared to non-pregnant women (17.8%). Candida albicans 69.6% was the most prevalent species while C. tropicalis (5.4%) was the least. Predisposing factors such as history of candidiasis was associated with VVC in pregnant women (P=0.009), while the presence of symptoms (P=0.011), and clothing preferences like trousers (P=0.048) were associated with VVC in non-pregnant women. Voriconazole (66.15%) was the most effective antifungal drug while caspofungin (81.25%) was least effective to all species. Conclusion: VVC has a higher prevalence in pregnant than in non-pregnant women with Candida albicans, being the most prevalent species. History of candidiasis, presence of symptoms, and clothing preferences like trousers were statistically associated with the presence of VVC in this study population. Voriconazole could serve as the drug of choice for management of VVC infection.