Incidence of Candida Albicans Amongst Pregnant Women/Owerri Metropolis and Non-pregnant
CHAPTER ONE
OBJECTIVES OF THE STUDY
The objective of this study include:
- Detection of Candida albicans in women attending the clinics
- To know the age group mostly affected
- To know the rate (incidence) of Candida infection in Owerri urban.
CHAPTER TWO
MATERIALS AND METHODS
ANALYTICAL REAGENTS/MATERIALS
- 70% Alcohol
- 10% Normal Saline
- Lactophenol Cotton-Blue.
GRAMSTAINING REAGENTS
- Crystal violet
- Lugols iodine
- Acetone
- Safranin
- Distilled water
MATERIALS
- Sterile swab sticks
- Petri dishes
- Digital weighing balance
- Conical Flask
- Measuring cylinder
- Microscope slide and cover slides
- Wire loop
- Portable autoclave
- Hot air oven
- Binocular Microscope with built-in illumination
- Contton wool (absorbed and non-absorbent)
- Pipette
- Distilled water
- Distilled water
- Disposable speculums
- Bunsen burner
- Incubator
- Disposable hand gloves
- Disinfectant
- Test tubes
- Filter paper
SAMPLE USED
High vaginal swabs (HIVS) were collected from non-pregnant (control) and pregnant women in their second trimester within the age range of 18-40 years and above.
STUDY AREA
Owerri is a capital of Imo state, one of the five Eastern states of Nigeria. Imo state has twenty-seven Local Government Areas. Out of this number, three Local Government, areas are in Owerri Town. These are: Owerri North Local Government area with headquarters at Uratta, Owerri West Local Government Area, headquarters at Umuguma, Owerri Municipal Council headquarters at Owerri Urban. Tow prominent hospitals are located in Owerri Urban Council, they are: Federal Medical Centre and General Hospital Owerri. These samples were collected from these hospitals. Hospital Owerri. These samples were collected from these hospitals.
POPULATION SAMPLE
A total of one hundred and twenty (120) samples were collected. Eighty (80) high vaginal swabs from pregnant women and forty (40) High Vaginal Swabs from non-pregnant women were collected respectively.
CHAPTER THREE
RESULTS
DATA PRESENTATION
A total of one hundred and twenty (120) high vaginal swab samples of pregnant and non-pregnant women were collected from two (2) hospitals within Owerri urban.
Graphical age Representation of the Relationship between age group and incidence of Candida albicans amongst pregnant and non pregnant women (control) at the clinics of FMC and General Hospital Owerri.
Form the above (Table 111, IV and fig.1). It is clearly shown that between age group (18-28 years), incidences of candida albicans rises progressively till the age of 29 years. At this age, progesterone and estrogen are secreted in sufficient amount following ovulation or the menstrual cycle.
CHAPTER FOUR
DISCUSSION
The findings of this research have confirmed that Candida albicans exist in the urinogenital tract of pregnant and non-pregnant women.
Adewole (1998) in his research work on the prevalence of venereal disease in Lagos discovered that the incidence of vaginal Thrush in pregnant women examined was 82.0% this is conformity with the result this (Done in Federal Medical Centre and General Hospital Owerri) which recorded an incidence rate of 85.0% and 40.0% respectively as shown in (tablesl and 11).
The work of Adewole (1998) for non-pregnant women are also in line with the tabulated percentages in this present work.
The incidence of Candida is more prominent in pregnant women and this is attributed to the following factors:
- High glycogen level of vagina during pregnancy especially especially in 2nd
- Provision of tropical microclimate by the vagina which is favourable for the incubation and hence proliferation of the organism.
- Natural immunosuppression during pregnancy.
The relationship between age and the incidence of Candida albicans was also confirmed by the studies of (martinez et al (1998) who found that during puberty and after menopause the incidence is low. The occurrence of Candida albicans is minimal at onset of menopause (table 111, IV and Fig 1).
This is attributed to:
- Fallen oestrogen level in the blood of such women which eventually brings about a reduction in the moisture content of the vagina.
- There is a low glycogen concentration in the vagina.
- Succession undergone by the natural microflora of the vagina associated with Candida alabicans.
CHAPTER FIVE
Conclusion
This study has shown that the incidence of Candida albican is higher in pregnant women than in non-pregnant female counterparts. This is due to the fact that for the causative organism, Candida albicans to germinate, a moist, warm and glycogen-rich environment is required. These conditions are provided during pregnancy at which time the vagina is enriched due to high oestrogen content.
It was shown that, the immunological suppressed state during pregnancy may be a contributing factor to high Candida infection. Sexual promiscuousness has little or no effect on the incidence of Candida albicans because male to female transmission of the disease is very rare, hence the incidence was comparatively lower in the non-pregnant women.
Other predisposing factors:
- Immunosuppressive therapy
- Diabetes mellitus
- Broad spectrum antibiotic therapy
- Chronic iron folic acid deficiency
- Lack of proper hygiene or health care
It is now obviously clear that between the age of 18 and 40 when the oestrogen support of the glycogen is at its peak, there is a higher degree of infection because this age group are sexually active and there is likelihood of recurrent pregnancies.
Incidence is comparatively low in non-pregnant women which is indicative of the fact that transmission through coitus is area and has little or nothing to do with sexual promiscuity. It is also due to low level of glycogen and absence of natural immunosuppression when not pregnant.
It is also an established fact that the incidence of Candida albicans is common among non-pregnant females (Tables 111 and IV) which suggest its dependence on some factors that predispose them to Candida albican infections such as: impaired immune system, inadequate self awareness due to asymptomatic Candida albicans, poor personal hygiene, humidity, moisture of the vaginal area, wearing synthetic and tight fitting wears, use of oral contraceptives, indiscriminate use of broad spectrum antibiotics, douching use of spermicidal creams, lubrication of the vagina, use of medicated or perfumed soaps and vaginal deodorants which eliminates the normal flora of the vagina thereby influencing the adherence and increasing the colonization rate and making them prone to infection.
The relationship between age group and the incidence of Candida albicans is also shown in figure 1. the role of age on the incidence of Candida ablicans was also confirmed by the studies of age on the incidence of Candida ablicans was also confirmed by the studies of (Martinez et al, 1998) who found that during puberty and after menopause the incidence is low.
RECOMMENDATION
From the result obtained, it is suggestive to create the awareness of this infection in the prenatal clinics and also coordinate health education on sexually transmitted infections (STI). Adequate treatment and proper personal hygiene will limit, if not eradicate the occurrences of this disease amongst females. It is therefore recommended that:
- Infected people should be treated as soon as they are diagnosed
- Avoidance of using perfumed or medicated soap and vaginal deodorants, refrain from shower gels, or douches to wash your vaginal area. Use just water.
- Avoidance of indiscriminate use of broad spectrum antibiotics.
- Avoid using spermicidal creams.
- Avoid using lubricants in the vagina
- Avoid wearing synthetic and tight-fitting wears; cotton underwear is best.
- The vagina should be kept as neat as possible to avoid the reduction of its acidity and its vulnerability to infections.
REFERENCES
- Adewol, B. (1998). Veneral disease of Fungi Origin and Vagina thrush on pregnant Women Inc.
- Adismap (2004). Candidiasis, Treatment and care on Patients incomplete (INC).
- Botu, G. (2002). The vaginal fungi in pregnant women pp 37, 39-44.
- Boyer and kienik. (2000). Candida albicans. An emotionally Conditioned symptom. Southern medical joumal 49:pp.1495-1501.
- Braga, P.C. dia-sasso, M., S.,.piatti, G., dannhorn, D.R., Bohn, M. (1009). Inhibition of Candid albicans adhesiveness To human buccal and vaginal cells by subinhibitory concentrations of relopirox, journal 45 (1): pp: 84-87.
- Cassone, R., Korting, H.c (1999). Effectives of the Human Immunodeficiency virus (HIV) proteinease Ihibitors sequinaivr on in-vitro Activities of secreted aspartyl proteinases of candida albicans isolates antimicrobial agents and chemotherapy 43 (8): pp. 2028, 2042.
- Center for disease control (CDC) (2004). Division of bacterial Disease and Mycotic Disease. Genital candidiasis (Vulvovaginal Candidiasis, VVC, Vaginal yeast infection).
- Cheesbrough, M. (2000). District Laboratory practice in Tropical country part2. 1st edition. Cambridge University press. London. Pp.98,110
