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Konadu DG, Owusu-Ofori A, Yidana Z, Boadu F, Iddrisu LF, Adu-Gyasi D, Dosoo D, Awuley RL, Owusu-Agyei S, Asante KP. Prevalence of vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis in pregnant women attending antenatal clinic in the middle belt of Ghana. BMC Pregnancy Childbirth 2019; 19:341. [PMID: 31547803 PMCID: PMC6757405 DOI: 10.1186/s12884-019-2488-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/30/2019] [Indexed: 01/11/2023] Open
Abstract
Background Vaginal infections usually caused by Candida sp, organisms responsible for bacterial vaginosis and Trichomonas vaginalis are associated with considerable discomfort and adverse outcomes during pregnancy and child birth. The study determined the prevalence of vulvovaginal candidiasis (VVC), bacterial vaginosis (BV) and trichomoniasis (TV) in pregnant women attending antenatal clinic at the Kintampo Municipal Hospital. Methods A study adopted a cross sectional design and recruited 589 pregnant women after seeking their informed consent from September, 2014 to March, 2015. Semi-structured questionnaire were administered to participants and vaginal swabs were collected. The samples were analysed using wet mount method and Gram stain (Nugent criteria) for vaginal infection. Univariate and multivariate analysis were used to investigate association of risk factors to vaginal infections. Results The overall prevalence of at least one vaginal infection was 56.4%. The prevalence of vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis were 36.5, 30.9 and 1.4% respectively. Women with more than four previous pregnancies (OR: 0.27, 95% CI: 0.13–0.58) and those in the third trimester of pregnancy (OR: 0.54, CI: 0.30–0.96) were associated with a lower risk of bacterial vaginosis. Douching and antibiotic use were neither associated with VVC or BV. Conclusion The prevalence of vaginal infections was high among pregnant women in the Kintampo area. There is the need for interventions such as adequate investigations and early treatment of vaginal infections to reduce the disease burden to avoid associated complications.
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Affiliation(s)
| | - Alex Owusu-Ofori
- Department of Clinical Microbiology, School of Medical Science, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Microbiology Department, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Zuwera Yidana
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Bono East, Ghana
| | - Farrid Boadu
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Bono East, Ghana
| | | | - Dennis Adu-Gyasi
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Bono East, Ghana
| | - David Dosoo
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Bono East, Ghana
| | | | - Seth Owusu-Agyei
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Bono East, Ghana.,University of Health and Allied Sciences, Ho, Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, P. O. Box 200, Kintampo, Bono East, Ghana
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Sangaré I, Sirima C, Bamba S, Zida A, Cissé M, Bazié WW, Sanou S, Dao B, Menan H, Guiguemdé RT. Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso. J Mycol Med 2017; 28:186-192. [PMID: 28939305 DOI: 10.1016/j.mycmed.2017.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 08/10/2017] [Accepted: 08/18/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Pregnant women are more susceptible to vaginal colonization and infection by yeast. The role of Candida colonization in the occurrence of preterm birth is well established. The knowledge of local epidemiology and identification of risk factors for preterm birth is important for the prevention and management strategies. The purpose of the study was to determine the prevalence of Candida sp. in vaginal swabs of pregnant women. METHODS Pregnant women attending routine antenatal visits in three primary health centres in Bobo-Dioulasso (Burkina Faso) were enrolled into a cross-sectional study carried out from February to April 2015. Vaginal swabs samples were taken from participants after obtaining oral consent. The swabs were inoculated into Sabouraud's glucose agar supplemented with chloramphenicol and incubated at 37°C for 24 to 48hours under aerobic conditions in order to perform fungal culture. The identification of the Candida species was done by culture on HiCrome Candida Differential Agar at 35°C for 48h for production of species-specific colors. RESULTS A total of 229 pregnant women were included. The prevalence of vulvovaginal candidiasis (VVC) was 22.71%, (95% CI [17.45-28.69]). Candida albicans accounted for 40.39% and non-Candida albicans species for 59.61% of the isolates, with mainly C. glabrata (32.69%), C. tropicalis (15.38%) and C. krusei (11.54%). CONCLUSIONS This study revealed a high prevalence of non-C. albicans species. The syndromic management guidelines for VVC in Burkina Faso will be revised to include a specific protocol for pregnant women.
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Affiliation(s)
- I Sangaré
- Institut supérieur des sciences de la santé, université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso; Département des laboratoires, CHU Souro Sanou, Bobo-Dioulasso, Burkina Faso.
| | - C Sirima
- Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - S Bamba
- Institut supérieur des sciences de la santé, université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso; Département des laboratoires, CHU Souro Sanou, Bobo-Dioulasso, Burkina Faso.
| | - A Zida
- CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
| | - M Cissé
- Institut supérieur des sciences de la santé, université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso; Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - W W Bazié
- Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - S Sanou
- Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - B Dao
- Institut supérieur des sciences de la santé, université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso; Jhpiego, Baltimore, United States.
| | - H Menan
- Unité de formation et de recherche en sciences pharmaceutiques et biologiques et médicales, université Félix Houphouet Boigny, Abidjan, Côte d'Ivoire.
| | - R T Guiguemdé
- Institut supérieur des sciences de la santé, université Nazi Boni, 01 BP 1091, Bobo-Dioulasso, Burkina Faso.
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Sherrard J, Donders G, White D, Jensen JS. European (IUSTI/WHO) guideline on the management of vaginal discharge, 2011. Int J STD AIDS 2012; 22:421-9. [PMID: 21795415 DOI: 10.1258/ijsa.2011.011012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Three common infections are associated with vaginal discharge: bacterial vaginosis, trichomoniasis and candidiasis, of which trichomoniasis is a sexually transmitted infection (STI). This guideline covers the presentation and clinical findings of these infections and outlines the differential diagnoses. Recommendations for investigation and management based on currently available evidence are made, including the management of persistent and recurrent infections.
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Affiliation(s)
- J Sherrard
- Department of Genitourinary Medicine, Churchill Hospital, Oxford, UK.
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Diagnosis and management of bacterial vaginosis and other types of abnormal vaginal bacterial flora: a review. Obstet Gynecol Surv 2010; 65:462-73. [PMID: 20723268 DOI: 10.1097/ogx.0b013e3181e09621] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
UNLABELLED Bacterial vaginosis (BV) is a common cause of abnormal vaginal discharge. It is characterised by an overgrowth of predominantly anaerobic organisms (Gardnerella vaginalis, Prevotella spp., Peptostreptocci, Mobiluncus spp.) in the vagina leading to a replacement of lactobacilli and an increase in vaginal pH. BV can arise and remit spontaneously, but often presents as a chronic or recurrent disease. BV is found most often in women of childbearing age, but may also be encountered in menopausal women, and is rather rare in children. The clinical and microscopic features and diagnosis of BV are herein reviewed, and antibiotic and non-antibiotic treatment approaches discussed. TARGET AUDIENCE Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES After completion of this educational activity, the participant should be better able to analyze bacterial vaginosis clinically, formulate an oral antibiotic treatment regimen for bacterial vaginosis and use vaginal treatments for bacterial vaginosis.
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