Vaginal candidiasis prevalence, associated factors, and antifungal susceptibility patterns among pregnant women attending antenatal care at bule hora university teaching hospital, Southern Ethiopia

Abstract

Background: Vulvovaginitis is common in women of reproductive age group characterized by purulent white discharge. The incidence of vulvovaginitis has risen recently due to the resistance of Candida species to commonly used antifungal agents and recurrent infections.

Objective: The study aimed to determine the prevalence, associated factors, and antifungal susceptibility patterns of vaginal candidiasis among pregnant women attending Bule Hora University Teaching Hospital.

Methods: A hospital-based cross-sectional study was conducted from May 2023 to August 2023. Using systematic random sampling, 317 pregnant women participated in the study. Sabouraud Dextrose Agar and Chromogenic Candida Differential Agar were used to isolate and identify Candida species from clinical samples. Antifungal susceptibility was performed using a modified disc diffusion method. Epi data version 4.6 was used for data entry and Statistical Packages for Social Sciences version 25 was used for statistical analysis. A P-value < 0.05 was declared statistically significant.

Result: The prevalence of vaginal candidiasis was 26.8% (95%, CI 21.9-31.72%). History of using contraceptives (AOR = 5.03, 95%CI, 1.21-11.37), past vaginal candidiasis (AOR = 6, 95%CI, 1.61-12.92), pregnant women infected with human immunodeficiency virus (HIV) (AOR = 4.24, 95%CI, 1.23-14.14), diabetic mellitus (AOR = 2.17, 95%CI, 1.02-4.64), history of antibiotic use (AOR = 3.55, 95%CI, 1.67-12.75), pregnant women in third trimester (AOR = 8.72, 95%CI, 1.30-23.07), were the significantly associated factors for vaginal candidiasis. The study revealed that itraconazole, amphotericin B, and miconazole were the most effective antifungal drugs for all Candida isolates.

Conclusion: The present study has identified a high prevalence of vaginal candidiasis among pregnant women. The isolated Candida species showed resistance to fluconazole, ketoconazole, and clotrimazole. Therefore, healthcare providers should increase awareness of the risks of Candida infections to reduce Candida species among pregnant women. Physicians should prescribe suitable medications based on antifungal drug test outcomes to treat pregnant women with vaginal candidiasis.

Keywords: Antenatal care; Bule hora; Pregnant women; Vaginal candidiasis.

Fig. 1

Proportion of Candida species isolated from pregnant women at Bule Hora University Teaching Hospital, west Guji zone, Southern Ethiopia, 2023