Infectious vaginitis among women seeking reproductive health services at a sexual and reproductive health facility in Kampala, Uganda.

BACKGROUND: Infectious vaginitis is one of the most prevalent conditions affecting women of reproductive age with significant clinical consequences. Bacterial vaginosis (BV), vulvo-vaginal candidiasis (VVC), and trichomoniasis (TV) are the main etiologies. Unfortunately, there is limited data on the prevalence and associated risk factors, especially in sub-saharan Africa. This study, thus, determined the prevalence and risk factors of infectious vaginitis among women seeking reproductive health services at a Marie-stopes health facility in urban areas of Kampala, Uganda. METHODS: A cross-sectional study with 361 participants was conducted from July to October 2021. Data on risk factors and infection were collected via a structured questionnaire and laboratory analysis of vaginal swabs, respectively, with data analysis performed using Stata version 14.0 college station, Texas 77,845 US. RESULTS: The ages of participants ranged from 18 to 49 years, with a mean age of 29.53 years. Overall, 58.45% were infected, of whom 33.24% had VVC, 24.93% had BV, and 0.28% had TV. Bivariate analysis revealed that women with pruritus (COR: 3.057, 95% CI: 1.940-4.819), pregnancy (COR: 4.914, 95% CI: 1.248-19.36), antibiotic use (COR: 1.592, 95% CI: 1.016-2.494), douching (COR: 1.719, 95% CI: 1.079-2.740), and multiple partners (COR: 1.844, 95% CI: 1.079-2.904) were more likely to have VVC, whereas having higher education status (University; Vocational) (COR: 0.325, 95% CI: 0.134-0.890; COR: 0.345, 95% CI: 0.116-0.905) reduced the risk. On the other hand, women with a smelly discharge (COR: 1.796, 95% CI: 1.036-3.110), IUD use (COR: 1.868, 95% CI: 1.039-3.358), and antibiotic use (COR: 1.731, 95% CI: 1.066-2.811) were more likely to have BV. Multivariable analysis identified pruritus (AOR: 2.861, 95% CI: 1.684-4.863) as the only independent predictor for VVC. CONCLUSION: Results indicate a high prevalence of infection among these women; therefore regular screening and treatment is recommended to curb the high rate of infection. More studies on risk factors of infection are recommended.

Aspectos da abordagem terapêutica sobre candidíase vulvovaginal / Aspects of the therapeutic approach to vulvovaginal candidiasis / Aspectos del abordaje terapéutico de la candidiasis vulvovaginal

A candidíase vulvovaginal, é uma infecção da vulva e vagina causada por vários tipos de Candida spp. Essa patologia afeta 75% de todas as mulheres pelo menos uma vez durante a vida, ocorrendo com mais frequência durante a idade fértil. A transmissão dessa infeção fúngica ocorre por meio de contato com mucosas e secreções em pele de portadores ou doentes, contato sexual, água contaminada e transmissão vertical. Alguns outros sintomas característicos mais vistos em casos de CVV, são lesões brancas, cremosas e planas, sendo mais intensos no período pré-menstrual, quando a acidez vaginal aumenta. numerosos antifúngicos estão disponíveis no mercado, os quais são encontrados para administração oral na forma de comprimidos ou, para uso tópico, na forma de cremes, loções, comprimidos vaginais, supositórios e tampões revestidos. O objetivo geral do trabalho foi analisar através da revisão de literatura, tratamentos convencionais e alternativos para abordagem terapêutica da Candidíase Vulvovaginal contextuando a mesma, utilizando definições, dados epidemiológicos e sua sintomatologia frente à sociedade. O presente trabalho é uma revisão integrativa, que teve a coleta de dados realizada de março de 2021 a outubro de 2021 nas bases de dados Lilacs, Scielo, Google acadêmico, A busca resultou em 902 artigos, dos quais 14 atenderam ao critério de inclusão. A busca por tratamentos frente a candidíase vulvovaginal tem se mostrado ampla de acordo com os artigos selecionadas. Concluímos que a patologia candidíase vulvovaginal, vem apresentando resistência em algumas abordagens terapêuticas, assim como algumas mulheres não aderem há algum tipo de tratamento, devido à falta de conhecimento sobre a patologia.

Vulvovaginal candidiasis is an infection of the vulva and vagina caused by various types of Candida spp. This condition affects 75% of all women at least once in their lifetime, occurring more frequently during their childbearing years. The transmission of this fungal infection occurs through contact with mucous membranes and secretions on the skin of patients or patients, sexual contact, contaminated water and vertical transmission. Some other characteristic symptoms more seen in cases of VVC are white, creamy and flat lesions, being more intense in the premenstrual period, when the vaginal acidity increases. numerous antifungals are available on the market which are available for oral administration in tablet form or, for topical use, in the form of creams, lotions, vaginal tablets, suppositories and coated tampons. The general objective of the work was to analyze, through a literature review, conventional and alternative treatments for the therapeutic approach of Vulvovaginal Candidiasis in its context, using definitions, epidemiological data and its symptoms in society. The present work is an integrative review, which had data collection carried out from March 2021 to October 2021 in the Lilacs, Scielo, Google academic databases. The search resulted in 902 articles, of which 14 met the inclusion criteria. The search for treatments against vulvovaginal candidiasis has been shown to be wide according to the selected articles. We conclude that the vulvovaginal candidiasis pathology has been showing resistance in some therapeutic approaches, as well as some women do not adhere to any type of treatment, due to lack of knowledge about the pathology.

La candidiasis vulvovaginal es una infección de la vulva y la vagina cau- sada por diversos tipos de Candida spp. Esta afección afecta al 75% de las mujeres al menos una vez en la vida, siendo más frecuente durante la edad fértil. La transmisión de esta infección fúngica se produce por contacto con mucosas y secreciones de la piel de pacientes o enfermos, contacto sexual, agua contaminada y transmisión vertical. Otros síntomas característicos más observados en los casos de CVV son las lesiones blancas, cremosas y planas, siendo más intensas en el período premenstrual, cuando aumenta la acidez vaginal. Existen en el mercado numerosos antifúngicos disponibles para adminis- tración oral en forma de comprimidos o, para uso tópico, en forma de cremas, lociones, comprimidos vaginales, supositorios y tampones recubiertos. El objetivo general del tra- bajo fue analizar, a través de una revisión bibliográfica, los tratamientos convencionales y alternativos para el abordaje terapéutico de la Candidiasis Vulvovaginal en su contexto, utilizando definiciones, datos epidemiológicos y su sintomatología en la sociedad. El pre- sente trabajo es una revisión integradora, que tuvo recolección de datos realizada de marzo de 2021 a octubre de 2021 en las bases de datos académicas Lilacs, Scielo, Google. La búsqueda resultó en 902 artículos, de los cuales 14 cumplieron los criterios de inclu- sión. La búsqueda de tratamientos contra la candidiasis vulvovaginal se ha mostrado am- plia según los artículos seleccionados. Concluimos que la patología de la candidiasis vul- vovaginal viene mostrando resistencia en algunos abordajes terapéuticos, así como algu- nas mujeres no se adhieren a ningún tipo de tratamiento, debido al desconocimiento de la patología.

[Epidemiological and etiological profile of vulvovaginal candidiasis in women in consultation in the gynecology-obstetrics department, CHU Gabriel Toure, Bamako - Mali]. / Profil epidemiologique et etiologique des candidoses vulvovaginales chez les femmes en consultation dans le service de gynecologie-obstetrique, CHU Gabriel Toure, Bamako - Mali.

Vulvovaginal candidiasis (VVC) is a fungal infection caused by yeasts of the genus Candida that leads to vulvar pruritus and vaginal discharge. METHOD: In order to evaluate the epidemiological and etiological Profile of vvc, we carried out a cross-sectional study among women in consultation in the gynecological department of the CHU-Gabriel Toure in Bamako. Two swabs were taken from each woman for mycological diagnosis. The presence of yeasts and pseudo-filaments was observed on direct examination. The culture was performed on Sabouraud-Chloramphenicol medium and at 37°C for 24 to 48 hours. Identification was based on the macroscopic and microscopic characteristics of the colonies, the germinative tube test and the Vitek•2 instrument. of the colonies, the germinative tube test and the VITEK® 2 instrument. RESULT: A total of 240 women were included with a mean age of 31.5 ± 3.15 [15-64 years]. Married women represented 91.67% (n=220) and 51.25% were housewises. Pruritus 49.17% (118/240) and dyspareunia 42.08% (101/240) were the most frequent clinical signs. Previous use of antifungals was demonstrated in 85.83% of women. Candida species were confirmed in 60.42% (145/240) of cases. C. albicans was the most frequent species followed by C. famata, C. dubliniensis, C. krusei.. This study allowed us to identify the most frequent cases of C. albicans, followed by C. famata, C. dubliniensis, and C. krusei..Further studies are still needed to characterize the antifungal susceptibility profile of the Candida species involved.

La candidose vulvo-vaginale (CVV) est une infection fongique causée par des levures du genre Candida provoquant du prurit vulvaire et des pertes vaginales. MÉTHODE: Afin d'évaluer le profil épidémiologique et étiologique des CVV, nous avons réalisé une étude transversale chez les femmes en consultation dans le service de gynécologie du CHU-Gabriel TOURE de Bamako. Deux écouvillons vaginaux ont été prélevés sur chaque femme pour le diagnostic mycologique. La présence de levures et de pseudo-filaments a été observée à l'examen direct. La culture a été réalisée sur milieu Sabouraud-Chloramphénicol et à 37°C pendant 24 à 48 heures. L'identification a été basée sur les caractéristiques macroscopiques et microscopiques des colonies, le test du tube germinatif et l'instrument VITEK® 2. RÉSULTAT: Un total de 240 femmes ont été incluses avec un âge moyen de 31,5 ans ± 3,15 [15-64 ans]. Les femmes mariées représentaient 91,67% et 51,25% étaient des menagères. Le prurit 49,17 % et la dyspareunie 42,08 % (101/240) étaient les signes cliniques les plus fréquents. La prise antérieure d'antifongiques a été retrouvée chez 85,83% des femmes. La présence des espèces de Candida a été confirmée dans 60,42 % des cas. L'espèce C. albicansétait lus fréquente suivies de C. famata, C. dubliniensis, C. krusei.. CONCLUSION: Les résultats de cette étude permettent d'élargir les connaissances sur l'épidémiologie du CVV au Mali. D'autres études restent nécessaires pour caractériser le profil de sensibilité aux antifongiques des espèces de Candida impliquées.

The application value of DNA hybridization probe test in the diagnosis of bacterial vaginosis and vulvovagi-nal candidiasis / 实用医学杂志

Objective To investigate the sensitivity and specificity of DNA hybridization probe test(Af-firm VPIII) in the identification related microorganisms of bacterial vaginosis(BV),vulvovaginal candidiasis (VVC). Methods Vaginal secretion were detected in 103 patients with symptom and sign of vaginitis in the out patient department. According to Nungent score,the fungal culture as the gold standard. BV blue reagent assay and wet mount microscopy as a common detection method,evaluated the sensitivity and specificity of Affirm VPIII. Results Compared with the Nungent score,the sensitivity and specificity of Affirm VPIII were 98% and 96.2%. Compared with the fungi culture,the sensitivity and specificity of Affirm VPIII were 89.4% and 98.3%. Conclusion Affirm VPIII has high sensitivity and specificity which can identify pathogenic microorganisms of BV,VVC,especially in BV diagnosis.

Prevalencia de resultado positivo de la citología para vaginosis bacteriana, candidiasis y tricomoniasis en una Empresa Social del Estado de Medellín (Colombia), 2010-2012 / Prevalence of positive cytology results for bacterial vaginosis, candidiasis and trichomoniasis in a Social State Institution in Medellín, Colombia, 2010-2012

Objetivo: determinar la prevalencia del resultado positivo de la citología para vaginosis bacteriana, candidiasis y tricomoniasis vaginal, y su distribución según edad, método de planificación y sector de residencia.Materiales y métodos: estudio de corte transversal en especímenes citológicos obtenidos de mujeres atendidas entre los años 2010-2012 en Metrosalud, red de instituciones de la que hacen parte cincuenta centros de salud y unidades hospitalarias de primer nivel en Medellín (Colombia). Se incluyó toda la población de mujeres del régimen subsidiado atendida en la institución, se excluyeron las citologías con muestras insatisfactorias por ausencia de células, exceso de eritrocitos o leucocitos, y extendido defectuoso. Se usó fuente de información secundaria. Los datos se almacenaron y analizaron en SPSS 21®, con medidas de resumen y frecuencias absolutas y relativas.Resultados: se incluyeron 206.035 registros. La prevalencia de vaginosis bacteriana fue 18 %, candidiasis 4,7 % y tricomoniasis 0,8 %. Los subgrupos con mayor prevalencia de infecciones fueron los adolescentes, con 22,8 % de vaginosis bacteriana, 9,2 % de candidiasis y 1,0 % para tricomoniasis; y quienes usan el dispositivo intrauterino (DIU) con 25,6, 5,1 y 1,2 % respectivamente.Conclusión: se halló una elevada prevalencia de las infecciones estudiadas, principalmente en adolescentes y usuarias del DIU; esta información resulta útil para los tomadores de decisiones en salud y para evaluar la pertinencia de estructurar programas de tamización de infecciones del tracto genital aunados a la tamización del cáncer cérvico-uterino.

Objective: To determine the prevalence of positive cytology results for bacterial vaginosis, candidiasis and vaginal trichomoniasis, and distribution by age, birth control method and place of residence. Materials and methods: Cross-sectional study of cytology samples from women seen between 2010 and 2012 at Metrosalud, a network of institutions comprising 50 healthcare centres and level I hospitals in Medellín, Colombia. All the female population under the subsidized insurance regime was included, and inadequate samples due to absence of cells, excess red or white blood cells, and defective smear were excluded. A secondary source of information was used. Data were stored and analysed using the SPSS 21®, with summary measurements and absolute and relative frequencies. Results: Overall, 206,035 records were included. The prevalence of bacterial vaginosis was 18 %, and the prevalence of candidiasis and trichomoniasis was 4.7 % and 0.8 %, respectively. The subgroups with the highest prevalence of infections were adolescents with 22.8 % bacterial vaginosis, 9.2 % candidiasis and 1.0 % trichomoniasis. Among women using the intrauterine device (IUD), the prevalence was 25.6 %, 5.1 % and 1.2 %, respectively.Conclusion: A high prevalence of the infections studied was found, mainly among adolescents and IUD users. This information is useful for healthcare decision-making and for evaluating the relevance of structuring screening programs for genitourinary tract infections together with screening for cervical and uterine cancer.

Synergistic activity between Echinophora platyloba DC ethanolic extract and azole drugs against clinical isolates of Candida albicans from women suffering chronic recurrent vaginitis.

OBJECTIVE: Candida albicans is one of the main causes of vaginitis, especially in women with recurrent episodes. The appearance of drug resistant C. albicans and adverse effects of chemical agents have raised interest in Echinophora platyloba as one of four native species in Traditional Persian-Iranian medicine. MATERIALS AND METHODS: This study evaluates the antifungal activity of ethanolic extract from dried aerial parts of E. platyloba against 27 clinical isolates of C. albicans from women suffering chronic recurrent vaginitis by micro-broth dilution assay. The synergistic effect of azole drugs and E. platyloba ethanolic extract were also determined by disc diffusion method after determining the MIC90. RESULTS: The results of this study showed a potent synergistic effect of E. platyloba ethanolic extract and itraconazole (P<0.01) and fluconazole (P<0.001) but an antagonistic effect between E. platyloba ethanolic extract and clotrimazole and miconazole against clinical isolates of C. albicans. CONCLUSION: These results must be confirmed by clinical application and by further clinical studies.