Prevalence and risk factors for vaginal candidiasis among women seeking primary care for genital infections in Dar es Salaam, Tanzania

Abstract

Objective: To determine the prevalence and risk factors for vaginal candidiasis (VC) among women seeking primary care for genital infections. Design: Cross-sectional study. Setting: Ilala Municipal Hospital in Dar es Salaam, Tanzania. Subjects: Four hundred and sixty four women presenting with complaints of genital infections. Results: Of the 464 women examined, 177 (38.1%) had abnormal vaginal discharge, 68(14.7%) had genital ulcers, 272 (58.6%) had genital pruritis, 18 (3.9%) had genital warts and 58 (12.5%) had chancre. The prevalencies of VC, bacterial vaginosis, HIV, T vaginalis, N. gonorrhoeae and syphilis were 45%, 48.4%, 22%, 93%, 1.5% and 4.3%, respectively. The occurrence of VC was positively associated with HIV, (OR=1.81, 95% CI (1.0-2.67), bacterial vaginosis; (OR=2.6, 95%CI (1.7-3.9), genital pruritis; (OR=1.8 1, 95%CI (1.2-2.7) genital discharge; (OR=1.867, 95% (1.28-2.73) and negatively with T. vaginalis (OR=0.27, 95% CI (0.12-0.6), occupation (OR=0.65, 95%CI (0.35-0.86)) and with education (OR=0.43, 95% CI (0.11-0.73). There were increased but non-significant odds for VC in patients with syphilis (OR=1.6 95%CI (0.6-4.3) and venereal warts (OR=2.5 95% CI (0.92-6.8) VC was not associated with N. gonorrhoeae, genital ulcers, age at first intercourse, number of sexual partners, marital status or antibiotic usage. Conculsion: The high prevalence of vaginal candidiasis among women with genital infections should be taken into account when updating policies concerning syndromic management of sexually transmitted diseases. More gender specific approach to syndromic management of sexually transmitted infections in females should be considered.

Screening of Tanzanian medicinal plants for anti-Candida activity

“…Those for Candida oesophagitis were painful swallowing, a feeling of obstruction on swallowing, substernal chest pain and discrete ulceration of the oesophagus [ 23 ]. The symptom for vaginal candidiasis was a cuddle milk discharge [ 24 ].…”

Medicinal plants used by Tanzanian traditional healers in the management of Candida infections

“…Oral thrush, which is the commonest form of oral candidiasis in Tanzania, is known as "Utando wa mdomoni" in Swahili language. Symptoms for candida oesophagitis were painful swallowing a feeling of obstruction on swallowing, substernal chest pain and discrete ulceration of the oesophagus (Connolly et al, 1989) and those for vaginal candidiasis was a cuddle milk discharge (Namkinga et al, 2005) known as "Maziwa ya mgando" in Swahili language.…”

Reproductive tract infections associated with vaginal discharge and their socio-demographic and reproductive determinants among clinic attendees in Bangladesh

“…We found that women with no education were less likely to have candidiasis than those with some education. Namkinga et al 23 and Bradshaw et al 24 reported a similar association. It is possible that educated women are more aware of genital hygiene and are more likely to use soap and water or other chemical agents to keep their genitals clean thus disturbing their vaginal flora.…”