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INCIDENCE OF CANDIDA ALBICANS AMONGST PREGNANT AND NON-PREGNANT WOMEN

CHAPTER ONE

INTRODUCTION

1.1      BACKGROUND TO THE STUDY

Candidiasis is a fungal disease caused by Candida species which is predominantly common in immune-compromised individuals and also a known causative agent of Vaginal Candidiasis in pregnant women (Shaheen and Teha, 2006). Candida species are the most common cause of fungal disease which range from simple mucocataneous to life threatening invasive fungal infection (Jacqueline and Bettina, 2010). The genus Candida is a taxonomic grouping that was originally used to define yeast like organism that were not considered to have a sexual reproductive life cycle (David et.al, 2011).

Vaginal Candidiasis (Candida albicans) also known as Candidal vulvovaginitis or vaginal thrush, is an infection of the vagina’s mucous membrane caused by Candida albicans. It is most commonly caused by excessive growth of one of a family of fungus known as Candida. They are normally present in the vagina in small number along with bacteria which are usually harmless. Under normal circumstances, the Candida yeast is held in check by normal body defenses together with other members of the normal flora. For instance, the acidity of the vagina is maintained at pH 4.0-4.5 (Nyirjesy, 2008). This acidity level prevents some vaginal pathogens from establishing. However, physiological changes in the balance of the body system would affect both beneficial and harmful yeasts, bacteria and other organisms in the body. This accordingly would alter the acidity of the vagina reducing it to pH 5.0-6.5, thereby giving room for the establishment of pathogenic organisms such as Candida (Akinbiyi et al., 2008). Vaginal pH may increase with age, phase of menstrual cycle, sexual activity, contraception choice, pregnancy, presence of necrotic tissue or foreign bodies, and use of hygienic products or antibiotics (Nyirjesy, 2008).

However, the vagina naturally contains a balanced mix of yeast and bacteria. The lactobacillus bacteria produce acid which inhibit the over growth of yeast in the vagina, but disruption of the healthy balanced bacteria can result in an overgrowth of yeast and thus can lead to vaginal itching, burning and other classic signs and symptoms of yeast infection. The overgrowth of yeast infection can result due to the following factors such as antibiotics uses, increased of oestrogen level in pregnant women, uncontrolled diabetes and impaired immune system which usually fight off infection is unable to effectively control the speed of the Candida fungus (Ilkit et al., 2011).

Candida contains over 350 heterogeneous species, but only minorities of those have been implicated in human disease (David et.al, 2011). Among the different species that cause vaginal candidiasis in pregnant women are Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, Candida parasilosis, Candida dubliniensis, Candida psedotropicals, Candida guillermondi, Candida kyfe. The vaginal candidiasis is of most common infection affecting nearly 75% of adult women in their life time and if this infection is untreated, it can cause pelvic inflammatory disease, a condition which can scar the fallopian tube and causes infertility in women (Ibrahim et.al, 2013).

The presence of yeast is typically diagnosed using vaginal wet mount microscopy and microbial culture (Ilkit et al., 2011). Vaginal candida infection can be treated with tropical or oral antifungal drugs such as fluconazole or nystatin. Both fluconazole and nystatin are effective for the treatment of Candida albicans but women with non-albicans spp. Only fluconazole is highly effective (Sobel, 2012).

1.2     STATEMENT OF THE PROBLEM

Vaginal candidiasis as a prevailing infection caused by Candida albicans among the pregnant women attending Olabisi Onabanjo University Teaching Hospital, Sagamu, implied worrisome. Analysis gather from various professional scientists has brought to light the deep concept of candidiasis infection that three out of four pregnant women are liable to the infection in their lifetime. Also researchers will be looking at the problem arising from the incessant re-occurrence of the infection after treatment. 

1.3     SIGNIFICANCE OF THE STUDY  

The results of this study will be important in planning intervention studies aimed at reducing vaginal infections and improving birth outcomes among pregnant women attending Olabisi Onabanjo University Teaching Hospital, Sagamu.

Also, the research will help to enlighten them on the possible signs and symptoms hold by the infection and also to forbidden them from self-medication by employing them to visit the hospital for diagnosis and proper treatment.

1.4     BENEFITS OF THE STUDY

This research will benefit the affected patient, entire community, government, and the school environment by educating them on how to be more careful. At the conclusion of this research, it will be beneficial to all especially medical laboratory scholars and practitioners and also to both the government and private medical diagnostic centres.

1.5     AIM OF THE STUDY

The aim of this study is to determine the prevalence of candidiasis among pregnant women attending Olabisi Onabanjo University Teaching Hospital, Sagamu.

1.6     OBJECTIVES OF THE STUDY

a)      To determine the prevalence of candidiasis.

b)     To determine the age range at which the occurrence mostly occurs among the pregnant women.

c)      To determine the control measures in reduction of the candidiasis infection among the pregnant women.

1.7     JUSTIFICATION OF THE STUDY

Among pregnant women attending Olabisi Onabanjo University Teaching Hospital, Sagamu, majority of the pregnant women are not going for check up on monthly basis. At the end of the research, the women will be enlightened on the adverse effect of candidiasis infection to them and ways of preventing it. Also, the student will find this research useful and also as a reference document on their research and to be relevant in source of materials for inclusion in related research.

1.8     HYPOTHESIS

Ho: Candidiasis is more prevalence in pregnant women attending Olabisi Onabanjo University Teaching Hospital, Sagamu.

Hi: Candidiasis is not prevalence in pregnant women attending Olabisi Onabanjo University Teaching Hospital, Sagamu.

1.9     DEFINITION OF TERMS

Candidiasis: this is a fungal infection caused by the growth of a type of yeast called candida, usually Candida albicans.

Vaginitis: this is a medical terms used for describing various condition that causes infection and inflammation of the vaginal.

Vulvovaginitis: this refer to inflammation of both the vaginal and vulva (the external female genitals).

Thrush: A contagious disease caused by a fungus, Candida albicans, that occurs most often in infants and children, characterized by small whitish eruptions on the mouth, throat, and tongue, and usually accompanied by fever, colic, and diarrhoea.

Yeast: this is a fungus that normally lives in the vaginal in small numbers.

Lactobacillus: this is a bacterium that exists naturally in the body primarily in the intestine and the vagina which produce fight against foreign organisms.

Inflammation:  this is a response that occurs when the body’s white blood cells and other substances produces fight against foreign organisms.

Bacteria: these are very tiny organism that made up of a single cell.

Oestrogen: this is a female steroid hormone that is produced by the ovaries which helps to control and guide sexual development.

Microbial culture: this is a method of multiplying micro-organisms by letting them reproduce in pre-determined culture media under controlled laboratory conditions.