CHAPTER ONE

INTRODUCTION

1.1 Background

Candida species are involved in the main opportunistic yeast infection in the world, candidiasis, being among the species of the genus, Candida albicans continues to be the most common (Carlisle and Kadosh, 2013). Although this yeast is responsible for approximately 50-90% of human candidiasis, Candida albicans is part of the commensal flora of more than half of the healthy population. Colonization by this yeast is beneficial to the host, because not only limits the growth of other opportunistic pathogenic fungi, but also promotes the functioning of the immune system (Matthews 2018). 

In the last two decades, it has been observed a considerable increase in the incidence of deep fungal infections, not only in immunocompromised patients, but also related to nosocomial infections, and even in healthy population (Desruisseeau 2009). Thus, with the increased incidence of deep fungal infections (chronic candidiasis), the primitive idea that they were related to a restrict number of pathogenic fungi and specific geographical area was completely changed. Furthermore, with the rapid increase of candidiasis incidence, other Candida species and microorganisms besides Candida albicans,have been involved in such infections (Jombo  2007).

The most common species are Candida albicans, Candida tropicalis, Candida glabrata, Candida dubliniensis, Candida parapsilosis, Candida orthopsilosis, Candida metapsilosis, Candida krusei, Candida famata, Candida guilliermondii and Candida lusitaniae. Other relevant fact associated with virulence is their apacity to form biofilms with other species, which together with the presence of teleomorph forms difficult the treatment and alter the susceptibility profiles to traditional antifungals agents (Pawlaczyk 2006). In Maroua- Far-North Cameroon (2010), investigation was carried out at two referral hospitals, involving 211 (112 pregnant and 99 non pregnant) women of age interval 16-45 years, to estimate the prevalence of vulvovaginal candidiasis (VVC) amongst pregnant women. The results indicated that the prevalence of candidiasis was higher amongst pregnant (55.4%) than non-pregnant women (35.4%) (Toua 2013).

1.2 Rationale 

Vaginal candidiasis is the most frequent type of genital yeast infection.  Approximately 75% of women experience at least once in their lifetime. Although, not being a threat to life, it is unpleasant and problematic, causing a variable degree of itching and whitish discharge, abundant and flocculent. This infection is very common among women of child-bearing age and in pregnant women, especially in the last trimester of pregnancy, when a variation of progesterone, estradiol and glycogen, associated with an increase in vaginal pH, favors the emergence of these infections. In this case, special attention should be given due to the potential occurrence of contamination of the fetus in the uterus, or even the child during childbirth. On the other hand, it has been observed that, in individuals with diabetes, the incidence of vaginal candidiasis is higher. Similarly, patient’s submitted to broad-spectrum of antibiotic therapy and even the use of oral contraceptives, are also important factors associated with higher rates of incidence of candidiasis. Therefore it is imperative assess knowledge of women of child-bearing age in Molyko on the causes and prevention of candidiasis community.

1.3 Goal of study

The goal of this study is to generate vital information on the causes and prevention of candidiasis among women of child-bearing age which will help to reduce the complication candidiasis among these women during pregnancy.

1.4 Research Questions

1. How can vaginal candidiasis be assessed in the Molyko community?
2. What are the preventive strategies of vaginal candidiasis among women of child bearing age in the Molyko community?
3. What are the challenges faced by women of child bearing age in the treatment of vaginal candidiasis in the Molyko community?

1.5 Research Objectives

1.5.1 General objective

The general objective of the study is to assess knowledge on the causes and prevention of candidiasis among women of child-bearing age in the Molyko community

1.5.2 Specific objectives

1. To assess knowledge of candidiasis among women of child-bearing age in the Molyko community
2. To identify the preventive strategies of candidiasis among women of child-bearing age in the Molyko community.

3. To identify challenges faced by women of child bearing age in the treatment of vaginal candidiasis in the Molyko community