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BMC Public Health Jan 2024Vulvovaginal Candidiasis (VVC) is a public health problem, with approximately 30-50% of women affected at least once during their lifetime. Recurrent Vulvovaginal...
INTRODUCTION
Vulvovaginal Candidiasis (VVC) is a public health problem, with approximately 30-50% of women affected at least once during their lifetime. Recurrent Vulvovaginal Candidiasis (RVVC) is diagnosed following three or four repeated episodes of VVC in a calendar year. This condition poses health concerns with significant impacts on the quality of life of women. This cross-sectional study estimated the prevalence of RVVC and assessed the relationship between feminine/vaginal washes and other factors on RVVC among Ghanaian women in the Sekondi/Takoradi Metropolis.
METHODOLOGY
A cross-sectional study was employed to gather data from 304 women. Data were collected using a pretested questionnaire. Bivariate and multivariate analyses, including chi-square/Fisher's exact test and logistic regression, were performed using Jamovi (R Core Team 2021) software. Proportions were calculated, and odds ratios and their corresponding 95% confidence intervals were computed with the level of significance set at 0.05.
RESULTS
The prevalence of RVVC was estimated as 48.4% (95% CI 42.6%, 54.1%). Feminine Vaginal wash use (aOR = 3.86; 95% CI = 2.18, 6.84); age 36-45 years (aOR = 0.36; 95% CI = 0.17, 0.76) marital status (aOR = 2.37; 95% CI = 1.17, 4.79) and Sexual activity (aOR:0.43: 95%CI = 0.21, 0.88) were significantly associated with RVVC with p < 0.005.
CONCLUSION
RVVC is prevalent among women in the Sekondi/Takoradi Metropolis of Ghana. Feminine/Vaginal washes could be cautiously linked to the development of RVVC.
Topics: Humans; Female; Adult; Middle Aged; Candidiasis, Vulvovaginal; Ghana; Cross-Sectional Studies; Quality of Life; Vagina
PubMed: 38183091
DOI: 10.1186/s12889-024-17668-x -
BMC Women's Health Jan 2024This study aims to investigate the relationship between abnormal vaginal microecology and human papillomavirus (HPV) infection, as well as the squamous intraepithelial...
OBJECTIVE
This study aims to investigate the relationship between abnormal vaginal microecology and human papillomavirus (HPV) infection, as well as the squamous intraepithelial lesions (SIL) progression.
METHODS
A total of 383 patients diagnosed with HPV infection in our hospital between March 2017 and February 2022 were selected as the experimental group. In addition, several volunteers (n = 898) who underwent physical examination during the same period were randomly selected as the control group. Subsequently, we conducted several investigations, such as HPV detection and gene typing, examined vaginal microecological imbalances, and performed cytological examinations to analyze the correlation between microecological changes, different types of HPV infection, and SIL progression.
RESULTS
HPV detection primarily included single and high-risk types of HPV infections. Moreover, significant disparities in the vaginal microecological environment between patients with persistent HPV infection and the control group, as well as patients with low-grade and high-grade SIL (LSIL and HSIL), were observed. The regression analysis revealed a correlation between LSIL and microflora density, diversity, bacteriological vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonas vaginalis (TV), sialidase, as well as Lactobacillus. In addition, we identified an association between HSIL and pH, flora density, diversity, BV, VVC, candida vaginitis (CV), leukocyte esterase, catalase, and Lactobacillus levels.
CONCLUSION
These findings revealed a significant association between abnormal vaginal microecology and both HPV infection and the SIL progression.
Topics: Female; Humans; Papillomavirus Infections; Vaginal Smears; Vagina; Squamous Intraepithelial Lesions; Candidiasis, Vulvovaginal; Papillomaviridae; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms
PubMed: 38167014
DOI: 10.1186/s12905-023-02824-z -
PloS One 2023Candidal infections, particularly vulvovaginal candidiasis (VVC), necessitate effective therapeutic interventions in clinical settings owing to their intricate clinical...
Candidal infections, particularly vulvovaginal candidiasis (VVC), necessitate effective therapeutic interventions in clinical settings owing to their intricate clinical nature and elusive understanding of their etiological mechanisms. Given the challenges in developing effective antifungal therapies, the strategy of repurposing existing pharmaceuticals has emerged as a promising approach to combat drug-resistant fungi. In this regard, the current study investigates molecular insights on the anti-candidal efficacy of a well-proven anticancer small molecule -3-bromopyruvate (3BP) against three clinically significant VVC causing Candida species viz., C. albicans, C. tropicalis and C. glabrata. Furthermore, the study validates 3BP's therapeutic application by developing it as a vaginal cream for the treatment of VVC. 3BP exhibited phenomenal antifungal efficacy (killing >99%) with minimum inhibitory concentrations (MIC) and minimum fungicidal concentrations (MFC) of 256 μg/mL against all tested Candida spp. Time killing kinetics experiment revealed 20 min as the minimum time required for 3BP at 2XMIC to achieve complete-killing (99.9%) in all Candida strains. Moreover, the ergosterol or sorbitol experiment explicated that the antifungal activity of 3BP does not stem from targeting the cell wall or the membrane component ergosterol. Instead, 3BP was observed to instigate a sequence of pre-apoptotic cascade events, such as phosphatidylserine (PS) externalization, nuclear condensation and ROS accumulations, as evidenced by PI, DAPI and DCFH-DA staining methods. Furthermore, 3BP demonstrated a remarkable efficacy in eradicating mature biofilms of Candida spp., achieving a maximum eradication level of 90%. Toxicity/safety profiling in both in vitro erythrocyte lysis and in vivo Galleria mellonella survival assay authenticated the non-toxic nature of 3BP up to 512 μg/mL. Finally, a vaginal cream formulated with 3BP was found to be effective in VVC-induced female mice model, as it significantly decreasing fungal load and protecting vaginal mucosa. Concomitantly, the present study serves as a clear demonstration of antifungal mechanistic action of anticancer drug -3BP, against Candida species. This finding holds significant potential for mitigating candidal infections, particularly VVC, within healthcare environments.
Topics: Female; Mice; Humans; Animals; Candidiasis, Vulvovaginal; Antifungal Agents; Reactive Oxygen Species; Vaginal Creams, Foams, and Jellies; Candida; Candidiasis; Candida glabrata; Candida tropicalis; Ergosterol; Candida albicans; Microbial Sensitivity Tests
PubMed: 38153954
DOI: 10.1371/journal.pone.0295922 -
Germs Jun 2023Infectious vaginitis is prevalent in developing countries. Most of the females suffer from vaginal infections at least once per lifetime. Due to limited resources, many...
INTRODUCTION
Infectious vaginitis is prevalent in developing countries. Most of the females suffer from vaginal infections at least once per lifetime. Due to limited resources, many infections are misdiagnosed or undiagnosed. Good diagnosis of these infections is critically important and will definitely help to guide treatment and prevent recurrence.
METHODS
A total of 1080 vaginal swabs were collected from symptomatic females. Nugent's score and Amsel's criteria were applied to diagnose bacterial vaginosis (BV). A rapid test was used to identify . Trichomonal vaginitis (TV) was diagnosed through microscopic examination. Vulvovaginal candidiasis (VVC) was also identified microscopically and using conventional culture. Finally, aerobic vaginitis (AV) was detected using Donder's scale combined with conventional culture and biochemical tests.
RESULTS
There was no statistically significant association between age and type of vaginal infection (p=0.130). Vulvovaginal inflammation, itching and redness were significantly associated with VVC (p≤0.012). BV was detected as single infection in 43.8%, followed by VVC 24.2%. On the contrary, AV and TV were scarcely detected among the participants; 4.9% and 0.5% respectively. Mixed infections between BV and VVC were noted in 26.6%.
CONCLUSIONS
BV showed the highest prevalence followed by VVC. Mixed infections between BV and VVC were evidently noted, therefore good reliable diagnosis using cost-effective methods is crucial for proper treatment. Aerobic vaginitis showed low prevalence and most of the spp. were isolated from pregnant females. The low prevalence of may be due to the dependance on conventional methods for diagnosis, and thus more advanced diagnostic tools are required.
PubMed: 38144250
DOI: 10.18683/germs.2023.1376 -
Journal of Fungi (Basel, Switzerland) Dec 2023The aim of this study is to establish a loop-mediated isothermal amplification (LAMP) method for the rapid detection of vulvovaginal candidiasis (VVC).
PURPOSE
The aim of this study is to establish a loop-mediated isothermal amplification (LAMP) method for the rapid detection of vulvovaginal candidiasis (VVC).
METHODS
We developed and validated a loop-mediated isothermal amplification (LAMP) method for detecting the most common species associated with VVC, including , , , and . We evaluated the specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and Kappa value of the LAMP method to detect different species, using the conventional culture method and internal transcribed spacer (ITS) sequencing as gold standards and smear Gram staining and real-time Rolymerase Chain Reaction (PCR) as controls.
RESULTS
A total of 202 cases were enrolled, of which 88 were VVC-positive and 114 were negative. Among the 88 positive patients, the fungal culture and ITS sequencing results showed that 67 cases (76.14%) were associated with , 13 (14.77%) with , 5 (5.68%) with , and 3 (3.41%) with other species. Regarding the overall detection rate, the LAMP method presented sensitivity, specificity, PPV, NPV, and Kappa values of 90.91%, 100%, 100%, 93.4%, and 0.919, respectively. Moreover, the LAMP had a specificity of 100% for , , and , with a sensitivity of 94.03%, 100%, and 80%, respectively. Moreover, the microscopy evaluation had the highest sensitivity, while the real-time PCR was less specific for than LAMP. In addition, CHROMagar Candida was inferior to LAMP in detecting (NAC) species.
CONCLUSIONS
Based on the cost-effective, rapid, and inexpensive characteristics of LAMP, coupled with the high sensitivity and specificity of our VVC-associated detection method, we provided a possibility for the point-of-care testing (POCT) of VVC, especially in developing countries and some laboratories with limited resources.
PubMed: 38132760
DOI: 10.3390/jof9121159 -
Journal of Fungi (Basel, Switzerland) Nov 2023Vulvovaginal candidiasis (VVC) is a prevalent condition affecting women worldwide. This study aimed to develop a rapid qPCR assay for the accurate identification of VVC...
Vulvovaginal candidiasis (VVC) is a prevalent condition affecting women worldwide. This study aimed to develop a rapid qPCR assay for the accurate identification of VVC etiological agents and reduced azole susceptibility. One hundred and twenty nine vaginal samples from an outpatient clinic (Bilbao, Spain) were analyzed using culture-based methods and a multiplex qPCR targeting fungal species, which identified as the predominant species (94.2%). Antifungal susceptibility tests revealed reduced azole susceptibility in three (3.48%) isolates. Molecular analysis identified several mutations in genes associated with azole resistance as well as novel mutations in and genes. In conclusion, we developed a rapid multiplex qPCR assay that detects in vulvovaginal specimens and reported new mutations in resistance-related genes that could contribute to azole resistance.
PubMed: 38132746
DOI: 10.3390/jof9121145 -
Gels (Basel, Switzerland) Dec 2023The global concern regarding the occurrence of antifungal resistance to synthetic conventional azoles used for treating vulvovaginal candidiasis, along with the...
The global concern regarding the occurrence of antifungal resistance to synthetic conventional azoles used for treating vulvovaginal candidiasis, along with the associated side effects, is significant. Consequently, the pursuit for substitutes such as natural therapies has ensued. Essential oils, derived from plants, have been extensively researched and found to possess antibacterial and antifungal properties. This study aimed to assess the antifungal efficacy of two essential oils, both alone and in combination, against . Essential oils were formulated into an emulgel separately and as combinations. The essential oils of and were used in this study. The resulting emulgel formulations were characterized for their antifungal activity against . Physiochemical properties such as pH, viscosity, and appearance were also determined. The prepared emulgels were thereafter observed for stability over a period of 1 month. The MIC of was seen to be 50 µL/mL while was seen to be more potent at 25 µL/mL against exhibiting strong synergistic effect at 0.4. The emulgel formed was white in color, smooth on skin, and had the odor of the essential oils, which is sweet to the nose. The pH of the formulations with the essential oils were acidic in the range of 3.70-3.83, making them suitable for vagina application. The emulgels had viscosities ranging from 4417.6 to 8968.7 mPas, owing to the thickness of the essential oils contained. The emulgel formulation with the combination of essential oils was more potent that the two with individual essential oils; furthermore, the one with was more potent than the one with . Based on the properties of the formulated emulgels and their activity against the test organism, the preparations have significant potential in the management of vulvovaginal candidiasis.
PubMed: 38131935
DOI: 10.3390/gels9120949 -
BMC Women's Health Dec 2023Infectious vaginitis is one of the most prevalent conditions affecting women of reproductive age with significant clinical consequences. Bacterial vaginosis (BV),...
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.
Topics: Pregnancy; Female; Humans; Adult; Reproductive Health; Cross-Sectional Studies; Uganda; Trichomonas Vaginitis; Vaginosis, Bacterial; Candidiasis, Vulvovaginal; Reproductive Health Services; Prevalence; Health Facilities; Anti-Bacterial Agents; Pruritus
PubMed: 38114988
DOI: 10.1186/s12905-023-02835-w -
Women's Health (London, England) 2023Recurrent urogenital infections such as bacterial vaginosis, vulvovaginal candidiasis, and urinary tract infections have a high prevalence and pronounced psychosocial... (Review)
Review
Recurrent urogenital infections such as bacterial vaginosis, vulvovaginal candidiasis, and urinary tract infections have a high prevalence and pronounced psychosocial impact. However, no review has compared the psychosocial impacts across infection types. This narrative review discusses the impact of common recurrent urogenital infections on psychosocial aspects, including quality of life, stress, mental health, sexual health, work productivity, race and ethnicity, and satisfaction of medical care. Validated questionnaires show that women with recurrent vulvovaginal candidiasis and urinary tract infections have decreased scores on all aspects of quality of life. Those with recurrent vulvovaginal candidiasis and urinary tract infections show lower mental health scores compared to the general population, with increased risk of anxiety and depression. Recurrent urogenital infections affect sexual relationships and intimacy, including avoidance due to symptoms or as a method of prevention. Recurrent infections also increase medical cost and negatively affect work productivity, leading to a combined estimated cost of over US$13 billion per year. There are clear effects of racial inequality involving minority populations that affect diagnosis, treatment, prevalence, and reporting of recurrent urogenital infections. Satisfactory medical treatment improves quality of life and mental health in those suffering from these conditions. Research evaluating psychosocial aspects of recurrent urogenital infections is variable and is not comparable across vulvovaginal conditions. Even so, psychosocial factors are important in understanding contribution and consequence of urogenital infections. Education, awareness, normalization, community support, and access to care can help to alleviate the negative implications of recurrent urogenital infections.
Topics: Humans; Female; Candidiasis, Vulvovaginal; Reinfection; Quality of Life; Vaginosis, Bacterial; Urinary Tract Infections
PubMed: 38099456
DOI: 10.1177/17455057231216537 -
Antimicrobial Agents and Chemotherapy Jan 2024Vulvovaginal candidiasis (VVC) is a common condition among women. Fluconazole remains the dominant treatment option for VVC. Oteseconazole is a highly selective... (Randomized Controlled Trial)
Randomized Controlled Trial
Vulvovaginal candidiasis (VVC) is a common condition among women. Fluconazole remains the dominant treatment option for VVC. Oteseconazole is a highly selective inhibitor of fungal CYP51. This randomized, double-blinded, phase 3 trial was conducted to evaluate the efficacy and safety of oteseconazole compared with fluconazole in treating severe VVC. Female subjects presenting with vulvovaginal signs and symptoms score of ≥7 and positive infection determined by potassium hydroxide test or Gram staining were randomly assigned to receive oteseconazole (600 mg on D1 and 450 mg on D2) or fluconazole (150 mg on D1 and D4) in a 1:1 ratio. The primary endpoint was the proportion of subjects achieving therapeutic cure [defined as achieving both clinical cure (absence of signs and symptoms of VVC) and mycological cure (negative culture of species)] at D28. A total of 322 subjects were randomized and 321 subjects were treated. At D28, a statistically significantly higher proportion of subjects achieved therapeutic cure in the oteseconazole group than in the fluconazole group (66.88% vs 45.91%; = 0.0002). Oteseconazole treatment resulted in an increased proportion of subjects achieving mycological cure (82.50% vs 59.12%; < 0.0001) and clinical cure (71.25% vs 55.97%; = 0.0046) compared with fluconazole. The incidence of treatment-emergent adverse events was similar between the two groups. No subjects discontinued study treatment or withdrew study due to adverse events. Oteseconazole showed statistically significant and clinically meaningful superiority over fluconazole for the treatment of severe VVC and was generally tolerated.
Topics: Female; Humans; Fluconazole; Candidiasis, Vulvovaginal; Antifungal Agents; Candida; Administration, Oral; Candida albicans
PubMed: 38095426
DOI: 10.1128/aac.00778-23