Project – Prevalence of Virginal candidiasis among pregnant women attending Antenatal care at Catholic maternity Hospital Ogoja

CHAPTER ONE

INTRODUCTION

• Background to the Study

Vaginal candidiasis, primarily caused by Candida albicans, is one of the most common fungal infections affecting women, especially during pregnancy. Pregnancy induces hormonal changes that significantly alter the vaginal environment, creating favorable conditions for Candida overgrowth (Sobel, 1997). Elevated levels of estrogen and glycogen during pregnancy increase the susceptibility to candidiasis, making pregnant women particularly vulnerable. The immune modulation that occurs to support fetal survival also compromises the body’s ability to manage fungal infections effectively (Denning, 1991).

Several studies have demonstrated a high prevalence of vaginal candidiasis among pregnant women attending antenatal clinics. For instance, a cross-sectional study conducted in Nigeria reported a prevalence rate of 28.3% among pregnant women attending antenatal care (Okungbowa et al., 2003). Similarly, a study in Ethiopia found a prevalence of 34.5%, indicating that vaginal candidiasis remains a significant concern in maternal health, particularly in low- and middle-income countries (Alemu et al., 2014). Factors such as poor hygiene, limited access to healthcare, and lack of awareness about vaginal infections contribute to these high prevalence rates.

Geographical differences play a crucial role in the prevalence of vaginal candidiasis among pregnant women. Studies conducted in more developed settings report varying, often lower rates. For instance, research from the United States showed a prevalence rate of approximately 15–20% among pregnant women (Sobel et al., 1998). Differences in socio-economic status, healthcare systems, and health education are key factors explaining these discrepancies. Moreover, variations in diagnostic techniques—from culture-based methods to modern molecular assays—may also account for differences in reported prevalence.

Risk factors for vaginal candidiasis during pregnancy have been well documented. These include previous history of candidiasis, antibiotic use, diabetes mellitus, and the third trimester of pregnancy (Babic & Hukic, 2010). Pregnant women in their third trimester are at greater risk due to maximum hormonal changes and immunosuppression. Awareness of these risk factors is critical for antenatal care providers to ensure early diagnosis and management, which can prevent complications such as ascending infections, preterm labor, and neonatal candidiasis.

The clinical implications of untreated vaginal candidiasis during pregnancy are significant. Although often considered a superficial infection, candidiasis can predispose pregnant women to more severe reproductive tract infections and can adversely affect neonatal outcomes (Pappas et al., 2018). Hence, routine screening and effective management strategies during antenatal care are recommended in many healthcare guidelines, especially for symptomatic women.

In conclusion, the prevalence of vaginal candidiasis among pregnant women attending antenatal care is notably high, particularly in low- and middle-income countries. Multiple factors, including hormonal changes, immunosuppression, and socio-economic disparities, influence its occurrence. Early diagnosis, patient education, and effective treatment protocols are essential to reduce maternal and neonatal morbidity associated with this infection. Continued research is necessary to explore regional differences and improve preventive strategies in diverse populations.

• Statement of the Problem

Vaginal candidiasis is a common infection among women of reproductive age, and its occurrence is significantly heightened during pregnancy due to physiological and immunological changes. Despite its frequent occurrence, vaginal candidiasis is often underdiagnosed or misdiagnosed, particularly in antenatal care settings where the primary focus may be on more severe pregnancy complications. The underestimation of this infection can lead to discomfort, increased risk of ascending infections, and potential adverse pregnancy outcomes, such as preterm labor and low birth weight.

The prevalence of vaginal candidiasis among pregnant women varies widely across different regions, influenced by socioeconomic factors, hygiene practices, and healthcare accessibility. In low- and middle-income countries, studies have reported particularly high rates of infection, suggesting a pressing public health issue that demands more attention within maternal healthcare frameworks. However, there remains a lack of standardized screening protocols during antenatal care visits, which contributes to delayed diagnosis and treatment.

Pregnant women are particularly vulnerable to vaginal candidiasis because of the hormonal shifts that promote fungal growth and the suppression of the immune response required to sustain the pregnancy. In many antenatal clinics, routine testing for vaginal infections is not implemented unless women present with severe symptoms. As a result, many mild or asymptomatic cases remain untreated, posing risks to both maternal and neonatal health.

Moreover, the consequences of untreated vaginal candidiasis extend beyond maternal discomfort. Studies have indicated associations between vaginal fungal infections and increased risks of complications such as preterm rupture of membranes, premature delivery, and neonatal candidiasis. These risks highlight the need for early detection and management as part of comprehensive antenatal care. However, limited awareness among both healthcare providers and patients exacerbates the problem, leading to insufficient preventive measures and poor health outcomes.

Another significant challenge is the variability in the clinical presentation of vaginal candidiasis. Symptoms such as itching, discharge, and irritation overlap with other vaginal infections, making accurate diagnosis without laboratory confirmation difficult. In resource-limited settings, diagnostic facilities are often inadequate, further compounding the problem. The reliance on empirical treatment without proper diagnosis can also lead to antifungal resistance, complicating future treatment efforts.

Given these issues, there is an urgent need to assess and document the prevalence of vaginal candidiasis among pregnant women attending antenatal care. Understanding the magnitude of the problem will aid in formulating targeted interventions, improving screening protocols, raising awareness among healthcare providers, and ultimately enhancing maternal and neonatal health outcomes. Addressing this often-overlooked infection is a crucial step toward more holistic maternal healthcare delivery.

1.3. Aim and Objectives of the Study

The aim of the study is to examine the prevalence of Virginal candidiasis among pregnant women attending Antenatal care  at Catholic maternity Hospital Ogoja. The specific objectives are:

1. To determine if the knowledge of vaginal candidiasis will affect pregnant women attending Antenatal care.
2. To assess the risk factors associated with vaginal candidiasis in pregnant women at the hospital.
3. To identify the most common symptoms of vaginal candidiasis in pregnant women at the hospital.
4. To evaluate the current treatment practices for vaginal candidiasis among pregnant women at the hospital.

1.4.  Research Questions

The research questions are buttressed below:

1. How will the knowledge of vaginal candidiasis affect pregnant women attending Antenatal care at Catholic Maternity Hospital?
2. What are the risk factors associated with vaginal candidiasis in pregnant women at the hospital?
3. What are the most common symptoms of vaginal candidiasis in pregnant women at the hospital?
4. What are the current treatment practices for vaginal candidiasis among pregnant women at the hospital?

1.5. Research Hypothesis

The hypothetical statement of the study is buttressed below:

Ho: Knowledge of vaginal candidiasis will not affect pregnant women attending Antenatal care.

H1: Knowledge of vaginal candidiasis will affect pregnant women attending Antenatal care.

1.6. Significance of the Study

This study is important because it sheds light on the burden of vaginal candidiasis among pregnant women, a group particularly vulnerable to infections due to physiological changes during pregnancy. By establishing the prevalence of vaginal candidiasis in this population, healthcare providers can better understand how widespread the issue is and can tailor antenatal care services to include routine screening and early intervention strategies. This could lead to a reduction in maternal discomfort and prevent the progression of infections that could threaten both maternal and fetal health.

For pregnant women, this study emphasizes the importance of early detection and treatment of vaginal candidiasis. Increased awareness can empower women to seek medical attention promptly when symptoms arise, rather than dismissing them as minor irritations. Educating pregnant women about candidiasis will also promote better hygiene practices and self-care during pregnancy, which are essential in preventing infections and maintaining overall reproductive health.

From a healthcare systems perspective, the findings of this study can guide policy formulation and resource allocation. Knowing the prevalence will help justify the need for improved diagnostic facilities, the development of standardized screening protocols during antenatal care visits, and the training of healthcare workers in the identification and management of vaginal candidiasis. This will contribute to strengthening maternal health services, especially in resource-limited settings where infectious diseases continue to pose significant risks to pregnant women.

Academically, this study will add to the growing body of literature on maternal infections, particularly fungal infections, which are often underrepresented compared to bacterial and viral diseases. It will provide a reference point for future research aimed at exploring the risk factors, clinical outcomes, and optimal management strategies for vaginal candidiasis in pregnancy. Furthermore, it can inspire comparative studies across different regions and populations to uncover broader patterns and inform global maternal health policies.

The study also has implications for newborn health. By addressing vaginal candidiasis effectively during pregnancy, the risk of transmitting the infection to the newborn during delivery can be minimized. Preventing neonatal candidiasis is critical, as fungal infections in newborns can lead to serious health complications, especially in preterm or low-birth-weight infants. Thus, the study indirectly supports the broader goal of improving neonatal survival rates and health outcomes.

In summary, the significance of this study lies in its potential to improve maternal and neonatal health outcomes by promoting early diagnosis and management of vaginal candidiasis. It will provide valuable insights for healthcare practitioners, policymakers, researchers, and pregnant women themselves. Through a better understanding of the prevalence and impact of this infection, the study can contribute to more comprehensive and effective antenatal care programs.

1.7. Scope of the Study

The study examines Prevalence of Virginal candidiasis among pregnant women attending Antenatal care at Catholic maternity Hospital Ogoja

1.8. Operational Definition of Terms

Prevalence: Prevalence refers to the total number of cases of a particular disease or condition present in a specific population at a given time. It is usually expressed as a percentage or proportion and helps in understanding how widespread a health issue is within a community.

Vaginal Candidiasis: Vaginal candidiasis, also known as a yeast infection, is a fungal infection caused mainly by Candida albicans. It leads to symptoms such as itching, abnormal vaginal discharge, irritation, and redness. This infection becomes more common during pregnancy due to hormonal and immune system changes.

Pregnant Women: Pregnant women are females who are carrying a developing embryo or fetus within their uterus. Pregnancy typically lasts about 40 weeks from the first day of the last menstrual period and involves significant physiological changes to support fetal development.

Antenatal Care: Antenatal care (ANC) refers to the routine health care provided to pregnant women by skilled health professionals. The main aim is to monitor the health of both the mother and the fetus, detect any potential complications early, and provide preventive and health education services to ensure a healthy pregnancy and delivery.

Maternity Hospital: A maternity hospital is a specialized healthcare facility focused on providing care related to pregnancy, childbirth, and the postpartum period. It offers services such as antenatal care, labor and delivery support, neonatal care, and sometimes gynecological services for women.

Project – Prevalence of Virginal candidiasis among pregnant women attending Antenatal care at Catholic maternity Hospital Ogoja