Exploring the prevalence, factors associated and treatment outcome of Symptomatic Vaginal Candidiasis in Non-Pregnant Women at Mwanza, Tanzania Outpatient Clinics

Background: Vaginal candidiasis is a prevalent concern for women, affecting approximately 70-75% of them at least once in their lifetime, with recurrence rates ranging from 6-9%. However, there is a notable scarcity of data regarding its prevalence, contributing factors, and treatment effectiveness among non-pregnant women. Methodology: A cross-sectional study was conducted from May 2022 to May 2023, focusing on non-pregnant women attending outpatient clinics at Bugando medical centre (BMC), Sekou Toure regional referral hospital (SRRH) and Sengerema district designated hospital (Sengerema DDH). The research employed standardized questionnaires to gather social and clinical data, while high vaginal swabs were collected using aseptic techniques and processed following established laboratory protocols. Data analysis, aligned with the study's objectives, was carried out using STATA version 13, with statistical significance determined at a 95% confidence level (P≤0.05). Results: The study included 548 participants with the median age of 35 [IQR 28-43] years. A substantial majority 65.7% had history of vaginal candidiasis at least once in their lifetime. Notably, 36.7% of participants had curd-like vaginal discharge, and 69.9% practiced vaginal douching. Laboratory-confirmed vaginal candidiasis was prevalent in 24.3% of recruited patients. Women presenting with curd-like vaginal discharge were seven times more likely to have positive culture results compared to those with other vaginal symptoms. Factors associated with vaginal candidiasis included an increase in age (OR 1.04, 95% CI 1.02-1.06, P=0.003), being a student (OR 2.9, 95% CI 1.2-6.9, P=0.015), history of antimicrobial use (OR 3.7, 95% CI 2.4-9.7, P=0.0009), and curd milk like discharge per vaginal (OR 3.1, 95% CI 1.6-5.9, P=0.0001). Approximately 20% of women continued to experience symptoms after a standard full dose of antifungal treatment. Conclusion: The study sheds light on the substantial burden of vaginal candidiasis among non-pregnant women. Age, being a student, antimicrobial history, and clinical symptoms were identified to be associated with candidiasis. The persistence of symptoms post-treatment emphasizes the need for further investigation into treatment efficacy and potential antifungal resistance. Addressing this knowledge gap is crucial for refining approaches to managing and preventing vaginal candidiasis in this population.