CHAPTER ONE

INTRODUCTION

1. BACKGROUND OF THE STUDY

Vaginal candidiasis (VC) is one of the most common reasons for consultations with a gynecologist, with an increasing trend in occurrence in female patients. The number of patients with recurrent and resistant vaginal candidiasis to standard local antimycotic therapy is constantly growing. A special aspect of this type of candidiasis is its treatment in pregnant women, and interpretation of cytological findings (PAP test) as well.

Vaginal candidiasis affects approximately 75% of women of child-bearing age (R. Kaufman, 2008). Factors that predispose women to vaginal candidiasis include hormonal fluctuation, i.e., during pregnancy, luteal phase of menstrual cycle, antibiotic uses and use of oral contraceptives (M. Gonzalez, 2008). Another 5% - 10% of seemingly healthy women suffer recurrent vaginal candidiasis without any predisposing factors (H. Mitchell, 2004). It is much more common in pregnant women than in healthy women. Moreover, a large proportion of women with chronic recurrent candidiasis first present with the infection during pregnancy.

In pregnant women, vaginal candidiasis has been related to emotional stress and suppression of immune system which steps up the risk of Candida species overgrowth and become pathogenic (J. Sobel, 2005). Other risk factors are associated with the eating habits of pregnant women of sugar rich containing food. The sugar increase ever more the threat of yeast infections powered by these sugary environments. Pregnancy induced hormonal modifications, altered the vaginal context and made Candida more likely to grow beyond acceptable boundaries (G. Monif, 2001).

Candida is the agent most frequently implicated in the invasive vaginal candidiasis. The most common Candida species causing vaginal candidiasis is primarily Candida albicans followed by Candida glabrata, Candida tropicalis and Candida parapsilosis (J. Sobel, 2005).

In the recent years, the number of serious opportunistic yeast infections, particularly in immunocompromised patients, has dramatically increased (M. Richardson and D. Warnock, 2003). Among them, Candida species accounts for a large number of serious opportunitistic yeasts in pregnant women. Previous studies done in Nigeria on the isolation and identification of Candida species used different clinical samples from different study populations. These included HIV/AIDS patients and children with acute respiratory infections where Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei among others were isolated and identified (C. Bii, 2004). However, no study has been done on pregnant women. Therefore, the present study is the first study to be carried out in Nigeria. In developing countries, there is scanty data on vaginal candidiasis in pregnant women and the distribution of the vaginal Candida species (S. El-Din, 2001).

1. STATEMENT OF THE PROBLEM

Poor personal hygiene is does not only affect our environment but also our overall health. The female body is more susceptible to various diseases and germs. Most of the infection most women experience is the fungal infection because it is usually contacted through sex and dirty toilets. Fungal infection like the candidiasis can transfer from one person to another in most of the public toilets. These fungal infections from urinogenital areas can prevent women from conceiving and can also cause miscarriage among women that are already pregnant. In Nigeria today proper documentation has not been kept on fungal infections; it is to this regard that the study is based on the prevalence of fungal species from urinogenital areas of women attending antenatal clinic.    

1.3 AIM AND OBJECTIVES OF THE STUDY

The study seeks to examine the prevalence of fungal species from urinogenital areas of women attending antenatal clinic. The objectives of the study are:

1. To determine the types of fungal species from urinogenital areas of women attending antenatal clinic
2. To identify the causes of Vaginal Candidiasis infection among women attending antenatal clinic
3. To determine the treatment procedures for Vaginal Candidiasis infection among women attending antenatal clinic
4. To recommend ways to prevent the prevalence of fungal species from urinogenital areas of women attending antenatal clinic

1.4 RESEARCH QUESTIONS

The following research questions will be used to achieve the objectives of the study:

1.   What are the types of fungal species from urinogenital areas of women attending antenatal clinic?
2. What are the causes of Vaginal Candidiasis infection among women attending antenatal clinic?
3. What are the treatment procedures for Vaginal Candidiasis infection among women attending antenatal clinic?
4. What are the ways to prevent the prevalence of fungal species from urinogenital areas of women attending antenatal clinic?

1.5 STATEMENT OF THE HYPOTHESIS

H0: the treatment procedures for Vaginal Candidiasis infection among women attending antenatal clinic is not very effective

H1: the treatment procedures for Vaginal Candidiasis infection among women attending antenatal clinic is very effective

1.6 SIGNIFICANCE OF THE STUDY

This study will throw more light on the prevalence of fungal species from urinogenital areas of women attending antenatal clinic

To the private and public health care centers; the findings of the study will show the treatment procedures for Vaginal Candidiasis infection among women attending antenatal clinic.

To the pregnant women attending antenatal, the study will explain ways to prevent the prevalence of fungal species from urinogenital areas of women attending antenatal clinic.

To the students this study will serve as a source of information on Vaginal Candidiasis and other fungal species affecting the urinogenital areas of women. Finally this study will contribute to the body of the existing literature on the prevalence of fungal species from urinogenital areas of women attending antenatal clinic

1.7 SCOPE OF THE STUDY

This study covers on the prevalence of fungal species from urinogenital areas of women attending antenatal clinic with focus on candidiasis among pregnant women in public health care centres over a period of one month.

1.8 LIMITATION OF THE STUDY

TIME CONSTRAINTS: One the challenges experienced by the researcher is the issue of time; the research will simultaneously engage in departmental activities like seminars and attendance to lectures. But the researcher was able to meet up with the deadline for the submission of the project.

FINANCIAL CONSTRAINTS: Every research work needs funding; however lack of adequate funds might affect the speed of the researcher in getting materials for completion of the project

1.9 DEFINITION OF TERMS

URINARY SYSTEM: The urinary system, also known as the renal system or urinary tract, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH.

FUNGUS: A fungus is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms