1.1 Introduction
Candida albicans is a fungal pathogen that is commonly associated with infections in humans, particularly in women. It is a type of yeast that is part of the normal flora of the mouth, throat, gut, and genitourinary tract. Similarly, candida albicans is a type of yeast that is commonly found in the human body, particularly in the mouth, gut, and genital tract. It is typically harmless but can cause infections when there is an overgrowth, leading to conditions like candidiasis, especially in women (Sobel, 2016).
Pregnancy is characterized by hormonal changes, including elevated estrogen levels, which can predispose women to Candida albicans overgrowth. These hormonal shifts, combined with changes in the vaginal environment, create favorable conditions for the fungus to thrive. As a result, pregnant women are more susceptible to vaginal candidiasis, commonly known as a yeast infection. On the other hand, non-pregnant women, while still susceptible, may experience candidiasis at lower rates due to the absence of these specific hormonal factors.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
The study of Candida albicans infections, particularly vulvovaginal candidiasis (VVC), has a long history, reflecting its significant impact on women’s health. As far back as the early 20th century, researchers began to recognize the association between fungal pathogens and vaginal infections. However, it wasn’t until the mid-20th century that Candida albicans was identified as the primary culprit behind the majority of vaginal yeast infections in women, including both pregnant and non-pregnant individuals (Mårdh et al., 2002).
In the 1980s and 1990s, the rise of modern gynecological and obstetric practices led to more detailed epidemiological studies on the incidence of Candida albicans in pregnant and non-pregnant women. Researchers noted that approximately 30-40% of women experience VVC at least once in their lifetime, with higher recurrence rates in pregnant women. These studies also began to explore other contributing factors, such as antibiotic use and the presence of underlying conditions like diabetes, which could predispose both pregnant and non-pregnant women to candidiasis (Sobel, 2007).
More recent studies have refined our understanding of Candida albicans infections, emphasizing the role of the host’s immune system, lifestyle factors, and variations in vaginal microbiota. Current research continues to investigate the genetic and environmental factors that contribute to the differences in infection rates between pregnant and non-pregnant women, with the goal of developing more effective preventive and therapeutic strategies tailored to each group (Fidel, 2007).
Candida albicans is a significant opportunistic pathogen and a common cause of fungal infections, particularly in women. It is a member of the normal human microbiota, residing in areas such as the gastrointestinal tract, oral cavity, and genitourinary tract. Under normal conditions, the growth of Candida albicans is controlled by the body’s immune system and the microbial balance in the host. However, when this balance is disrupted, it can lead to an overgrowth, causing candidiasis. Among women, vulvovaginal candidiasis (VVC) is a common manifestation of Candida albicans infection, which affects millions globally.
Pregnancy is one of the key factors that increase the susceptibility of women to candidiasis. The hormonal changes, particularly elevated estrogen levels during pregnancy, can result in a favorable environment for Candida albicans proliferation. Increased glycogen levels in the vaginal epithelium, alongside a reduction in the immune response, further contribute to this susceptibility (Sobel, 2016). This makes pregnant women particularly prone to Candida albicans infections compared to their non-pregnant counterparts.
Non-pregnant women, though still at risk for candidiasis, tend to experience infections due to other factors such as antibiotic use, diabetes, contraceptive use, and immunosuppressive conditions. These risk factors contribute to altering the vaginal flora and pH, providing conditions for Candida albicans to thrive. However, the incidence and severity of infection are generally lower in non-pregnant women due to the absence of pregnancy-related physiological changes.
Research on the incidence of Candida albicans among pregnant and non-pregnant women is crucial for understanding the epidemiology of candidiasis and improving clinical management. Studies have shown that about 20% of pregnant women experience recurrent VVC compared to a lower percentage in non-pregnant women (Sobel, 2016). Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the incidence of candida albicans amongst pregnant and non-pregnant women.
1.3 Statement of Problems
Investigation revealed that the incidence of Candida albicans infections among women, particularly during pregnancy, remains a significant public health concern due to the discomfort, complications, and recurring nature of the condition. While candidiasis is common in both pregnant and non-pregnant women, the increased vulnerability of pregnant women due to physiological changes poses unique challenges for effective management. Elevated estrogen levels, changes in the vaginal pH, and a weakened immune response in pregnancy are known contributors to the higher prevalence of vulvovaginal candidiasis during this period (Sobel, 2016). However, despite these known factors, there is still insufficient understanding of the exact differences in the incidence rates between pregnant and non-pregnant women and the specific contributing factors that influence these rates.
Current research suggests that up to 40% of pregnant women may experience candidiasis, yet there are gaps in identifying specific risk factors and preventive measures that could reduce this high prevalence (Fidel, 2007). Additionally, non-pregnant women face candidiasis linked to other factors like antibiotic use, diabetes, and lifestyle habits, but comprehensive data comparing their infection rates directly with those of pregnant women is limited. This lack of detailed comparative data hampers the development of targeted interventions that could be more effective in addressing the specific needs of each group.
The persistence of high candidiasis rates among pregnant women also raises concerns about the potential complications for both maternal and fetal health. Untreated or recurrent candidiasis can lead to discomfort, stress, and in some cases, more serious infections that can impact pregnancy outcomes (Sobel, 2007). Similarly, in non-pregnant women, recurrent candidiasis can lead to chronic infections, affecting quality of life and requiring repeated medical treatments.
The primary problem this study seeks to address is the gap in knowledge regarding the comparative incidence of Candida albicans infections between pregnant and non-pregnant women, as well as the identification of risk factors unique to each group.
1.4 Aim and Objectives of Study
The aim of the study is to assess the incidence of candida albicans amongst pregnant and non-pregnant women. In achieving this aim, the following specific objectives were laid out as follows:
- To identify the risk factors that contributes to the development of Candida albicans infections in pregnant women and non-pregnant women.
- To determine the prevalence of Candida albicans infections among pregnant women compared to non-pregnant women.
- To compare the severity and recurrence rates of Candida albicans infections between pregnant and non-pregnant women.
- To explore the impact of Candida albicans infections on the health and well-being of pregnant and non-pregnant women.
- To provide recommendations for the prevention and effective management of Candida albicans infections in both pregnant and non-pregnant women.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the incidence rate of Candida albicans infections among pregnant women compared to non-pregnant women?
- What are the primary risk factors contributing to Candida albicans infections in pregnant women and non-pregnant women?
- How do the severity and recurrence rates of Candida albicans infections differ between pregnant and non-pregnant women?
- What impact do Candida albicans infections have on the health and well-being of pregnant and non-pregnant women?
- What preventive measures and management strategies can be recommended to reduce the incidence and recurrence of Candida albicans infections in both pregnant and non-pregnant women?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: Pregnant women do not have higher incidence of Candida albicans infections compared to non-pregnant women.
- H1: Pregnant women have a higher incidence of Candida albicans infections compared to non-pregnant women.
Hypothesis Two
- H0: Hormonal changes and immune modulation during pregnancy do not significantly increase the risk of Candida albicans infections.
- H1: Hormonal changes and immune modulation during pregnancy significantly increase the risk of Candida albicans infections.
1.7 Significance of Study
The outcome realized from the research findings will be significant to the following stakeholders:
- The study will provide healthcare professionals with vital information on the comparative incidence and risk factors of Candida albicans infections in pregnant and non-pregnant women, enabling more targeted and effective patient care.
- The findings will help pregnant women better understand the risks and prevention methods associated with Candida albicans infections during pregnancy, potentially leading to improved maternal health outcomes.
- Public health organizations will benefit from the study’s insights into infection rates and risk factors, enabling them to develop more effective educational campaigns and intervention programs tailored to the needs of women in different reproductive stages.
- Policy makers will be able to use the research outcomes to inform guidelines and health policies that address the prevention and management of Candida albicans infections among women, leading to enhanced health strategies.
- Researchers will gain a deeper understanding of the factors contributing to Candida albicans infections in different populations, providing a foundation for future studies focused on improving women’s reproductive health.
1.8 Scope of Study
The scope of the research is focused on the incidence of candida albicans amongst pregnant and non-pregnant women using Abeokuta North Local Government Area of Ogun State as a case study.
1.9 Limitations of the Study
The study was limited by insufficient data due to the difficulty in accessing comprehensive medical records and laboratory results from both pregnant and non-pregnant women. This limitation was compounded by the frequent power failures experienced during the data collection process, which disrupted laboratory work and delayed data analysis.
Delays from respondents in returning questionnaires and participating in interviews also affected the study. Some participants were either unavailable or unresponsive, leading to a smaller sample size than initially anticipated.
Additionally, financial constraints were another limitation, as limited resources restricted the extent of the research, including the ability to reach a larger number of respondents and conduct more comprehensive laboratory analyses.
Furthermore, time constraints were significant, as the research had to be completed within a specific timeframe, limiting the depth of the investigation and the ability to explore the study’s variables more thoroughly.
1.10 Definition of Terms
Candida albicans:
A type of yeast that is commonly found in the human body, particularly in the mouth, gut, and genital tract. It is typically harmless but can cause infections when there is an overgrowth, leading to conditions like candidiasis, especially in women (Sobel, 2016).
Vulvovaginal Candidiasis (VVC):
A common fungal infection caused by the overgrowth of Candida albicans in the vaginal area. It is characterized by itching, discharge, and discomfort, and is more prevalent in women during pregnancy (Fidel, 2007).
Pregnant Women:
It refers to women who are carrying a developing fetus within their uterus. Pregnancy involves significant physiological changes, including hormonal shifts that can influence the incidence of Candida albicans infections (Redondo-Lopez et al., 1990).
Incidence:
It means the occurrence, rate, or frequency of a disease, infection, or medical condition within a specified population over a particular period (Porta, 2014). In this context, it refers to the frequency of Candida albicans infections among pregnant and non-pregnant women.
Non-Pregnant Women:
It entails women who are not currently pregnant. In this study, non-pregnant women are used as a comparison group to assess differences in the incidence of Candida albicans infections in the absence of pregnancy-related hormonal and physiological changes.
