scholarly journals Prevalence, risk factors and antifungal susceptibility pattern of Candida species among pregnant women at Debre Markos Referral Hospital, Northwest Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alem Tsega ◽  
Feleke Mekonnen
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Amphotericin B ◽  
Antifungal Susceptibility ◽  
Northwest Ethiopia ◽  
Candida Krusei ◽  
Referral Hospital ◽  
Vaginal Candidiasis ◽  
Debre Markos ◽  
Multiple Drugs

Abstract Background Candida is the commonest opportunistic fungi in human. Candida species cause diverse types of diseases. Vaginal candidiasis has been reported as one of the most common type of fungal diseases among pregnant women. However; In Ethiopia, due to scarcity of data, much has not been documented regarding the prevalence of Candida among pregnant women. Objective This study aimed to determine the prevalence, possible risk factors and antifungal susceptibility profile of Candida species among pregnant women attending Debre Markos Referral Hospital, Northwest Ethiopia. Method A cross-sectional study was conducted from February to May 2017. A total of 384 pregnant women were included using a systematic random sampling technique. Vaginal specimens were collected, inoculated on Candida HiV eg culture Medium and incubated at 37 °C for 24 h.Colonies were identified using standard microbiological methods and selected for further Candida Species identification using Hi Chrome agar and germ tube test. Fungal suspensions were made and adjusted at 0.5% MacFarland standard. Modified Kirby-Bauer disk diffusion technique was used for antifungal susceptibility. Data was entered, cleaned using Ep info version 7.1and transported to Statistical Packages for Social Sciences (SPSS) version 21 for analysis. Descriptive statistics and logistic regression were performed. P. value < 0.05 at 95% confidence interval was considered as statistically significant. Result From a total of 384 study participants, 96 (25%) were positive for Candida species. The predominant Candida species was Candida albicans 54(56.25%) followed by Candida krusei 21(21.9%), Candida glabrata 17(17.7%), Candida tropicalis 1(1%) and 3(3.1%) were other Candida species. Contraceptive use (AOR: 0.394; 95% CI = 0.20–0.74) and prolonged antibiotic uses (AOR: 0.393; 95% CI = 0.21–0.72) were risk factors. All isolates except Candida krusei were 100% susceptible to amphotericin-B. Resistance rate was high against itraconazole and Ketoconazole 55(57.3%). Conclusion The prevalence of Candida species among symptomatic pregnant women was significantly higher than asymptomatic pregnant women. Age group between 26 and 40 years was significantly associated with Candida infection. Amphotericin B was the most sensitive antifungal drug. High rate of multiple drugs resistant Candida species was detected. Therefore Symptomatic women should be routinely screened and treated.

scholarly journals Prevalence and Antifungal Susceptibility patterns of Candida isolated on CHROMagarTMCandida at a tertiary referral hospital, Eastern Uganda.

2019 ◽  
Author(s):  
Juliet Watsemwa ◽  
Jacob Iramiot ◽  
JOHN BOSCO KALULE
Keyword(s):  
Pregnant Women ◽  
Amphotericin B ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Vulvovaginal Candidiasis ◽  
Referral Hospital ◽  
Vaginal Candidiasis ◽  
Dilution Method ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

Abstract Background Pregnant women are susceptible to vaginal candidiasis and maternal vulvovaginal candidiasis is a major risk factor for colonization and/or infection of the infant. The purpose of this study was to determine the prevalence and antifungal patterns of albicans and non-albicans Candida among pregnant women attending a tertiary referral hospital. Methods Vaginal discharge- cotton swabs were self-collected from pregnant women clinically proven to have vulvovaginal candidiasis at the antenatal clinic of a tertiary referral hospital between January and July 2018. Microscopy and culture on Sabouraud's Dextrose Agar with chloramphenicol was done on the vaginal discharge-cotton swabs. Confirmatory fungal identification was done using CHROM agarTM Candida. Antifungal susceptibility testing was carried out using the standardized Kirby Bauer dilution method. Results Candida were isolated from 50.81% (126/249) of the swabs and included C. albicans (80.16%, 101/126), C. glabrata (19.05% (24/126) and C. krusei (0.79%, 1/126). Of the women from whom Candida were isolated, 11.1% (14/126) were in the first trimester, 39.7% (50/126) were in the second, while 49.2% (62/126) were in the third. Of the Candida isolates, 80.16% (101/126) were C. albicans, 19.05% (24/126) were C. glabrata and 0.79% (1/126) were C. krusei. Overall, all the isolates were non-susceptible to Amphotericin B, while 60.3% (76/126), 50% (63/126), 62.7% (79/126), and 48.4% (61/126) were non-susceptible to itraconazole, fluconazole, nystatin, and clotrimazole respectively. All the non-albicans Candida were resistant to itraconazole, amphotericin B, and fluconazole. Conclusion Vulvovaginal candidiasis due to multidrug resistant C.glabrata among pregnant women will require that treatment regimes are adjusted to carter for the recurrent forms. The use of CHROMagarTMCandida media for identification of clinically relevant Candida should be adopted instead of conventional methods that are tedious and time consuming such that treatment is based on laboratory evidence.

scholarly journals Prevalence and Antifungal Susceptibility patterns of Candida Isolated on CHROMagarTMCandida at a Tertiary Referral Hospital, Eastern Uganda

2019 ◽  
pp. 1-6
Author(s):  
Watsemwa Juliet Jane ◽  
Jacob Stanley Iramiot ◽  
John Bosco Kalule
Keyword(s):  
Pregnant Women ◽  
Amphotericin B ◽  
Candida Species ◽  
Vaginal Discharge ◽  
Antifungal Susceptibility ◽  
Vulvovaginal Candidiasis ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Eastern Uganda

Background: Pregnant women are susceptible to vaginal candidiasis and maternal vulvovaginal candidiasis is a major risk factor for colonization and/or infection of the infant. The purpose of this study was to determine the prevalence and antifungal patterns of albicans and non-albicans Candida among pregnant women attending a tertiary referral hospital. Methods: Vaginal discharge- cotton swabs were self-collected from pregnant women clinically proven to have vulvovaginal candidiasis at the antenatal clinic of a tertiary referral hospital between January and July 2018. Microscopy and culture on Sabouraud's Dextrose Agar with chloramphenicol was done on the vaginal discharge-cotton swabs. Confirmatory fungal identification was done using CHROM agarTM Candida. Antifungal susceptibility testing was carried out using the standardized Kirby Bauer method. Results: Candida were isolated from 50.81% (126/249) of the swabs  and included C. albicans (80.16%, 101/126), C. glabrata (19.05% (24/126) and C. krusei (0.79%, 1/126). Candida albicans showed resistance to amphotericin B (70.63%, 89/126), clotrimazole (11.9%, 15/126), nystatin (3.17%, 4/126), fluconazole (23.02%, 29/126), and itraconazole (17.46%, 22/126). Among the non-albican Candida species, C. glabrata showed resistance to fluconazole (100% ,24/24), amphotericin B (100% ,24/24), clotrimazole (14.29%, 18/24), nystatin (1.59%, 2/24), and itraconazole (18.25%, 23/24). C. krusei showed resistance to fluconazole (100%, 1/1), amphotericin B (100%,1/1), and itraconazole (100%, 1/1). Conclusion: The candida species commonly associated with VVC in Eastern Uganda are C. albicans C. glabrata and C. krusei. Antifungal resistance was highly prevalent among the candida isolated. The use of CHROMagarTMCandida media for identification of clinically relevant Candida should be adopted instead of conventional methods that are tedious and time consuming such that treatment is based on laboratory evidence.

scholarly journals Clinical Outcome of Meningitis and Its Risk Factors Among Children Admitted in Debre Markos Referral Hospital Pediatric Ward, Northwest Ethiopia,2019

2020 ◽  
Author(s):  
Hailemariam Abiy ◽  
Zelalem Shiferaw ◽  
Yilkal Tafere
Keyword(s):  
Risk Factors ◽  
Health Care Team ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Referral Hospital ◽  
P Value ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Debre Markos ◽  
Hospital Pediatric

Abstract Background:Meningitis remains a major cause of mortality and morbidity in patients in many countries of the world including Ethiopia. This study aimed to assess clinical outcomes and associated risk factors of meningitis among children who were admitted to Debre Markos Referral Hospital from January 2017 to December 2018.A backward stepwise multivariable logistic regression was applied with 95% confidence interval of odds ratio (OR) andstatistical significance less than 0.05 p-value were taken as cut off value.Methods:A retrospective cross-sectional study was conducted. The study includesAll pediatric meningitis 211 cases from the age of one month to fourteen who were admitted due to meningitis in Debre Markos Referral Hospitalfrom January 2017 to December 2018.Data were entered, cleaned, and analyzed using SPSS for Windows, version 20.Results:The study showed that 18.9% of children with meningitis developed bad outcomes. In this study, children who were a worse clinical condition at admission 6 times more likely to develop bad outcomes [AOR= 6.321(2.121, 18.837)] and having a seizure at admission almost 19 times more likely to develop bad outcomes [AOR=18.953(6.677, 53.799)]. Conclusions:About one in five children with meningitis developed bad outcomes. The health care team should due attention to improving care for patients with severe conditions at admission and seizures were the alarming signs for poor outcomes in children.

scholarly journals Seroprevalence of Anti–Toxoplasma gondii Antibodies and Associated Factors Among Pregnant Women Attending Antenatal Care at Debre Markos Referral Hospital, Northwest Ethiopia

2020 ◽  
Vol 13 ◽  
pp. 117863372094887
Author(s):  
Senait Mulugeta ◽  
Abaineh Munshea ◽  
Endalkachew Nibret
Keyword(s):  
Risk Factors ◽  
Toxoplasma Gondii ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Potential Risk ◽  
Congenital Toxoplasmosis ◽  
Northwest Ethiopia ◽  
Referral Hospital ◽  
Behavioral Risk Factors ◽  
Behavioral Risk

Background: Toxoplasma gondii is an obligate intracellular protozoan parasite that causes a zoonotic disease called toxoplasmosis. If the infection acquired during pregnancy is not detected and treated early, the parasite can be transmitted transplacentally to the fetus, resulting in congenital toxoplasmosis, which likely leads to serious consequences in the fetus. Toxoplasmosis constitutes a major public health problem particularly in low- and middle-income countries including Ethiopia. This study aimed to determine the seroprevalence and to assess the potential risk factors of toxoplasmosis among pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia. Methods: In this cross-sectional study, data on the sociodemographic and potential obstetric and behavioral risk factors were gathered through pretested structured questionnaires, and 3 mL of venous blood was also drawn from each of randomly selected 233 study subjects. The serum samples were separated from the blood samples and tested for anti- Toxoplasma antibody using Toxo-latex slide agglutination test. Logistic regression analysis was used to examine the association between risk factors considered and T gondii infection. Results: The overall prevalence of T gondii infection was 67.8%, indicating a high prevalence of toxoplasmosis in the study area. In multivariate analysis, keeping domestic cat at home was found to be the only explanatory variable of toxoplasmosis (adjusted odds ratio = 2.449, 95% confidence interval = 1.183-5.070, P = .016). All sociodemographic variables and most of the potential obstetric and behavioral risk factors were not statistically significant explanatory variables of T gondii infection. Conclusion: The prevalence of toxoplasmosis is high in the study area. Thus, pregnant women should be aware of the potential risk of the disease when keeping cats at home and management of their litter. Inclusion of serologic screening for T gondii infection at antenatal care is warranted for prevention of congenital toxoplasmosis.

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