Vaginal colonization and vertical transmission of Candida species: prevalence and associated factors among pregnant women and their neonates at public health facilities of Northeast Ethiopia.

IF 2.8 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Alemu Gedefie, Getnet Shimeles, Hilina Motbainor, Brhanu Kassanew, Chalachew Genet
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引用次数: 0

Abstract

Background: Vaginal colonization by Candida can lead to vulvovaginal candidiasis, which is the second most prevalent vaginal condition globally. It is frequently associated with sepsis and adverse neonatal outcomes in pregnant women. This issue is worsening in Sub-Saharan Africa, including Ethiopia. However, evidence of the existing problem is very scarce yet crucial. Thus, this study aimed to determine the vaginal colonization and vertical transmission of Candida species and their associated factors among pregnant women and their neonates in public health facilities of northeast Ethiopia.

Methods: A facility-based cross-sectional study was conducted at selected public health facilities in Dessie town from April 1 to June 30, 2023, among 348 pregnant women and their newborns, using convenience sampling techniques. Socio-demographic, and clinical-related data were collected using a pre-tested, semi-structured questionnaire. Vaginal swab samples from pregnant women and pooled swabs from the external ear, nasal area, and umbilical areas of the newborns were collected and transported using Amies transport media. The samples were inoculated into Sabouraud Dextrose Agar for isolation, followed by inoculation onto a standard CHROM agar Candida plate for species identification, and a germ-tube test confirmed pseudophyphae of C.albicans. Data was entered into Epi Data version 4.6.0 software and exported and analyzed by SPSS version 25.0. A stepwise logistic regression model was used to identify the associated factors. Variables with p < 0.05 and their 95% confidence interval were considered statistically significant.

Result: A total of 348 pregnant women attending vaginal delivery were included in the study. The maternal and neonatal colonization rates of Candida species were 14.1% (49/348) and 6.3% (22/348), respectively. The overall proportion of vertical transmission of Candida species was 44.9% (22/49, 95% CI: 41.2, 49.7). Among Candida isolates, 63.3% (31/49) were C. albicans and 36.7% (18/49) were C. krusei. Gestational diabetes mellitus (AOR: 4.2, 95% CI: 1.23-38.6, P = 0.047) and HIV (AOR: 1.58, 95% CI: 1.11-6.12, P = 0.049) were independently associated with maternal colonization of Candida species. Moreover, rural residence (AOR = 3.6, 95% CI: 1.37-9.5, P = 0.010) and maternal age above 28 years (AOR = 2.39, 95% CI: 1.97-5.89, P = 0.048) were independently associated with vertical transmission of Candida species.

Conclusion: The findings of this study highlight the need for effective screening and treatment of Candida colonization during antenatal care.

念珠菌的阴道定植和垂直传播:埃塞俄比亚东北部公共卫生机构孕妇及其新生儿的流行率及相关因素
背景:念珠菌的阴道定植可导致外阴阴道念珠菌病,这是全球第二常见的阴道疾病。它通常与孕妇败血症和不良新生儿结局有关。在包括埃塞俄比亚在内的撒哈拉以南非洲,这一问题正在恶化。然而,现有问题的证据非常少,但却至关重要。因此,本研究旨在确定念珠菌在埃塞俄比亚东北部公共卫生机构孕妇及其新生儿中的阴道定植和垂直传播及其相关因素。方法:采用方便抽样方法,于2023年4月1日至6月30日在德西镇选定的公共卫生机构对348名孕妇及其新生儿进行了基于机构的横断面研究。使用预先测试的半结构化问卷收集社会人口统计学和临床相关数据。收集孕妇阴道拭子样本以及新生儿外耳、鼻区和脐区收集的拭子样本,并使用Amies运输介质进行运输。将样品接种于Sabouraud Dextrose琼脂进行分离,接种于标准CHROM琼脂假丝酵母菌平板进行菌种鉴定,试管试验证实为白色念珠菌假菌体。数据输入Epi Data 4.6.0版本软件,导出并使用SPSS 25.0版本进行分析。采用逐步logistic回归模型确定相关因素。结果:共有348名参加阴道分娩的孕妇被纳入研究。母鼠和幼鼠念珠菌定殖率分别为14.1%(49/348)和6.3%(22/348)。念珠菌垂直传播的总比例为44.9% (22/49,95% CI: 41.2, 49.7)。念珠菌分离株中白色念珠菌占63.3%(31/49),克氏念珠菌占36.7%(18/49)。妊娠期糖尿病(AOR: 4.2, 95% CI: 1.23 ~ 38.6, P = 0.047)和HIV (AOR: 1.58, 95% CI: 1.11 ~ 6.12, P = 0.049)与母体念珠菌定植独立相关。此外,农村居民(AOR = 3.6, 95% CI: 1.37 ~ 9.5, P = 0.010)和母亲年龄大于28岁(AOR = 2.39, 95% CI: 1.97 ~ 5.89, P = 0.048)与念珠菌垂直传播独立相关。结论:本研究结果强调了在产前护理中对念珠菌定植进行有效筛查和治疗的必要性。
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来源期刊
BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-
CiteScore
4.90
自引率
6.50%
发文量
845
审稿时长
3-8 weeks
期刊介绍: BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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