Standardizing Vulvovaginal candidiasis diagnosis in Uganda: A case for British Association for Sexual Health and HIV 2019 guidelines

Abstract

Vulvovaginal candidiasis (VVC) significantly affects women’s health in Uganda, with an annual economic burden of 280.77 billion Ugandan Shillings (US$75,696 annually), which is 11.22% of health spending. Current clinical practices predominantly rely on syndromic management or, where available, Sabouraud Dextrose Agar cultures, which cannot distinguish between colonization and active infection, leading to misdiagnosis and inappropriate antifungal use. The 2019 British Association for Sexual Health and HIV guidelines offer a structured diagnostic framework that integrates clinical assessment, microscopy, and targeted culture techniques. This review proposes implementing these guidelines within Uganda’s laboratory hub network to improve diagnostic accuracy and antifungal stewardship.