EVALUATION OF CANDIDA ALBICANS AND ITS ASSOCIATED RISK FACTORS AMONG MARRIED WOMEN OF REPRODUCTIVE AGE IN ZAKHO CITY, KURDI-STAN REGION, IRAQ

Background: Candida vaginitis is a major fungal infection of the female genital tract ranging from mucosal to systemic infection.  Candida species has remained a major public health issue affecting women globally. Objectives: The aim of this study was to evaluate the prevalence of Candida albicans and its associated risk factors among married women with signs and symptoms of vaginitis referring to Obstetrics and Gynecological Hospital at Zakho City, Iraq. Methods: Vaginal samples were collected from 150 symptomatic women aged 18-48 years from October 2021-to April 2022 using two sterile cotton swabs. Wet mount was initially performed from first swab for the presence of budding yeast cells, and pseudo-hyphae of Candida infection. The second collected swabs were cultured on Sabouraud dextrose agar and incubated at 35°C for 24-48 hrs. C. albicans was then detected using morphologic characteristics of the colony.  Candida colonies were finally confirmed by germ tube test. Results: Overall, 58 (38.67%) C. albicans were diagnosed. The highest rate of infection was reported in the age group of 31-40 years (45%) and non-educated people (37%), but statistically not significant (p>0.05). C. albicans was also higher in women who used pills as a contraceptive (45.45%) than other types of contraceptives. Women who had low number of births were significantly associated with C. albicans (OR; 1.01, 95% CI; 0.94-1.26, p=028). C. albicans was also significantly associated among symptomatic patients with vaginal itching (67.19%) (OR; 9.69, 95% CI; 4.52-20.79, p=0.001) and vaginal pH level > 4.5 (OR; 0.39, 95% CI; 0.19-0.82, p=0.001). C. albicans was also significantly higher among participants who had whitish vaginal discharges (96.67%) (OR; 8.0, 95%CI, 3.8-16.85, p=0.001), and yellow-green vaginal discharges (58.62%) (OR; 0.12, 95% CI; 0.01-0.93, p=0.007). Conclusions: C. albicans is a relatively common gynaecological problem among married women in our region. C. albicans is significantly higher among child bearing age women who had vaginal discharges and itching in our study. These results call for preventive measures to protect women against Candidiasis. Therefore, public health education and campaign should be implemented.