Factors associated with the presence of Candida spp. in vaginal fluid samples from women living in quilombola communities
DOI:
https://doi.org/10.11606/issn.2176-7262.v53i2p171-181Keywords:
Candida, Candida albicans, Vulvovaginal candidiasis, Social VulnerabilityAbstract
Objective: Investigate the frequency and factors associated with the detection of Candida spp. in vaginal fluid from women living in a quilombola settlement. Materials and Method: A cross-sectional study was conducted with 177 women living in a quilombola settlement in Northeast, Brazil. Socio-demographic data, living habits, general health, and reproductive health were collected. The material collected in the region of the cervix was submitted to cytopathological examination. Vaginal fluid samples were collected for microbiological analysis. Chi-square test, exact Fisher’s test, and logistic regression models were used for the statistical analysis. Results: Candida spp. was detected in 28.9% of the samples. The most frequent species in positive cases were Candida albicans (49%), followed by Candida krusei (39.2%). After adjustment, it was observed that women aged over 50 years had a higher chance of detecting Candida spp. in vaginal fluid (OR adjusted = 3.46; 95% CI= 1.68-7.12), while women complaining of vaginal discharge had a lower chance of detecting Candida spp. (OR adjusted = 0.29; 95% 95% CI= 0.11-0.78). Conclusion: The findings suggest a high detection of Candida spp. in vaginal fluid among women living in quilombola settlements, which indicates the need for planning measures for prevention and track the cases of vulvovaginal candidiasis in this population group. Besides, the presence of Candida spp. was higher in women from the fifth decade of life, lower in women with complaints of vaginal discharge.
Downloads
References
Ilkit M, Guzel AB. The epidemiology, pathogenesis, and diagnosis of vulvovaginal candidosis: a mycological perspective. Crit. rev. microbiol. 2011 [acesso em 01 nov 2019]; 37(3): 250-261. Disponível em: https://www.researchgate.net/publication/51153185_The_epidemiology_pathogenesis_and_diagnosis_of_vulvovaginal_candidosis_A_mycological_perspective
Donders GGG, Grinceviciene S, Bellen G, Ruban K. Is multiple-site colonization with Candida spp. related to inadequate response to individualized fluconazole maintenance therapy in women with recurrent Candida vulvovaginitis? Diagn. microbiol. infect. dis. 2018 [acesso em 01 nov 2019]; 92(3): 226-229. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/30293562
Sobel JD. Vulvovaginal candidosis. Lancet. 2007 [acesso em 01 nov 2019];369(9577):1961-1971. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/17560449
Sobel JD. Recurrent vulvovaginal candidiasis. Am. j. obstet. gynecol. 2016 [acesso em 01 nov 2019]; 214(1): 15-21. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26164695
Aballéa S, Guelfucci F, Wagner J, Khemiri A, Dietz JP, Sobel J, et al. Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA. Health qual. life outocomes. 2013 [acesso em 01 nov 2019]; 11(1): 169. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815627/pdf/1477-7525-11-169.pdf
Fukazawa EI, Witkin SS, Robial R, Vinagre JG, Baracat EC, Linhares IM. Influence of recurrent vulvovaginal candidiasis on quality of life issues. Arch. gynecol. obstet. 2019 [acesso em 01 nov 2019]; 300(3): 647-650. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815627/pdf/1477-7525-11-169.pdf
Rodríguez-Cerdeira C, Gregorio MC, Molares-Vila A, López-Barcenas A, Fabbrocini G, Bardhi B, et al. Biofilms and Vulvovaginal Candidiasis. Colloids surf. B. 2019 [acesso em 01 nov 2019]; 174(1): 110-125. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/30447520
Cassone, A. Vulvovaginal Candida albicans infections: pathogenesis, immunity and vaccine prospects. Int. j. gynaecol. obstet. 2015 [acesso em 01 nov 2019]; 122(6): 785-794. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/25052208
Brandolt TM, Klafke GB, Gonçalves CV, Bitencourt LR, Martinez AMBD, Mendes JF, et al. (2017). Prevalence of Candida spp. in cervical-vaginal samples and the in vitro susceptibility of isolates. Braz. j. microbiol. 2017 [acesso em 01 nov 2019]; 48(1):145-150. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1517-83822017000100145
Nakamura-Vasconcelos SS, Fiorini A, Zanni PD, de Souza Bonfim-Mendonça P, Godoy JR, Almeida-Apolonio AA, et al. (2017). Emergence of Candida glabrata in vulvovaginal candidiasis should be attributed to selective pressure or virulence ability? Arch. gynecol. obstet. 2017 [acesso em 01 nov 2019]; 296(3): 519-526. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28730269
Brasil. Comunidades quilombolas certificadas. 2019 [acesso em 10 dez 2019]. Disponível em: http://dados.gov.br/dataset/comunidades-quilombolas-certificadas
Abreu JA. Fugitive Slave Communities in Northern Brazil between 1880 and 1900: Territoriality, Resistance, and the Struggle for Autonomy. J. Lat. Am. Geogr. 2018 [acesso em 10 dez 2019]; 17(1): 195-221. Disponível em: https://digitalcommons.lsu.edu/jlag/vol17/iss1/9/
Silva MJGD, Lima FSDS, Hamann EM. Uso dos serviços públicos de saúde para DST/HIV/aids por comunidades remanescentes de Quilombos no Brasil. Saúde Soc. 2010 [acesso em 10 dez 2019]; 19(1): 109-120. Disponível em: https://www.revistas.usp.br/sausoc/article/view/29695/31569
Oliveira MV, Guimarães MDC, França EB. Fatores associados a não realização de Papanicolau em mulheres quilombolas. Ciênc. Saúde Colet. 2014 [acesso em 10 dez 2019]; 19(1): 4535-4544. Disponível em: http://www.scielo.br/scielo.php?script=sci_abstract&pid=S1413-81232014001104535&lng=en&nrm=iso&tlng=pt
Marques AS, Freitas DA, Leão CDA, Oliveira SKM, Pereira MM, Caldeira AP. Atenção Primária e saúde materno-infantil: a percepção de cuidadores em uma comunidade rural quilombola. Ciênc. Saúde Colet. 2014 [acesso em 10 dez 2019]; 19(1): 365-371. Disponível em: http://www.scielo.br/pdf/csc/v19n2/1413-8123-csc-19-02-00365.pdf
Ferreira HS, Torres ZMC. Comunidade quilombola na Região Nordeste do Brasil: saúde de mulheres e crianças antes e após sua certificação. Rev. Bras. Saúde Mater. Infant. (Online). 2015 [acesso em 10 dez 2019]; 15(2): 219-229. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1519-38292015000200219
Barroso SM, Melo AP, Guimarães MDC. Fatores associados à depressão: diferenças por sexo em moradores de comunidades quilombolas. Rev. bras. epidemiol. 2015 [acesso em 10 dez 2019];18(2): 503-514. Disponível em: http://www.scielo.br/scielo.php?pid=S1415-790X2015000200503&script=sci_arttext&tlng=pt
Silva VH, Rocha JSB, Caldeira AP. Fatores associados à autopercepção negativa de saúde em mulheres climatéricas. Ciênc. Saúde Colet. 2018 [acesso em 10 dez 2019]; 23(1): 1611-1620. Disponível em: http://www.scielo.br/scielo.php?pid=S1413-81232018000501611&script=sci_abstract&tlng=pt
Fernandes NFS, Galvão JR, Assis MMA, Almeida PFD, Santos AMD. (2019). Acesso ao exame citológico do colo do útero em região de saúde: mulheres invisíveis e corpos vulneráveis. Cad. Saúde Pública (Online). 2019 [acesso em 01 nov 2019]; 35(10): e00234618. Disponível em: http://www.scielo.br/pdf/csp/v35n10/1678-4464-csp-35-10-e00234618.pdf
Sá MCN, Sousa HRD, Amaro CSO, Pinheiro DN, Oliveira MMMD, Pinheiro MDCN. Isolamento de Candida no esfregaço cérvico-vaginal de mulheres não gestantes residentes em área ribeirinha do Estado do Maranhão, Brasil, 2012. Rev. Pan-Amazônica Saúde. 2014 [acesso em 10 dez 2019]; 5(1): 25-34. Disponível em: http://scielo.iec.gov.br/scielo.php?script=sci_arttext&pid=S2176-62232014000100003
Andrioli JL, Oliveira GSA, Barreto CS, Sousa ZL, Oliveira MCHD, Cazorla IM, et al. Frequency of yeasts in vaginal fluid of women with and without clinical suspicion of vulvovaginal candidiasis. Rev. bras. ginecol. obstet. 2009 [acesso em 10 dez 2019]; 31(6): 300-304. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/19684965
Ishaku MJ, Yami AL, Zamfara KA, Nganjiwa SG. The prevalence of Vaginal Candida colonization among female students in Bingham University. Microbiol. Res. J. Int. 2016 [acesso em 10 dez 2019]; 12(2): 1-7. Disponível em: https://www.researchgate.net/publication/287968722_The_Prevalence_of_Vaginal_Candida_Colonization_among_Female_Students_in_Bingham_University
Sianou A, Galyfos G, Moragianni D, Baka S. Prevalence of vaginitis in different age groups among females in Greece. J. obstet. gynaecol. 2017 [acesso em 10 dez 2019]; 37(6): 790-794. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28468531
Gonçalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Crit. rev. microbiol. 2016 [acesso em 10 dez 2019]; 42(6): 905-927. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26690853
Kennedy MA, Sobel JD. Vulvovaginal candidiasis caused by non-albicans Candida species: new insights. Emerging Infect. Dis. 2010 [acesso em 10 dez 2019]; 12(6): 465-470. Disponível em: https://www.researchgate.net/publication/49824209_Vulvovaginal_Candidiasis_Caused_by_Non-albicans_Candida_Species_New_Insights
Guzel AB, Ilkit M, Akar T, Burgut R, Demir SC. Evaluation of risk factors in patients with vulvovaginal candidiasis and the value of chromID Candida agar versus CHROMagar Candida for recovery and presumptive identification of vaginal yeast species. Med. mycol. 2011 [acesso em 10 dez 2019]; 49(1): 16-25. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/20608776
Rad MM, Zafarghandi S, Abbasabadi B, Tavallaee M. The epidemiology of Candida species associated with vulvovaginal candidiasis in an Iranian patient population. Eur. j. obstet. gynecol. reprod. biol. 2011 [acesso em 10 dez 2019]; 155(2): 199-203. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/21194828
Maraki S, Mavromanolaki VE, Stafylaki D, Nioti E, Hamilos G, Kasimati A. Epidemiology and antifungal susceptibility patterns of Candida isolates from Greek women with vulvovaginal candidiasis. Mycoses. 2019 [acesso em 10 dez 2019]; 62(1): 692-697. Disponível em: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-31132175
Vermitsky JP, Self MJ, Chadwick SG, Trama JP, Adelson ME, Mordechai E, et al. Survey of vaginal-flora Candida species isolates from women of different age groups by use of species-specific PCR detection. J. clin. microbiol. 2008 [acesso em 10 dez 2019]; 46(4): 1501-1503. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292962/
Bitew A, Abebaw Y. Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern. BMC womens health. 2018 [acesso em 10 dez 2019]; 18(1):94. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/29902998
Brown SE, Schwartz JA, Robinson CK, O'Hanlon DE, Bradford LL, He X, et al. The Vaginal Microbiota and Behavioral Factors Associated With Genital Candida albicans Detection in Reproductive-Age Women. Sex. transm. dis. 2019 [acesso em 10 dez 2019]; 46(11): 753-758. Disponível em: https://www.ajog.org/article/S0002-9378(18)30957-8/fulltext
Aguilar G, Araujo P, Godoy E, Falcón M, Centurión MG, Ortiz R, et al. Identificación y características de Candida spp. en secreción vaginal de pacientes embarazadas y no embarazadas. Mem. Inst. Invest. Cienc. Salud (Impr.) 2017 [acesso em 10 dez 2019]; 15(3):6-12. Disponível em: https://revistascientificas.una.py/index.php/RIIC/article/view/1262/1140
Betancourt AAS, Alvarez OS, Camacho RA, Espinoza EG. Candida famata mediastinitis. A rare complication of open heartsurgery. Case report and brief review. IDCases. 2016 [acesso em 10 dez 2019]; 5(1): 37-39.
Marchaim D, Lemanek L, Bheemreddy S, Kaye KS, Sobel JD. Fluconazole-resistant Candida albicans vulvovaginitis. Obstet. gynecol. 2012 [acesso em 10 dez 2019]; 120(6): 1407-1414. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/23168767
Ying C, Zhang H, Tang Z, Chen H, Gao J, Yue C. Antifungal susceptibility and molecular typing of 115 Candida albicans isolates obtained from vulvovaginal candidiasis patients in 3 Shanghai maternity hospitals. Med. mycol. 2016 [acesso em 10 dez 2019]; 54 (4): 394–399. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26468549
Córdoba S, Taverna C, Vivot W, Szusz W, Vivot M, Isla G, et al. Emergence of Resistance to Fluconazole in Candida albicans Isolated From Vaginal Discharge. Curr. Fungal Infect. Rep. 2018 [acesso em 10 dez 2019]; 12(4):155-160. Disponível em: https://link.springer.com/article/10.1007/s12281-018-0329-6
Whaley SG, Berkow EL, Rybak JM, Nishimoto AT, Barker KS, Rogers PD. Azole antifungal resistance in Candida albicans and emerging non-albicans Candida species. Front. cell. infect. microbiol. 2017 [acesso em 10 dez 2019];7(1): 2173. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226953/
Leli C, Mencacci A, Meucci M, Bietolini C, Vitali M, Farinelli S, et al. Association of pregnancy and Candida vaginal colonization in women with or without symptoms of vulvovaginitis. Minerva ginecol. 2013 [acesso em 10 dez 2019]; 65(3): 303-309. Disponível em: https://www.researchgate.net/publication/236923480_Association_of_pregnancy_and_Candida_vaginal_colonization_in_women_with_or_without_symptoms_of_vulvovaginitis
Merenstein D, Hu H, Wang C, Hamilton P, Blackmon M, Chen H, et al. Colonization by Candida species of the oral and vaginal mucosa in HIV-infected and noninfected women. AIDS res. hum. retroviruses. 2013 [acesso em 10 dez 2019];29(1):30-4. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/23098053
Mikamo H, Yamagishi Y, Sugiyama H, Sadakata H, Miyazaki S, Sano T, et al. High glucose-mediated overexpression of ICAM-1 in human vaginal epithelial cells increases adhesion of Candida albicans. J. obstet. gynaecol. 2018 [acesso em 10 dez 2019]; 38(2): 226-230. Disponível em: https://www.researchgate.net/publication/319893562_High_glucose-mediated_overexpression_of_ICAM-1_in_human_vaginal_epithelial_cells_increases_adhesion_of_Candida_albicans
Zakout YMA, Salih MM, Ahmed HG. Frequency of Candida species in Papanicolaou smears taken from Sudanese oral hormonal contraceptives users. Biotech. & histochem. 2012 [acesso em 10 dez 2019]; 87(2): 95-97. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/21235288
Güzel AB, Aydın M, Meral M, Kalkancı A, Ilkit M. Clinical characteristics of Turkish women with Candida krusei vaginitis and antifungal susceptibility of the C. krusei isolates. Infect. dis. obstet. gynecol. 2013 [acesso em 10 dez 2019]; 698736. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/24396265
Srivastava AN, Misra JS. ASCUS (Atypical Squamous Cells of Undetermined Significance) in the Cervical Smears of Women from Rural Population of Lucknow West. J. obstet. gynecol. India. 2019 [acesso em 10 dez 2019]; 69(2): 165-170. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/31686751
Modak T, Arora P, Agnes C, Ray R, Goswami S, Ghosh P, et al. Diagnosis of bacterial vaginosis in cases of abnormal vaginal discharge: comparison of clinical and microbiological criteria. J. Infect. Dev. Ctries. 2011 [acesso em 10 dez 2019]; 5(5): 353-360. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/21628811
Tine RC, Sylla K, Ka R, Dia L, Sow D, Lelo S, et al. A Study of Trichomonas vaginalis Infection and Correlates in Women with Vaginal Discharge Referred at Fann Teaching Hospital in Senegal. J. parasitol. res. 2019 [acesso em 10 dez 2019]; 1-8. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/31057956
Batista JE, Saddi VA, de Carvalho KPA, Ribeiro AA, Segati KD, Carneiro MA, et al. Human papillomavirus genotypes 68 and 58 are the most prevalent genotypes in women from quilombo communities in the state of Maranhão, Brazil. Int. j. infect. dis. 2017 [acesso em 10 dez 2019]; 55(1): 51-55. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28088590
Nascimento MDDSB, Vidal FCB, da Silva MACN, Batista JE, Barbosa MDCL, Muniz Filho WE, et al. Prevalence of human papillomavirus infection among women from quilombo communities in northeastern Brazil. BMC womens health. 2018 [acesso em 10 dez 2019]; 18(1):1-10. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/29291721
Downloads
Published
Issue
Section
License