Etiology and Risk Factors in Patients with VulvovaginalCandidiasis in Abidjan (Côte d'Ivoire)

Background: Limited data on the molecular identification of vulvovaginal candidiasis (VVC) pathogenesis in Côte d'Ivoire are available. Objective: We sought to update the data on the causes of VVC in Abidjan, Côte d'Ivoire. Methods: Conducted between May 2023 and January 2024, this cross-sectional study focused on patients with symptoms suggestive of VVC in Abidjan. Each patient underwent swab collection, direct examination, and culture. Candida chromatic agar and Auxacolor®-based identification tests were performed. A molecular-based polymerase chain reaction (PCR) targeting the hyphal wall protein 1 (hwp1) gene was used to differentiate between C. albicans, C. africana, and C. dubliniensis. Results: The overall prevalence of fungal VVC was 53.6% (222/414 patients). After PCR, no C. africana or C. dubliniensis were observed. C. albicans isolates exhibited two PCR profiles: 941 bp and 941+850 bp, with C. albicans being the most frequently isolated species (70.7%) after C. tropicalis (9.9%). The most affected groups were patients younger than 25 (p = 0.018), those living in precarious housing (p < 0.0001), and pregnant women (p = 0.006). In addition, the presence of vulvovaginal candidiasis was significantly associated with vaginal irrigation (i.e., douching) frequency (p = 0.003), douche used (e.g., antibacterial or not) (p = 0.003), and underwear type (p = 0.037). The most common symptom reported was vaginal itching (46.4%). Conclusion: No strains of C. africana and C. dubliniensis were found. The increased prevalence of VVC in Abidjan warrants further studies.