Candida species are one of the commonest causes of vaginitis in healthy women of reproductive age. Vulvovaginal candidiasis (VVC) is characterized by vulvovaginal itching, redness and discharge. Candida albicans, which is a common genito-urinary tract commensal, has been the prominent species and remains the most common fungal agent isolated from clinical samples of patients diagnosed with VVC. In recent times, however, there has been a notable shift in the etiology of candidiasis with non-albicans Candida (NAC) species gaining prominence. The NAC species now account for approximately 10% to as high as 45% of VVC cases in some studies. This is associated with treatment challenges and a slightly different clinical picture. NAC species vaginitis is milder in presentation, often occur in patients with underlying chronic medical conditions and symptoms tend to be more recurrent or chronic compared with C. albicans vaginitis. C. glabrata is the most common cause of NAC-VVC. C. tropicalis, C. krusei, C. parapsilosis, and C. guilliermondii are the other commonly implicated species. Treatment failure is common in NAC-VVC, since some of these species are intrinsically resistant or show low susceptibilities to commonly used antifungal agents. This article reviews the etiology, pathogenesis, clinical features, diagnosis, and management of NAC vulvovaginitis.

Detection of acute HIV infection is a unique problem that fourth-generation HIV assays were expected to alleviate. In this commentary, we draw attention to the limitations and challenges with use of currently available rapid antigen–antibody (Ag/Ab) combination tests for detection of acute HIV infection in sub-Saharan Africa. Laboratory-based HIV-1 Ag/Ab immunoassays are complex, requiring specialized equipment and handling that are currently not affordable in many settings in Africa. The point-of-care Ag/Ab platform on the other hand is easier to deploy and potentially more accessible in resource-limited settings. However, available fourth-generation HIV-1 rapid diagnostic tests have demonstrated poor performance characteristics in field studies where non-B subtypes of HIV-1 dominate. The potential for point-of-care HIV-1 Ag/Ab diagnostics to significantly improve detection of acute HIV infection remains yet to be realized in sub-Saharan Africa. Assay platforms need to be optimized to identify local circulating subtypes, and optimal algorithms need to be determined.

Reports from Asia and other parts of the world have demonstrated that the incidence of Candida auris infection is on the rise. Candida auris is a fungal pathogen causing a wide variety of infections affecting people of all age groups. Candida auris was first described in 2009 and has since emerged as an important cause of invasive fungal infection, most importantly healthcareassociated candidaemia. Large outbreaks have been reported worldwide, with therapeutic failure and associated high mortality rates recorded. The emergence and spread of C. auris raises public health concerns because of some characteristics of this pathogen. First it is resistant to many antifungal agents making this infection very difficult to treat. It is also associated with horizontal transmission in health care settings causing outbreaks among hospitalized individuals with high mortality rates. Furthermore, identification of C auris is a challenge. Routine identification methods usually misidentify the organism as other yeasts especially Candida haemulonii. This review discusses the current knowledge on the epidemiology, treatment and control of this infection. The urgent need for the stakeholders in Nigerian tertiary hospitals to set machinery in motion for prompt diagnosis, management and prevention of transmission of this infection are also discussed. Infection a Candida auris: Comment le Nigeria est-il prepare pour cet agent fongique emergent? Des rapports en provenance d'Asie et d'autres parties du monde ont démontré que l'incidence de l'infection à Candida auris est en augmentation. Candida auris est un pathogène fongique causant une grande variété d'infections affectant les personnes de tous les groupes d'âge. Candida auris a été décrit pour la première fois en 2009 et est depuis apparu comme une cause importante d'infection fongique invasive, surtout la candidémie associée aux soins de santé. De grandes épidémies ont été signalées dans le monde entier, avec des échecs thérapeutiques et des taux de mortalité élevés associés enregistrés. L'émergence et la propagation de C. auris soulèvent des préoccupations en matière de santé publique en raison de certaines caractéristiques de ce pathogène. D'abord, il est résistant à de nombreux agents antifongiques rendant cette infection très difficile à traiter. Il est également associé à la transmission horizontale dans les milieux de soins de santé, ce qui provoque des éclosions parmi les personnes hospitalisées avec des taux de mortalité élevés. De plus, l'identification de C auris est un défi. Les méthodes d'identification de routine confondent généralement l'organisme avec d'autres levures, en particulier Candida haemulonii. Cette revue discute les connaissances actuelles sur l'épidémiologie, le traitement et le contrôle de cette infection. Le besoin urgent pour les parties prenantes des hôpitaux tertiaires du Nigeria de mettre en place un système de diagnostic rapide, de prise en charge et de prévention de la transmission de cette infection est également discuté

Introduction: Most women who acquire HIV and other sexually transmitted infections (STIs) are in their child bearing years and are current or potential users of contraceptive methods. The study was undertaken to provide information on the association between the hormonal contraceptive methods and vulvo vaginal candidiasis among women attending Family Planning clinics, University College Hospital, Ibadan, Nigeria. Methods: It was a cross-sectional study in a population of women using hormonal contraceptive methods attending Family Planning clinics. Detailed medical history, endocervical and high vaginal swabs were collected from the women to establish diagnosis after clinical examination and informed consent. Aliquots of sera from venous blood samples of the women were tested for antibodies to HIV-1/2. Data was analysed using SPSS for windows’ version 17.0. Results: There were 116 women using hormonal contraceptive methods who participated in the study with mean age of 28.70 years (SD = 6.72, range = 19 –54). The mean age of sexual debut of the women was 19.2 years (SD = 2.96). The prevalence of vulvo-vaginal candidosis was 23.3%. Other associated sexually transmitted infections were bacterial vaginosis (24.1%), HIV (12.1%), trichomoniasis (10.3%), chlamydia cervicitis (7.8%), syphilis (5.2%), genital warts (6.0%) and gonorrhoea (2.6%).Younger age of sexual debut influenced the decision of selecting various forms of hormonal contraceptives especially the emergence of oral contraceptive forms (P = 0.043). Majority of the women on hormonal contraceptives had multiple sexual partners. Vulvovaginal candidosis is strongly associated with vaginal discharge and pruritus in women utilizing hormonal contraceptive methods (P = 0.001, 4.2 (1.0–13.2). Conclusions: Women seeking contraception to prevent unintended pregnancy are as much in need of education about prevention of STIs. The study found that younger age, numbers sexual partners, and use of hormonal contraceptives could increase the risk of acquiring vulvovaginal candidosis. Candidose vulvo-vaginale dans une cohorte d'utilisateurs contraceptifs hormonaux a Ibadan, Nigeria Introduction: La plupart des femmes qui contractent le VIH et d'autres infections sexuellement transmissibles (IST) sont en âge de procréer et sont des utilisatrices actuelles ou potentielles de méthodes contraceptives. L'étude a été entreprise pour fournir des informations sur l'association entre les méthodes contraceptives hormonales et la candidose vulvo vagin chez les femmes fréquentant les cliniques de planification familiale, University College Hospital, Ibadan, Nigeria. Méthodes: Il s'agissait d'une étude transversale menée auprès d'une population de femmes utilisant des méthodes contraceptives hormonales dans des cliniques de planification familiale. Des antécédents médicaux détaillés, des prélèvements endocervicaux et des prélèvements vaginaux élevés ont été effectués auprès des femmes pour établir un diagnostic après un examen clinique et un consentement éclairé. Des aliquotes de sérums d'échantillons de sang veineux des femmes ont été testées pour rechercher des anticorps anti-VIH-1/2. Les données ont été analysées à l'aide de SPSS pour la version 17.0 des veuves. Résultats: 116 femmes utilisant des méthodes contraceptives hormonales ont participé à l'étude avec un âge moyen de 28,70 ans (ET = 6,72, intervalle = 19-54). L'âge moyen des débuts sexuels des femmes était de 19,2 ans (ET = 2,96). La prévalence de la candidose vulvo-vaginale était de 23,3%. Les autres infections sexuellement transmissibles étaient la vaginose bactérienne (24,1%), le VIH (12,1%), la trichomonase (10,3%), la chlamydia cervicite (7,8%), la syphilis (5,2%), les verrues génitales et la gonorrhée. . L'âge plus jeune des débuts sexuels a influencé la décision de choisir différentes formes de contraceptifs hormonaux, en particulier l'émergence de formes contraceptives orales (p = 0,043). La majorité des femmes sur les contraceptifs hormonaux avaient plusieurs partenaires sexuels. La candidose vulvovaginale est fortement associée aux pertes vaginales et au prurit chez les femmes utilisant des méthodes contraceptives hormonales (p = 0,001, 4,2 (1,0-13,2). Conclusions: Les femmes qui recherchent une contraception pour prévenir les grossesses non désirées ont autant besoin d'éducation sur la prévention des IST. L'étude a révélé que le plus jeune âge, le nombre de partenaires sexuels et l'utilisation de contraceptifs hormonaux pourraient augmenter le risque d'acquisition de la candidose vulvo-vaginale.

Trichomonas vaginalis is one of the common non- viral sexually transmitted infections that infect both men and women worldwide. It is largely asymptomatic and its association with the risk of HIV transmission has made it a compelling public health concern. Therefore, this study aims to determine the prevalence and the risk factors associated with T. vaginalis among asymptomatic undergraduate students at Babcock University, Ilisan-Remo, Ogun state, Nigeria. This is a descriptive cross-sectional study involving 246 asymptomatic students of Babcock University between February 2019 to April 2020. Information on socio-demographic and associated risk factors was obtained by structured-questionnaire in an interview-based manner. First-void urine was collected from each participant for the detection of T. vaginalis using the traditional wet prep method and TV in-pouch. The data were analyzed by SPSS Version 23. The overall prevalence of T. vaginalis among the participants was 12.2% (30/246). The use of wet-preparation showed 8.5% (21/246) while the use of TV inpouch yielded 12. 2% (30/246) prevalence of positive results. The results of the wet prep in comparison to the in-pouch technique was statistically significant among the study population. (P < 0.001). Sexual intercourse, use of hormonal contraceptives and practice of internet-based sex seeking behaviour were factors that had increase likelihood of T. vaginalis infection on multivariate analysis. The occurrence of T. vaginalis and, its associated risk factors among the asymptomatic population in this study is very high. We advocate for the screening of young people.