Socio Demographic Determinants and Risk Factors for Candidiasis in Immunocompromised Patients: Evidence from Northwest Cameroon

Candidiasis, primarily caused by Candida albicans , represents a significant
opportunistic infection in immunocompromised individuals, particularly those living with HIV.
Understanding socio demographic determinants and risk factors is essential for developing
targeted public health interventions.
Objective:
To investigate socio demographic determinants and risk factors associated with
oral, gastrointestinal (GI), and vulvovaginal candidiasis (VVC) among immunocompromised
patients in Northwest Ca meroon.
Methods:
A cross sectional study was conducted at Bamenda Regional Hospital involving 500
immunocompromised patients. Data were collected through structured questionnaires
assessing socio demographic characteristics, candidiasis knowledge, and clin ical symptoms.
Microbiological cultures from oral, stool, and high vaginal swabs confirmed C. albicans
infections. Antifungal susceptibility testing was performed using disk diffusion methods.
Statistical analyses included descriptive statistics, and multi variate logistic regression (SPSS
v21.0).
Results:
The study population was predominantly female (86.4%), aged 25 34 years (49.6%),
married (57.8%), and Christian (98.2%). Candidiasis prevalence was 4.2% for oral infections
(95% CI: 2.4 6.0%), 6.4% for GI infections (95% CI: 4.2 8.6%), and 28.0% for VVC (95% CI:
24.0 32.0%). Female sex (OR=4.1, 95% CI: 2.3 7.4, p<0.001) and low candidiasis knowledge
(OR=2.8, 95% CI: 1.6 4.9, p<0.001) emerged as significant determinants. Site specific risk
factors included o ral lesions (oral candidiasis), abdominal discomfort and constipation (GI
candidiasis), and vaginal irritation with discharge (VVC). Median knowledge scores of 4 /10,
indicated substantial awareness gaps. Antifungal susceptibility varied: clotrimazole (100 %
sensitive for oral infections), itraconazole (93.1% for GI), flucytosine (97% for VVC), and
fluconazole (>82% overall), while griseofulvin showed complete resistance.
Conclusions:
Female sex, inadequate knowledge, and limited education represent critical
determinants of candidiasis in immunocompromised Cameroonians. These findings
underscore the urgent need for targeted public health interventions, including gender specific
education programs, enhanced screening protocols, and antimicrobial stewardship in itiatives
to reduce disease burden and combat antifungal resistance.