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

Background: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 essentialfor 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 Cameroon.

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 clinical symptoms. Microbiological cultures from oral, stool, and high vaginal swabs confirmed C. albicansinfections. Antifungal susceptibility testing was performed using disk diffusion methods. Statistical analyses included descriptive statistics, and multivariate 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 oral 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 criticaldeterminants 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 initiatives to reduce disease burden and combat antifungal resistance.