Intestinal candidiasis and antibiotic usage in children: case study of Nsukka, South Eastern Nigeria.

Ifeoma M Ezeonu, Ntun W Ntun, Kenneth O Ugwu
Department of Microbiology, University of Nigeria, Nsukka.
Email addresses:
Ifeoma M Ezeonu,
E-mail: ifeoma.ezeonu@unn.edu.ng
Tel: +234 803 795 4649
Ntun W Ntun,
E-mail: ntun.ntun@unn.edu.ng
Tel: +234 803 310 5167
Kenneth O Ugwu,
E-mail: kennyugwu@yahoo.com
Tel: +234 803 881 4796

Abstract
Background: Overgrowth of candida results from factors that disrupt the intestinal microbial balance, such as the use of antibiotics. Unregulated antibiotic use and rampant practice of self-medication in Nigeria, is a cause for concern.

Methods: A total of 314 stool specimens were collected from children <1 to 12 years of age in Nsukka, South Eastern Nigeria and screened for candida species using standard methods. Questionnaires were used to collect relevant information on the participants.

Results: Out of the 314 participants, 31.2% had candidiasis, indicated by growth of ≥105 CFU/ml. Four different species of candida were identifed. Candida albicans had the highest prevalence (59.0%), while Candida krusei had the least prevalence (6.0%). Of the 314 participants, 46.5% had diarrhoea, out of which 58.9% had intestinal candidiasis while only 14.3% of the non-diarrhoeic children had candidiasis. Of 208 participants who had taken antibiotics within three weeks of the study, 42.3% had
candidiasis compared to 20.8% of those with no recent history of antibiotic use.

Conclusion: The results of this study showed a high prevalence of intestinal candidiasis among children in Nsukka. Strong
associations were observed between the presence of intestinal candidiasis and diarrhoea, age and use of antibiotics (p<0.001).

Keywords: Intestinal candidiasis, children, antibiotic use, diarrhea.