The current study was aimed at carrying out a comprehensive population- based epidemiological study of candidiasis among women and school children in the city of Nablus. The study investigated the susceptibility of recovered yeast isolates to selected drugs and certain plant extracts and the cytotoxic effects of certain plant extracts on selected human cell lines. The study was conducted during the period of January- May 2002. It involved 119 women, attending a gynecologist private clinic, and 463 school children aged 15-18 years (251 males and 212 females). Of the 119 women complaining from vaginal discharge and suspected for yeast infection, 63 (52.9%) were yeast positive. Associated symptoms included itching (22.5%), dysparenia (8.9%), burning and dysurea (8.9%), urinary tract infection (7.9%), bad odor (7.9%) and other symptoms (17.5%). The highest rate of infection was observed among women aged (21-30); women residents in villages (61.9%) and in pregnant women (58.1%).
The infection rates of 36.3% and 19.8% were found among male and female school children, respectively. The most prevalent symptom among both males and females was interdigital (92.3% and 57.1%), respectively. Male refugee camp inhabitants showed the highest infection rates (85%), compared to city (66.2%) and village (40.0%) residents. Whereas female population showed the highest rate of infection among village residents (100%) compared to city (68.9%) and refugee camp (38.1%) inhabitants. Other mycotic infections showed the highest percentage of associated disorders (19.8%) among males, whereas eczema was the predominant associated disorder among females (9.5%). Other practices such as use of common facilities did not seem to indicate an association between such practice and infection in both males and females, while contact with domestic animals showed a significant association with infection in both males (58.2%) and females (80.9%). Feet drying practice showed a convenient positive association with infection especially among females who reported not to dry their feet (64.3%), whereas it was contradictory in males who claimed to dry their feet but showed a positive yeast infection (57.1%).
With respect to anticandidal activity of plant extracts, all tested plants showed pronounced activity to various degrees. Allium sativum (Garlic) showed the highest effect (100%) followed by Pistacia lentiscus (3.8%), Salvia dominica (2.25%) and Petrosilinum sativum (2.25%) compared to reference antibiotics (Nystatin and Econazole).
Studies on the cytotoxic effects of plant extracts (Anagalis arvensis, Anthemis tictoria L. and Parieteria diffusa) against human cell lines showed that all extracts were cytotoxic at ≥ 500 μg against HT29 human cell line, more pronounced effects were observed for Parieteria diffusa and Anagalis arvensis, respectively. Anthemis tinctoria L. showed the most pronounced effect against human cell line L929, however, extracts of Anagalis arvensis and Parieteria diffusa showed effects at ≥ 500 μg. All three extracts showed cytotoxic effects at ≥ 5000 μg against cell line Hep G2, however, Anagalis arvensis showed the same effect at ≥ 500 μg. Anthemis tinctoria L. showed a pronounced cytotoxic effect at ≥ 5000 μg against human pulp fibroblasts, however, Anagalis arvensis and Parieteria diffusa showed reduced effects using the same concentration compared to their effects at 500 μg.
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