Distribution of Candida species isolated from people living with human immunodeficiency virus with oropharyngeal and oral candidiasis in Africa in the era of universal test and treat policy: a systematic review and meta-analysis.

Autor: Musinguzi B; Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.; Department of Medical Laboratory Science, Faculty of Health Sciences, Muni University, Arua, Uganda., Obuku EA; Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.; Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, UK.; Department of Global Health Security, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda., Mwesigwa A; Department of Microbiology, School of Medicine, Kabale University, Kabale, Uganda., Migisha R; Department of Physiology, Mbarara University and Science and Technology, Mbarara, Uganda., Kinengyere AA; Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.; Sir Albert Cook Medical Library, College of Health Sciences, Makerere University, Kampala, Uganda., Ndagire R; Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.; Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Baguma A; Department of Microbiology, School of Medicine, Kabale University, Kabale, Uganda., Okek EJ; Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda., Olum R; School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda., Itabangi H; Department of Microbiology and Immunology, Faculty of Health Sciences, Busitema University, Mbale, Uganda., Mboowa G; Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.; African Centre of Excellence in Bioinformatics and Data Intensive, Sciences, the Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda., Sande OJ; Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda., Achan B; Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. beatriceachan@yahoo.co.uk.
Jazyk: angličtina
Zdroj: Tropical medicine and health [Trop Med Health] 2024 Nov 27; Vol. 52 (1), pp. 88. Date of Electronic Publication: 2024 Nov 27.
DOI: 10.1186/s41182-024-00649-6
Abstrakt: Background: The introduction of antiretroviral therapy (ART) and the implementation of the human immunodeficiency virus (HIV) universal test and treat (UTT) policy have led to a decline in the incidence of opportunistic infections. However, oropharyngeal and oral candidiasis remain prevalent and continue to pose challenges among people living with human immunodeficiency virus (PLHIV) in Africa, indicating the need for a better understanding of the distribution of Candida species responsible for these infections. This systematic review and meta-analysis aimed to determine the distribution of Candida species isolated from PLHIV with oropharyngeal and oral candidiasis in Africa in the era of UTT policy.
Methods: The review followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. A comprehensive search was conducted to identify eligible studies to be included in the meta-analysis and analysed using a random effects model in STATA version 17. The risk of bias was assessed using the Joanna Briggs Institute quality assessment tool.
Results: Fourteen studies with 4281 participants were included in the review. Overall, 2095 Candida isolates were reported, 78.7% (1650/2095) of which were C. albicans, 19.6% (410/2095), non-albicans Candida (NAC), and 1.7% (35/2095) could not be identified to the Candida specific species level. The most prevalent NAC species were C. glabrata (26.3%), followed by C. tropicalis (24.9%), C. krusei (15.6%), C. parapsilosis (11%), and C. dubliniensis (6.3%). The pooled prevalence of oropharyngeal and oral candidiasis was 48% (95% CI 34-62%). The prevalence of oropharyngeal candidiasis was higher in the pre-UTT era, at 56% (95% CI 40-72%, p < 0.001), than in the post-UTT era, at 34% (95% CI 10-67%, p < 0.001). The risk of bias assessment revealed that 71.4% (10/14) of the included studies had a low risk of bias and that 28.6% (4/14) had a moderate risk of bias.
Conclusions: While C. albicans remain, the predominant species causing oropharyngeal and oral candidiasis among PLHIV in Africa, NAC species also contribute significantly to the infection burden. Despite ART and UTT policies, oropharyngeal candidiasis remains prevalent, emphasizing the need for targeted interventions.
Competing Interests: Declarations. Ethics approval and consent to participate: Although ethical approval was obtained from the Makerere University School of Biomedical Sciences Research Ethics Committee (Reference number: SBS-2022–254) for the larger study, this systematic review analysed published studies without identifiable patient data; as such, ethical approval was not needed. Consent for publications: Not applicable. Competing interests: The author(s) declare no potential conflicts of interest concerning the research, authorship, and/or publication of this article.
(© 2024. The Author(s).)
Databáze: MEDLINE
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