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.
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 cont...
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Kabale University
2024
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| Online Access: | http://hdl.handle.net/20.500.12493/2420 |
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| author | Musinguzi, Benson Obuku, Ekwaro A. Mwesigwa, Alex Migisha, Richard Kinengyere, Alison Annet Ndagire, Regina Baguma, Andrew Okek, Erick Jacob Olum, Ronald Itabangi, Herbert Mboowa, Gerald Sande, Obondo James Achan, Beatrice |
| author_facet | Musinguzi, Benson Obuku, Ekwaro A. Mwesigwa, Alex Migisha, Richard Kinengyere, Alison Annet Ndagire, Regina Baguma, Andrew Okek, Erick Jacob Olum, Ronald Itabangi, Herbert Mboowa, Gerald Sande, Obondo James Achan, Beatrice |
| author_sort | Musinguzi, Benson |
| collection | KAB-DR |
| description | 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 immunodefciency 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 analyzed 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. glabrate (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 remains, 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. |
| format | Article |
| id | oai:idr.kab.ac.ug:20.500.12493-2420 |
| institution | KAB-DR |
| language | English |
| publishDate | 2024 |
| publisher | Kabale University |
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| spelling | oai:idr.kab.ac.ug:20.500.12493-24202024-12-12T00:00:58Z 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. Musinguzi, Benson Obuku, Ekwaro A. Mwesigwa, Alex Migisha, Richard Kinengyere, Alison Annet Ndagire, Regina Baguma, Andrew Okek, Erick Jacob Olum, Ronald Itabangi, Herbert Mboowa, Gerald Sande, Obondo James Achan, Beatrice Candida C. albicans Oropharyngeal Oral Candidiasis Test Treat 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 immunodefciency 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 analyzed 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. glabrate (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 remains, 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. 2024-12-11T10:53:28Z 2024-12-11T10:53:28Z 2024 Article Musinguzi, B. et al. (2024). 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. Kabale: Kabale University. http://hdl.handle.net/20.500.12493/2420 en Attribution-NonCommercial-NoDerivs 3.0 United States http://creativecommons.org/licenses/by-nc-nd/3.0/us/ application/pdf Kabale University |
| spellingShingle | Candida C. albicans Oropharyngeal Oral Candidiasis Test Treat Musinguzi, Benson Obuku, Ekwaro A. Mwesigwa, Alex Migisha, Richard Kinengyere, Alison Annet Ndagire, Regina Baguma, Andrew Okek, Erick Jacob Olum, Ronald Itabangi, Herbert Mboowa, Gerald Sande, Obondo James Achan, Beatrice 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. |
| title | 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. |
| title_full | 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. |
| title_fullStr | 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. |
| title_full_unstemmed | 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. |
| title_short | 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. |
| title_sort | 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 |
| topic | Candida C. albicans Oropharyngeal Oral Candidiasis Test Treat |
| url | http://hdl.handle.net/20.500.12493/2420 |
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