Prevalence of HIV-associated esophageal candidiasis in sub-Saharan Africa: a systematic review and meta-analysis

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dc.contributor.authorOlum, Ronald
dc.contributor.authorBaruch Baluku, Joseph
dc.contributor.authorOkidi, Ronald
dc.contributor.authorAndia-Biraro, Irene
dc.contributor.authorBongomin, Felix
dc.date.accessioned2023-01-24T11:10:30Z
dc.date.available2023-01-24T11:10:30Z
dc.date.issued2020
dc.description.abstractEsophageal candidiasis (OC) is a common AIDS-defining opportunistic infection. Antiretroviral therapy (ART) reduces the occurrence of OC and other opportunistic infections among persons living with HIV (PLHIV). We sought to determine and compare the prevalence of OC in the ART and pre-ART era among PLHIV in sub-Saharan Africa (SSA). Methods: We searched PubMed, Embase, Web of Science, and the African Journals Online databases to select studies in English and French reporting the prevalence of HIV-associated OC in SSA from January 1980 to June 2020. Reviews, single-case reports, and case series reporting < 10 patients were excluded. A random-effect cumulative meta-analysis was performed using STATA 16.0, and trend analysis performed using GraphPad Prism 8.0. Results: Thirteen eligible studies from 9 SSA countries including a total of 113,272 patients were qualitatively synthesized, and 9 studies were included in the meta-analysis. Overall pooled prevalence of HIV-associated OC was 12% (95% confidence interval (CI): 8 to 15%, I2 = 98.61%, p <. 001). The prevalence was higher in the pre-ART era compared to the ART era, but not to statistical significance (34.1% vs. 8.7%, p = 0.095). In those diagnosed by endoscopy, the prevalence was higher compared to patients diagnosed by non-endoscopic approaches, but not to statistical significance (35.1% vs. 8.4%, p = .071). The prevalence of OC significantly decreased over the study period (24 to 16%, p < .025). Conclusion: The prevalence of OC among PLHIV in the ART era in SSA is decreasing. However, OC remains a common problem. Active endoscopic surveillance of symptomatic patients and further empirical studies into the microbiology, optimal antifungal treatment, and impact of OC on quality of life of PLHIV in SSA are recommended.en_US
dc.identifier.citationOlum, R., Baluku, J. B., Okidi, R., Andia-Biraro, I., & Bongomin, F. (2020). Prevalence of HIV-associated esophageal candidiasis in sub-Saharan Africa: a systematic review and meta-analysis. Tropical Medicine and Health, 48(1), 1-10. https://doi.org/10.1186/s41182-020-00268-xen_US
dc.identifier.urihttps://doi.org/10.1186/s41182-020-00268-x
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7148
dc.language.isoenen_US
dc.publisherTropical Medicine and Healthen_US
dc.subjectEsophageal candidiasisen_US
dc.subjectPrevalenceen_US
dc.subjectHIV/AIDSen_US
dc.subjectSub-Saharan Africaen_US
dc.subjectReviewen_US
dc.subjectMeta-analysisen_US
dc.titlePrevalence of HIV-associated esophageal candidiasis in sub-Saharan Africa: a systematic review and meta-analysisen_US
dc.typeArticleen_US
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