Epidemiological, etiological, and antifungal resistance patterns of vulvovaginal Candida spp. infections in Cameroon: A systematic review and meta-analysis.
Megane D Malieuze Nanfah, Michel M Yop Kite, Solange Meyin A Ebong et al.
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In 30 seconds
This systematic review and meta-analysis pooled evidence from 34 studies of vulvovaginal Candida infection and vulvovaginal candidiasis (VVC) in Cameroon. Estimated proportions were 33.3% for vulvovaginal Candida infection and 31.6% for VVC. Candida albicans was the most frequently isolated species (23.3%). Among reported resistance results for C. albicans, resistance was 51.1% to fluconazole and 50.5% to itraconazole. The authors also report that pregnancy status, diagnostic methods, and HIV infection influenced species proportions, while evidence on drug profiles for non-albicans species was limited.
Key findings
- Pooled proportions were 33.3% (95% CI 25.5%-41.6%) for vulvovaginal Candida infection and 31.6% (95% CI 26.9%-36.4%) for VVC.
- Candida albicans was the leading species, at 23.3% (95% CI 17.9%-29.1%).
- Reported C. albicans resistance was 51.1% (95% CI 21.2%-80.7%) to fluconazole and 50.5% (95% CI 41.3%-100%) to itraconazole.
- Pregnancy status, diagnostic methods, and HIV infection influenced species proportions; evidence on non-albicans drug profiles was limited.
Why it matters
The pooled estimates indicate a substantial burden of VVC in the included Cameroonian evidence, while the reported azole resistance levels raise concern about relying on these agents without local susceptibility information. Variation associated with diagnostic methods and limited data for non-albicans species also matter when interpreting prevalence and resistance estimates. The review supports attention to surveillance and consistent diagnostic approaches.
What to keep in mind
Evidence on drug profiles for non-albicans species was limited, and the pooled estimates were drawn from studies using differing diagnostic methods.