Epidemiology of oral candidiasis: a household-based population survey in a medium-sized city in Amazonas
Keywords:Candida albicans; Non-Candida albicans; Elderly; Oral candidiasis.
There was an increase in the number of elderly people in Brazil and, along with this fact, there was an increase in the incidence of oral candidiasis in this population, so the early identification of the disease and the etiologic agent for effective intervention is essential. The study aimed to describe the prevalence of oral candidiasis and its clinical manifestations, identifying Candida yeast species and their prevalence in the palatine mucosa and dentures in the palatine mucosa and dentures, comparing these factors in rural and urban elderly people in this city. The study was conducted in the city of Tefé, Amazonas, with elderly people aged 65 to 74 years old registered in primary health care services in urban and rural areas, where through sample calculation we had a total sample of 484 elderly people after losses and refusals. These elderly people were randomly selected from within the entire public service network, which enabled the samples to be collected in all municipal Basic Health Units. Data collection included clinical oral examinations (use, duration, and need for dental prosthesis) and collection of biological material with swabs, which were stored in CHROMAgar™ Candida medium, during home visits to determine the prevalence of the species through staining and colony morphology. Statistical analysis was performed with Stata MP software, using relative and absolute frequencies. The prevalence of oral candidiasis was found in 20.7% of the elderly in the different areas of residence studied. A greater number of cases and clinical manifestations of the disease were found in elderly people living in urban areas (p < 0.05). The odds ratios for developing the disease were higher in women, edentulous elderly, and users of dental prostheses. Candida albicans species were prevalent in infection and colonization of prostheses, while oral colonization showed similar percentages among Candida non-albicans (p = 0.657). As for the prevalence of species about the studied area of residence, Candida albicans prevailed in the urban area and Candida non-albicans in the rural area (p <0.05). In conclusion, this study identified a high prevalence of oral candidiasis in elderly participants in the research, who were mainly infected with Candida albicans species, but when comparing the living areas of the elderly, those living in the urban area had more prevalent colonization in the area. urban and Candida non-albicans in the rural area, therefore, species differentiation was found regarding the place where the elderly person lives.
Arendorg, T. M., & Walker, D. M. (1980). The prevalence and intra-oral distribution of Candida albicans in man. Arch Oral Biol.; 25:1-10.
Bianchi, C. M. P. C., Bianchi, H. A., Tadano, T., Paula, C. R., Hoffmann-Santos, H. D., & Leite Jr., D. P. (2016). Factors related to oral candidiasis in elderly users and non-users of removable dental prostheses. Rev. Inst. Med. trop.; 58: 17-22.
Bilings, M., Dye, B. A., Lafolla, T., Grisius, M., & Alevizos, I. (2017). Elucidating the role hyposalivation and autoimmunity in oral candidiasis. Oral Dias. 23(3): 387-394.
Bhattacharya, S., Sae-Tia, S., & Fries, B. C. (2020). Candidiasis and Mechanisms of Antifungal Resistance. Antibiotics (Basel). 9(6):312.
Brazil. (2012). Ministry of Health Secretariat of Health Care. Department of Primary Care. Dermatology in Primary Health Care. Primary Care Notebooks, No. 9. Brasília.
Brucki, S. M. D., Nitrini, R., Caramelli, P., Bertolucci, P. H. F., & Okamoto, I. H. (2003) Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr. 61(3B):777-81.
Chung, L. M., Liang, J. A., Lin, C. L., Sun, L. M., & Kao, C. H. (2017). Cancer risk in patients with candidiasis: a nationwide population-based cohort study. Oncotarget. 8: 63562-63573.
Cortegiani, A., Misseri, G., & Chowdhary, A. (2019). Intensive Care Med.; 45(5): 512.
Glažar, I., Muhvić Urek, M., Kuiš Prpić, J., Mišković, I., Kovačevic Pavičić, D., & Pezelj-Ribarić, S. (2016). Salivary Flow, Oral Yeast Colonization and Dental Status in Institutionalized and Non-Institutionalized Elderly. Acta Clin Croat. 55: 390-395.
Guinea, J. (2014). Global trends in the distribution of Candida species causing candidemia. Clin Microbiol Infect. 20: 5-10.
Hertel, M., Schmidt-Westhausen, A., & Stritzel, F. P. (2016). Local, systemic, demographic and health-related factors that influence the pathogenic yeast spectrum and the frequency of antifungal drug administration in oral candidiasis: a retrospective study. Clin Oral Inv. 20(7): 1477-86.
Hu, L., He, C., Zhao, C., Chen, X., Hua, H., & Yan Z. (2019). Characterization of oral candidiasis and the Candida species profile in patients with oral mucosal diseases. Microb Pathog. 134(5):134-140.
Justiz Vaillant, A. A., & Qurie, A. (2020). Immunodeficiency. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Khan, A., Thapa, J. R., & Zhang, D. (2017). Preventive Dental Checkups and Their Association with Access to Usual Source of Care Among Rural and Urban Adult Residents. J Saude Rural. 2017; 33(4): 419-426.
Kassebaum, N. J., Smith, A. G. C., Bernabé, E., Fleming, T. D., Reynolds, A. E., Vos, T., Murray, C. J. L., & Marcenes, W. (2017). Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J. Dent Res. 96: 380-387.
Kawashita, Y., Funahara, M., Yoshimatsu, M., Nakao, N., Soutome, S., Saito, T., & Umeda, M. (2018). A retrospective study of factors associated with the development of oral candidiasis in patients receiving radiotherapy for head and neck cancer: Is topical steroid therapy a risk factor for oral candidiasis? Medicina (Baltimore). 97(44): e13073.
Lydia, R. M., & Saravana, K. P. (2016). Prevalence of Candida species in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry. J Mycol Med. 26: 359-367.
Martori, E., Ayuso-Montero, R., Martinez-Gomis, J., Viñas, M., & Peraire, M. (2014). Risk factors for denture-related oral mucosal lesions in a geriatric population. J Prosthet Dent.; 111(4): 273-9.
Mothibe, J.V., & Patel, M. (2017). Pathogenic characteristics of Candida albicans isolated from oral cavities of denture wearers and cancer patients wearing oral prostheses. Microb Pathog., 110:128-134.
Myazaki, H., Jones, J. A., & Beltran-Aguillar, E. D. (2017). Surveillance and monitoring of oral health in elderly people. Int Dent J. 67(2): 34-41.
Neville, B., Damm, D. D., Allen, C., & Chi, A. (2015). Oral and Maxillofacial Pathology. 4 ed. Saunders.
Núñez, M. J., Novío, S., Suárez, J. A., Balboa, J., & Freire-Garabal, M. (2010). Effects of psychological stress and fluxetine on development of oral candidiasis in rots. Clin Vaccine Immunol. 17: 668-73.
Odgaard, L., & Kothari, M. (2018). Prevalence and association of oral candidiasis with dysphagia in individuals with acquired brain injury. Brain Inj. 32(2): 247-251.
Peterson, D. E. (1992). Oral candidiasis. Clin Geriatr Med. 8(3): 512-527.
Sato, T., Kishi, M., Suda, M., Sakata, K., Shimoda, H., Miura, H., Ogawa, A., & Kobayashi, S. (2017). Prevalence of Candida albicans and non-albicans on the tongue dorsa of elderly people living in a post-disaster area: a cross-sectional survey. BMC Oral Health. 17(1): 51-8.
Sakaguchi, G. (2017).Tratament and preventionon of candidiasis in elderly patients. Med Mycol J. 58: 43-49.
Sakaguchi, H. (2017). Tratament and prevention of oral candidiasis in elderly patients. Med Mycol. 58(2): 43-49.
Singh, R., Kumari, A., Kaur, K., Sethi, P., & Chakrabarti, A. (2018). Relevance of antifungal penetration in biofilm-associated resistance of Candida albicans and non-albicans Candida species. J Med Microbiol. 67(7): 922-926.
Shintani, T., Fujii, T., Yamasaki, N., Kitagawa, M., Iwata, T., Saito, S., Okada, M., Ogawa, I., Unei, H., Hamamoto, K., Nakaoka, M., Kurihara, H., & Shiba, H. (2020). Oral environment and taste function of Japanese HIV-infected patients treated with antiretroviral therapy. AIDS Care. 32(7):829-834.
Silva, S., Negri, M., Henriques, M., Oliveira, R., Williams, D. W., & Azeredo, J. (2012). Candida glabrata, Candida Parapsilosis e Candida Tropicalis: biology, epidemiology, pathogenicity and antifungal resistance. FEMS Microbiol Rev. 36(2): 288-305.
Spampinato, C., Leonardi, D. (2013). Candida infections, causes, targets, and resistance mechanisms: traditional and alternative antifungal agents. BioMed Research International. (2013):1–13.
Susewind, S., Lang, R., & Hahnel, S. (2015). Biofilm formation and Candida albicans morphology on surface of denture base materials. Mycoses. 58(12): 719-27.
Ribeiro dos Santos, E., Huang, H., Menezes, P. R., & Scazufca, M. (2016). Prevalence of depression and depression care for populations registred in primary care in two remote cities in the Brazilian Amazon. PLoS One, 11(3): e0150046.
Taj-Aldeen, S. J., Kolecka, A., Boesten, R., Alolagi, A., Almaslamani, M., Chandra, P., Meis, K. F., & Boekhout, T. (2014). Epidemiology of Candidemia in Quatar, Middle East: Using Maldi-tof to identify Candida species, distribution and pattern and susceptibility. Infection. 42(2): 393-404.
Taylor, M., Raja, A. (2021). Oral Candidiasis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, PMID: 31424866.
WHO. World Health Organization (1997). Oral health surveys: basic medicines. 4 ed. Geneva: World Health Organization.
Zakaria, M. N., Furuta, M., Takeshita, T., Shibata, Y., Sundari, R., Eshima, N., Ninomiya, T., & Yamashita, Y. (2017). Oral mycobiome in community dwelling elderly and its relation to oral and general health conditions. Oral Dis. 23(7): 973-982.
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