Epidemiology of oral candidiasis: a household-based population survey in a medium-sized city in Amazonas

Ellen Roberta Lima Bessa,Luciane Dias De Oliveira,Ana Bessa Muniz,Ormezinda Celeste Cristo Fernandes,Giselle Diniz Guimarães Da Silva,Fernando José Herkrath

doi:10.33448/rsd-v10i10.18664

Ellen Roberta Lima Bessa, Luciane Dias De Oliveira + Show 4 more

Open Access

https://doi.org/10.33448/rsd-v10i10.18664

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Abstract

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.

Highlights

Candidiasis, caused by Candida yeast, a commensal fungus found in approximately 50% of the population, is a fungal infection that commonly affects individuals
Given the importance of early identification of oral candidiasis and pathogen for effective drug therapy, surveillance and monitoring are essential for the development of oral health strategies and actions at individual and population levels. In this context, knowing the importance of performing an analysis on the epidemiology of oral candidiasis in the elderly, we chose to achieve this through a household-based population survey, due to the need for these studies focusing on clinical and microbiological manifestations in municipalities in the interior of the Amazonas (AM), this 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 dental prostheses, comparing these factors in rural and urban elderly people in the municipality of Tefé -Am
The sample size calculation considered a prevalence of 50% of outcomes, accuracy of 0.05, and 10% of dropouts or refusals, which was later adjusted for the finite population, resulting in a total of 511 elderly, after losses and refusals of 27 elderly people (5 .3%), the final sample consisted of 484 elderly people, 325 of whom were residents of the urban area and 159 of the rural area, who were randomly chosen from the registration lists of their respective UBS's

Summary

Introduction

Candidiasis, caused by Candida yeast, a commensal fungus found in approximately 50% of the population, is a fungal infection that commonly affects individuals. It is usually asymptomatic, but it can cause infections depending on the host's immunological conditions. When infection is found in the oral mucosa region it is called Oral Candidiasis (Arendorg & Walker, 1980; Neville, Damm, Allen & Chi, 2015) This opportunistic fungus may cause several clinical manifestations in its pathogenic form, from mild and superficial to invasive infections, severe bloodstream infection, affect several organs, and life-threatening conditions in the most severe forms of infection (Taylor & Raja, 2021). 65% of Candida species are known to be unable to grow at a temperature of 37°C, which prevents them from being successful or becoming human commensal pathogens (Spampinato & Leonardi, 2013)

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