Oral candidiasis among African human immunodeficiency virus-infected individuals: 10 years of systematic review and meta-analysis from sub-Saharan Africa.

Oral candidiasis (OC) is the most common opportunistic fungal infection among immunocompromised individuals. This systematic review and meta-analysis reports on the contribution of non- species in causing OC among human immunodeficiency virus (HIV)-infected individuals in sub-Saharan Africa between 2005 and 2015. Thirteen original research articles on oral infection/colonization among HIV-infected African populations were reviewed. The prevalence of OC ranged from 7.6% to 75.3%. Pseudomembranous candidiasis was found to range from 12.1% to 66.7%. The prevalence of non- species causing OC was 33.5% [95% confidence interval (CI) 30.9-36.39%]. Of 458 non- species detected, . (23.8%; 109/458) was the most common, followed by . (22%; 101/458) and . (10.7%; 49/458). The overall fluconazole resistance was 39.3% (95% CI 34.4-44.1%). was significantly more resistant than non-albicans species to fluconazole (44.7% vs 21.9%;  < 0.001). One-quarter of the cases of OC among HIV-infected individuals in sub-Saharan Africa were due to non- species. isolates were more resistant than the non- species to fluconazole and voriconazole. Strengthening the capacity for fungal diagnosis and antifungal susceptibility testing in sub-Saharan Africa is mandatory in order to track the azole resistance trend.