Burden of Invasive Candidiasis in West Africa: A Systematic Review and Meta-Analysis

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Résumé

Invasive candidiasis (IC) is an emerging opportunistic fungal infection associated with high mortality among hospitalized patients. Although the epidemiology of IC is progressively changing worldwide, the trend in Africa still needs to be es- tablished. This review aimed to evaluate the epidemiology of IC in Western re- gion of Africa. A comprehensive literature search was performed on major elec- tronic databases to identify relevant articles. DerSimonian and Laird random- effects model was used to pool overall prevalence and estimated incidence data. We identified 1975 articles, among which 23 met our inclusion criteria for the systematic review. Available data showed that only 50% (8/16) of West African countries were reported data on IC and only 25% reported at least one labor- atory confirmed IC case. The global prevalence of candidemia and non-can- didemic deep-seated candidiasis were 0.35% [95% CI 0.23; 0.47] and 0.32% [95% CI 0.00; 2.03], respectively. Among clinical IC cases, only 5.21% were reported before 2010, while 50.08% were reported in the past 5 years. The pooled esti- mated incidence was 5.55/100,000 [95% CI 5.46; 5.64] and 1.15/100,000 [95% CI 1.11; 1.19, 95% CI]/inhabitants for candidemia, and Candida peritonitis, respec- tively. The case fatality rate was 57.58%. Low gestational age, exposure to broad- spectrum antibiotics and invasive procedures were associated with a higher risk of IC in newborn patients. Candida albicans (32.98%) was the most com- mon causative species of IC followed by C. tropicalis (11.34%) and C. parapsilo- sis (6.19%). This study showed the scarcity of IC data in western region of Africa and the existence of undiagnosed IC cases.

Mots-clés

Invasive Candidiasis, Epidemiology, West Africa, Meta-Analysis