A Systematic Review And Meta-analysis Of The Prevalence, Risk Factors, Agents And Laboratory Diagnosis Of Vulvovaginal Candidiasis İn Türkiye;

Abstract

Objective: Vulvovaginal candidiasis (VVC) is the most common superficial mycosis among women, and it is estimated that 75% of women experience at least one in their lifetime, and about 40-50% have a second exposure. This study aims to determine the prevalence, risk factors, etiological factors and laboratory diagnosis of VVC in Türkiye. Methods: In the study, original scientific articles for the reporting of VVC epidemiological features published in English and Turkish languages in national and international databases (PubMed, Embase, Scopus, Google Scholar, Web of Science and Turkish Medline) between January 1995 and December 2021 were searched. Electronic databases were searched using various combinations of “vaginal yeast infection”, “vaginal candidiasis”, “vulvovaginal candidiasis Turkey”, “candidal vaginitis”, “Candida vaginitis”, “vaginal candidosis”, “Candida species”, “epidemiology” key terms. Results: The mean prevalence of VVC in adult women was found to be 57.91% in all of the 28 included studies, and 68.21% in the 2-18 age group. Considering the causative distribution, the most common Candida albicans (54.76%), Candida glabrata (24.04%), other Candida species (12.29%), Candida krusei (3.68%), Candida kefyr (3.37%), and Candida tropicalis (2.07%) positivity has been reported. In the included studies, the most common predisposing factors of the patients were pregnancy (35.71%) and diabetes (35.71%). When the articles were examined according to the year they were published and the provinces, it was seen that the prevalence of Candida did not differ significantly (p>0.05). In the studies, VITEK®2 (bioMérieux, Marcy l’Etoile, France) automatic identification system (15), Germ tube (7) and CHROMagar (7) diagnostic methods were used to identify strains. As a result of the meta analysis, it was determined that there was a high level of heterogeneity among studies (I2=95.28). Conclusion: As a result of our meta-analysis study, the prevalence of VVC was found to be high in women and children in Turkey. In addition, it was determined that non-albicans species increased in the etiology of VVK. It has been observed that the incidence of C. glabrata species in the etiology of VVC has increased since 1999. Considering that VVK infection increases the susceptibility to other sexually transmitted diseases, as well as the risk of preterm birth and congenital cutaneous candidiasis in pregnant women, it is essential to raise awareness of patients on issues such as treatment follow-up and protection from the disease. © (2024), (Refik Saydam National Public Health Agency (RSNPHA)). All Rights Reserved.