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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Oral candidiasis as a marker of HIV disease progression among Zimbabwean women
Journal of Acquired Immune Deficiency Syndromes, Volume 47, No. 5, Year 2008
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Description
OBJECTIVES: To estimate oral disease prevalence among Zimbabwean women by HIV serostatus and CD4 cell count and to assess accuracy of oral disease diagnoses made by nurses as compared with an oral surgeon. METHODS: Standardized oral mucosa examinations were performed by trained nurse-examiners and by an oral surgeon among women recruited in Harare, Zimbabwe. RESULTS: A total of 461 women (320 HIV-infected, 141 uninfected) were seen by nurses and an oral surgeon within a 2-week period. Oral candidiasis (OC) was the most common lesion diagnosed in nearly one quarter of HIV-infected women, whereas hairy leukoplakia and Kaposi sarcoma were found in <3%. The prevalence of OC diagnosed by nurses or the surgeon was significantly higher among women with a CD4 count <200 cells/mm than in women with a CD4 count from 200 to 499 cells/mm or a CD4 count >499 cells/mm. The sensitivity of nurse examinations compared with examinations by the oral surgeon among HIV-infected women for the diagnosis of OC was 73%, the specificity was 95%, and the κ-statistic was 0.71. CONCLUSIONS: OC was the most common lesion in HIV-infected women and was strongly associated with a low CD4 cell count. Interexaminer agreement was good for the diagnosis of OC among HIV-infected women. This study suggests that OC may play a role, in combination with other clinical indicators as a marker of disease progression in resource-poor settings. © 2008 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Chidzonga, Midion Mapfumo
Zimbabwe, Harare
University of Zimbabwe
Mwale, Magda
Zimbabwe, Harare
University of Zimbabwe
Malvin, Kathy
United States, San Francisco
University of California, San Francisco
Martin, Jeffrey N.
United States, San Francisco
Ucsf School of Medicine
Greenspan, John S.
United States, San Francisco
University of California, San Francisco
Shiboski, Caroline H.
United States, San Francisco
University of California, San Francisco
Statistics
Citations: 17
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0b013e318160a554
ISSN:
15254135
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Zimbabwe
Participants Gender
Female