Site distribution of Oral Pseudomembraneous Candidiasis in HIV positive Nigerians
Objective: Oral Candidiasis which comprises Pseudomembraneous Candidiasis (PC), Erythemathous Candidiasis, Angular Cheilitis and occasionally Hyperplastic Candidiasis is the commonest oral manifestations of HIV/AIDS. The Pseudomembraneous variant otherwise known as “Thrush” has severally been documented as the commonest seen in this group. Different parts of the mouth could be affected by it. This study outlines the preferred oral site(s) for PC infestation in an adult HIV-positive Nigerian population. Methods: A cross-sectional study involving 138 HIV sero-positive adults with PC seen at a dedicated clinic in the Jos University Teaching Hospital, Nigeria. Diagnosis of PC was based on the criteria proposed by the European Economic Community (EEC) Clearinghouse on oral problems related to HIV infection (1993). The mouth was demarcated into Tongue, Palate, Buccal mucosa, Labial mucosa, Gingiva and the Floor of the mouth. In situations where the PC affected more than one site in a patient's mouth, each site was taken individually for analysis. Correlation analysis was by the use of SPSS version 11. Results: Age range of the patients was 20 – 70years with a mean of 36.21 ± 9.49. 57.2% were females. PC was found at multiple sites in 83 (60.1%) patients. The age group 31 – 40years (44.2%) was the most affected. The Palate (34.1%) was the commonest site affected followed by the Tongue (25.5%), Labial mucosa (20.6%), Buccal mucosa (10.5%), Gingiva (5.2%) and the Floor of the mouth (4.1%). There is a significant preponderance for the labial mucosa in the female patients (c2 = 3.950, p = 0.047). No association exists between the age groups of the patients and the site(s) of infection (p > 0.05). Conclusions: Pseudomembraneous Candidiasis can occur at any mucosal location in the oral cavity of the HIV sero-positive patient. The palate is the commonest site of infection in an adult HIV positive Nigerian population.