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Martha F Mushi1, Nathaniel Ngeta2, Mariam M Mirambo1, Stephen E. Mshana1
DOI: https://dx.doi.org/10.4314/ahs.v18i2.33
Cite as: Mushi MF, Ngeta N, Mirambo MM, Mshana SE. Letter to the editor 2: Predictors of oesophageal candidiasis in persons with or without
HIV infection. Afri Health Sci. 2018;18(2): 470-471. https://dx.doi.org/10.4314/ahs.v18i2.33
In reply,
With great curiosity we have read the letter to editor by Bongomin F. and colleagues1 written as a comment to our recent published article in African Health Sciences2, we appreciate their interest to our article and inputs. The interest of the study was to investigate the risk factors for esophageal candidiasis (EC). The risk factors are clearly indicated in the original manuscript regardless of HIV status1. In addition, HIV was also analysed as one of the risk factor as previously reported elsewhere 3,4. The increase in age was found to protect the patients from developing EC as previous published5. In order not to confuse the reader, the odd ratio and 95%confidence interval for age variable in table 2 in the original article1 was reversed to |
show the decrease in age as the risk of ECand presented in the abstract and content of the original manuscript1. In addition, in this letter to editor we have included results regarding factors associated with EC in HIV negative individuals. Of 554 HIV negative patients, 20(3.6%) had EC. On multivariate logistic regression analysis, increase in age independently protected HIV negative population from getting EC (OR 0.95, 95%CI; 0.92-0.99; p=0.0035), whilebeing female (OR 11.74, 95%CI; 1.55-
88.82; p=0.017), alcohol use(OR 20.45, 95%CI; 4.8986.56; <=0.001), smoking(OR 5.44, 95%CI; 1.18-25.12; p=0.03), antibiotic use(OR 5.2, 95%CI; 1.67-16.21; p<0.005), and having peptic ulcer diseases (OR 8.24, 95%CI; 2.21-30.72; p<0.002) independently predicted EC among HIV negative patients (table 4). |
Table 4: Risk factors associated with esophageal candidiasis among HIV negative
patients attending endoscopy unit (n=554)
Variable | Univariate | Multivariate | |||
EC n
(%) |
OR(95%CI) | P value | OR(95%CI) | P | |
Age* | 3931-50 | 0.99(0.96-1.02) | 0.365 | 0.95(0.92-0.99) | 0.035 |
Sex | |||||
Male (307) | 11(3.6) | 1 | |||
Female (247) | 9(3.6) | 1.02(0.414-2.496) | 0.97 | 11.74(1.55-88.82) | 0.017 |
Alcohol | |||||
No (475) | 6(1.3) | 1 | |||
Yes (79) | 14(17.7) | 16.8(6.25-45.35) | <0.001 | 20.45(4.89-86.56) | <0.001 |
Smoking | |||||
No (515) | 13(2.5) | 1 | |||
Yes (39) | 7(18) | 8.45(3.15-22.64) | <0.001 | 5.44(1.18-25.12) | 0.03 |
Corticosteroid use | |||||
No (551) | 18(3.3) | 1 | |||
Yes (3) | 2(66.7) | 59.2(5.13-683.5) | 0.001 | – | – |
Clinical presentation | |||||
No (241) | 3(1.2) | 1 | |||
Yes (313) | 17(5.43) | 4.56(1.32-15.73) | 0.016 | 3.90(0.90-16.85) | 0.068 |
Antibiotics use | |||||
No (448) | 9(2.01) | 1 | |||
Yes (106) | 11(10.38) | 5.64(2.27-14.01) | <0.001 | 5.2(1.67-16.21) | 0.005 |
Diabetic | |||||
Negative (542) | 14(2.6) | 1 | |||
Positive (12) | 6(50.0) | 37.7(10.81-
131.62) |
<0.001 | – | – |
PUD | |||||
No (473) | 13(2.8) | 1 | |||
Yes (81) | 7(8.6) | 3.35(1.29-8.66) | 0.013 | 8.24(2.21-30.72) | 0.002 |
Asthma | |||||
No (550) | 18(3.27) | 1 | |||
Yes (4) | 2(50.0) | 29.56(3.94-
221.79) |
0.001 | – | – |
PUD is the peptic ulcer diseases; some known variable like use of corticosteroid, having diabetic and asthma were not include in multivariate analysis because the patients with EC were very few which could lead to a very wide confidence interval.
African
Health Sciences |
© 2018 Mushi et al. Licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
470 African Health Sciences Vol 18 Issue 2, June, 2018
Furthermore, we have noted that, the original published presented during proofreading, for this reason we have article did not incorporate the corrections which were presented the correct table 3 as seen below:
Table 3: Characteristics of HIV negative patients with EC
S/number | Sex | Age | Presentation | Alcohol | Smoking | Antibiotic | Diabetic | Cirrhosis | PUD | Asthma |
1 | Male | 20 | Hemoptysis | Yes | Yes | No | No | Yes | No | No |
2 | Female | 24 | Ep. pain | No | No | Yes | No | No | Yes | No |
3 | Male | 32 | Ep. Pain | Yes | Yes | Yes | No | No | No | No |
4 | Female | 30 | Ep. Pain | Yes | No | Yes | No | No | No | No |
5 | Male | 47 | Dysphagia | Yes | Yes | Yes | Yes | No | No | No |
6 | Female | 17 | Dysphagia | No | No | No | No | No | No | Yes |
7 | Male | 40 | Ep. pain | Yes | No | Yes | No | No | Yes | No |
8 | Female | 38 | Ep. pain | Yes | No | No | Yes | No | No | No |
9 | Female | 47 | Ep. pain | No | No | No | Yes | No | No | No |
10 | Male | 77 | Ep. pain | Yes | Yes | Yes | No | No | No | No |
11 | Female | 38 | Ep. pain | No | No | Yes | No | No | Yes | No |
12 | Male | 34 | UGIB | Yes | Yes | No | No | No | Yes | No |
13 | Female | 60 | Ep. pain | Yes | No | Yes | No | No | Yes | No |
14 | Male | 28 | Ep. pain | Yes | Yes | No | No | No | No | No |
15 | Male | 40 | Dysphagia | Yes | No | No | Yes | No | Yes | No |
16 | Male | 36 | Ep. pain | Yes | No | Yes | Yes | No | No | No |
17 | Male | 44 | UGIB | Yes | Yes | No | No | Yes | No | No |
18 | Female | 62 | Ep. pain | No | No | No | Yes | No | No | No |
19 | Female | 33 | Ep. pain | Yes | No | Yes | No | No | Yes | No |
20 | Male | 23 | Ep. pain | No | No | Yes | No | No | No | Yes |
Note; Ep. Pain is epigastric pain and UGIB is upper gastro intestinal bleeding
References
1. Bongomin F, Fayemiwo S: Predictors of oesophageal candidiasis in persons with or without HIV infection. Afri Health Sci 2018, 18(2). 2. Mushi MF, Ngeta N, Mirambo MM, Mshana SE: Predictors of esophageal candidiasis among patients attending endoscopy unit in a tertiary hospital, Tanzania: a retrospective cross-sectional study. African Health Sciences 2018, 18(1):66-71. 3. Crowe SM, Carlin JB, Stewart KI, Lucas CR, Hoy JF: |
Predictive value of CD4 lymphocyte numbers for the development of opportunistic infections and malignancies in HIV-infected persons. Journal of acquired immune deficiency syndromes, 1991, 4(8):770-776.
4. Martinez AC, Tobal FG, Ruiz-Irastorza G, Lopez AG, Navia FA, Sangrador CO, Arribas MM: Risk factors for esophageal candidiasis. European Journal of Clinical Microbiology and Infectious Diseases, 2000, 19(2):96-100. 5. Greenwald DA: Aging, the gastrointestinal tract, and risk of acid-related disease. The American Journal of Medicine Supplements 2004, 117(5):8-13. |
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