Global burden of recurrent vulvovaginal candidiasis: a systematic review

Abstract

Recurrent vulvovaginal candidiasis is a debilitating, long-term condition that can severely affect the quality of life of affected women. No estimates of the global prevalence or lifetime incidence of this disease have been reported. For this systematic review, we searched PubMed, Embase, and Web of Science databases for population-based studies published between 1985 and 2016 that reported on the prevalence of recurrent vulvovaginal candidiasis, defined as four or more episodes of the infection every year. We identified 489 unique articles, of which eight were included, consisting of 17 365 patients from 11 countries. We generated estimates of annual global prevalence, estimated lifetime incidence and economic loss due to recurrent vulvovaginal candidiasis, and predicted the number of women at risk to 2030. Worldwide, recurrent vulvovaginal candidiasis affects about 138 million women annually (range 103-172 million), with a global annual prevalence of 3871 per 100 000 women; 372 million women are affected by recurrent vulvovaginal candidiasis over their lifetime. The 25-34 year age group has the highest prevalence (9%). By 2030, the population of women with recurrent vulvovaginal candidiasis each year is estimated to increase to almost 158 million, resulting in 20 240 664 extra cases with current trends using base case estimates in parallel with an estimated growth in females from 3·34 billion to 4·181 billion. In high-income countries, the economic burden from lost productivity could be up to US$14·39 billion annually. The high prevalence, substantial morbidity, and economic losses of recurrent vulvovaginal candidiasis require better solutions and improved quality of care for affected women.

Estimated burden of fungal infections in Sweden

“…RVVC is related to high morbidity and affects the life‐quality of the patients dramatically. In high‐income countries, the economic burden from lost productivity could be up to US$14·39 billion annually . A recent systemic review by Denning et al shows that RVVC affects about 138 million women annually (range 103‐172 million), with a global annual prevalence of 3871 per 100 000 women worldwide.…”

“…Recurrent vulvovaginal candidiasis (RVVC) was defined as at least four episodes per year. A rate of 5%‐9% of adult women have RVVC according to a study by Denning et al . The prevalence of fungal keratitis was estimated to be 14.3% of population according to the data from Vos et al …”

Randomised clinical trial in women with Recurrent Vulvovaginal Candidiasis: Efficacy of probiotics and lactoferrin as maintenance treatment

“…It can be found in about one‐third of women without any symptoms and was identified in 70% of women during a 1‐year observation period . Recurrent vulvovaginal candidiasis (RVVC) is defined as the 4 or more episodes of symptomatic VVC within 1 year . RVVC is less common than acute form, affecting up to 9% of women of reproductive age but can greatly affect the quality of life of women, causing symptoms such as itching and soreness of the vulva, dyspareunia, dysuria and the classic “cottage cheese‐like” discharge .…”

“…Recurrent vulvovaginal candidiasis (RVVC) is defined as the 4 or more episodes of symptomatic VVC within 1 year . RVVC is less common than acute form, affecting up to 9% of women of reproductive age but can greatly affect the quality of life of women, causing symptoms such as itching and soreness of the vulva, dyspareunia, dysuria and the classic “cottage cheese‐like” discharge . It is most commonly caused by Candida albicans , but other non‐ albicans species such as C. glabrata , C. krusei , C. tropicals and C. parapsilosis , although less frequent, are more commonly associated with recurrence .…”

“…5 RVVC is less common than acute form, affecting up to 9% of women of reproductive age but can greatly affect the quality of life of women, causing symptoms such as itching and soreness of the vulva, dyspareunia, dysuria and the classic "cottage cheese-like" discharge. 5 It is most commonly caused by Candida albicans, but other non-albicans species such as C. glabrata, C. krusei, C. tropicals and C. parapsilosis, although less frequent, are more commonly associated with recurrence. 6,7 An increased rate of vaginal colonisation represents a phase of susceptibility to RVVC and causes may be genetic, biologic, or behavioural: diabetes, atopy, antibiotic or corticosteroids use, vaginal douching, orogenital sex etc.…”