Assessing the vulnerability of Candida colonization through social determinants of health among college students in Puebla, Mexico.

BACKGROUND: Socioeconomic disparities have been observed to negatively impact student health by increasing vulnerability to infectious diseases due to opportunistic pathogens. This research aims to assess the vulnerability of Candida through Social Determinants of Health among college students in Puebla, Mexico. METHODS: A descriptive cross-sectional study was conducted on 112 patients from a university community. Candida isolates were obtained from oral samples directly deposited on two culture media. Species were phenotypically identified and confirmed using VITEK®2 YST. Socioeconomic characteristics were assessed through a survey using the main indicators of the Marginalization Index, a measurement tool for social inequality from the perspective of territorial units in Mexico. Pearson's Chi-square test and Spearman's correlation were used to evaluate the association between individual determinants and Candida colonization. Additionally, a multiple binary logistic regression model was employed to identify the most important determinants in Candida colonization. RESULTS: The prevalence of Candida spp. colonization in the population was 58.9%. Four species were identified, with C. glabrata (26.6%) being the most frequent; however, in the female population, C. albicans was the most frequent. The results did not indicate a significant association between most determinants; however, a significant difference was observed regarding carbohydrate-rich diet (p < 0.05). The most important social determinants in Candida colonization among college population were identified as age (with increasing age, the probability of colonization increases, OR = 2.3170; CI: 1.0325, 5.1997), students not using the health care system (OR = 3.1576; CI: 1.0232, 9.7445), and those frequently consuming high-sugar or junk food (OR = 3.8996; CI: 1.3559, 11.2152). CONCLUSIONS: The importance of encouraging the use of health services in college population for timely medical care and the prevention of comorbidities and habits that may be risk factors for Candida colonization and potential infection is highlighted. Additionally, measures promoting healthy eating among students are proposed.