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Open AccessArticle

Fungal Diseases in Taiwan—National Insurance Data and Estimation

1
Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan
2
National Aspergillosis Center, Wythenshawe Hospital, Manchester M23 9LT, UK
3
The University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PL, UK
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Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County 35053, Taiwan
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Department of Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
6
National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli County 35053, Taiwan
*
Author to whom correspondence should be addressed.
J. Fungi 2019, 5(3), 78; https://doi.org/10.3390/jof5030078
Received: 7 July 2019 / Revised: 9 August 2019 / Accepted: 16 August 2019 / Published: 21 August 2019
(This article belongs to the Special Issue Fungal Epidemiology)
The burden of fungal diseases based on the real-world national data is limited. This study aimed to estimate the Taiwan incident cases with selected fungal diseases in 2013 using the National Health Insurance Research Database (NHIRD) which covered 99.6% of the 23.4 million population. Over 80,000 incident cases were found and the majority were superficial infections including vulvovaginal candidiasis (477 per 100,000 adult women) and oral candidiasis (90 cases per 100,000 population). Common potentially life-threating fungal diseases were Pneumocystis pneumonia (5.35 cases per 100,000 population), candidemia (3.68), aspergillosis (2.43) and cryptococcal meningitis (1.04). Of the aforementioned cases cancer patients contributed 30.2%, 42.9%, 38.6% and 22.2%, respectively. Of 22,270 HIV-infected persons in NHIRD in 2013, four common diseases were Pneumocystis pneumonia (28.3 cases per 1000 HIV-infected patients), oral candidiasis (17.6), esophageal candidiasis (6.06) and cryptococcal meningitis (2.29). Of pulmonary aspergillosis 32.9% occurred in patients with chronic pulmonary diseases and 26.3% had a prior diagnosis of tuberculosis. There are some notable gaps related to insurance claim data. Cutaneous, urinary tract and eye fungal infections were not captured. View Full-Text
Keywords: fungal infections; epidemiology; nationwide estimation; Taiwan fungal infections; epidemiology; nationwide estimation; Taiwan
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Huang, Y.-S.; Denning, D.W.; Shih, S.-M.; Hsiung, C.A.; Wu, U.-I.; Sun, H.-Y.; Chen, P.-Y.; Chen, Y.-C.; Chang, S.-C. Fungal Diseases in Taiwan—National Insurance Data and Estimation. J. Fungi 2019, 5, 78.

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