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Open AccessReview

The Burden of Fungal Infections in Ethiopia

by Tafese B. Tufa 1,2,* and David W. Denning 3,4
1
Asella Teaching and Referral Hospital, College of Health Sciences, Arsi University, P.O. Box 04, Asella, Ethiopia
2
Hirsch Institute of Tropical Medicine (HITM), Heinrich-Heine University, P.O. Box 04, Asella, Ethiopia
3
The National Aspergillosis Centre, Wythenshawe Hospital, Manchester M23 9LT, UK
4
The University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PL, UK
*
Author to whom correspondence should be addressed.
J. Fungi 2019, 5(4), 109; https://doi.org/10.3390/jof5040109
Received: 23 August 2019 / Revised: 25 October 2019 / Accepted: 6 November 2019 / Published: 22 November 2019
The burden of severe fungal infections (FIs) is not well addressed in Ethiopia. We have estimated the burden of FIs from multiple demographic sources and by searching articles from PubMed. Opportunistic FIs were estimated using modelling and 2017 national HIV data. The burdens of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA) were estimated by using the prevalence of asthma, chronic obstructive pulmonary disease, and annual the incidence of tuberculosis. Of the 105,000,000 estimated Ethiopian population, 610,000 are thought to have HIV infection. Our estimation of HIV-related FIs were: 9900 cryptococcal meningitis (CM), 12,700 Pneumocystis jirovecii pneumonia (PCP), 76,300 oral and 56,000 oesophageal candidiasis cases. A remarkable 7,051,700 4–14-year-olds probably have tinea capitis and 1,469,000 women probably have recurrent Candida vaginitis. There were 15,200 estimated CPA cases (prevalence) and 11,500 invasive aspergillosis (IA) cases (incidence). Data are scant, but we estimated 5300 candidaemia and 800 Candida peritonitis cases. In conclusion, approximately 8% of Ethiopians suffer from FIs annually, mostly schoolchildren with tinea capitis. IA, CM and PCP are the major causes of fungal deaths. The absence of CD4 count is challenging the identification of HIV patients at risk of opportunistic FIs. There is a pressing need to improve FI diagnosis, probably including national surveillance. View Full-Text
Keywords: invasive fungal infections; tinea capitis; epidemiology; Ethiopia invasive fungal infections; tinea capitis; epidemiology; Ethiopia
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Tufa, T.B.; Denning, D.W. The Burden of Fungal Infections in Ethiopia. J. Fungi 2019, 5, 109.

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