Special Issue "Fungal Burden in Different Countries"

A special issue of Journal of Fungi (ISSN 2309-608X).

Deadline for manuscript submissions: closed (29 January 2018)

Special Issue Editors

Guest Editor
Prof. Donald C. Cole

Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
Website | E-Mail
Interests: health research capacity development; global health; occupational and environmental epidemiology
Guest Editor
Prof. Malcolm D. Richardson

Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust, and Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
Website | E-Mail
Interests: pathogenesis of candidosis; pathogenesis of aspergillosis; antifungal agents; fungal diagnostics

Special Issue Information

Dear Colleagues,

Estimating the burden from serious fungal diseases, nationally, is an important step in moving towards their greater recognition among our clinical, medical imaging, laboratory and public health colleagues. For this Special Issue of an international, peer-reviewed scientific, open access journal devoted to all aspects of fungal research, we are seeking your contribution estimating the burden of fungal diseases in your country, building on information on incidence and prevalence as available.

As you describe your methods and discuss results for the different conditions, the paper by Bongomin et al., Global and Multi-National Prevalence of Fungal Diseases—Estimate Precision. J Fungi 2017, 3(4), 57; doi:10.3390/jof3040057, https://www.mdpi.com/2309-608X/3/4/57 should be helpful. However, we recognize the paucity of national epidemiological studies supported by appropriate diagnostics in many countries.

As you consider the implications of your work for national health policies and programs and clinical practice in your discussion, you may find another paper helpful: Cole et al. Improvement of fungal disease identification and management: combined health systems and public health approaches. Lancet Infectious Dis. 2017 Jul 31, DOI: http://dx.doi.org/10.1016/S1473-3099(17)30308-0.

We are looking forward to working with you to include your nation’s paper in this Special Issue. 

Sincerely,

Prof. Donald C. Cole
Prof. Malcolm D. Richardson
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Fungi is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 350 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mycoses
  • burden of illness
  • epidemiology
  • health systems

Published Papers (13 papers)

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Editorial

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Open AccessEditorial
Special Issue “Fungal Burden in Different Countries”
J. Fungi 2018, 4(3), 80; https://doi.org/10.3390/jof4030080
Received: 29 June 2018 / Revised: 2 July 2018 / Accepted: 2 July 2018 / Published: 3 July 2018
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Abstract
Adults and children living in many countries face a combined burden of infectious diseases
including fungal infections (for example, tinea capitis, recurrent vulvo-vaginal thrush, chronic
pulmonary aspergillosis, candidemia) [...] Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)

Research

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Open AccessArticle
Estimated Burden of Serious Fungal Infections in Mozambique
J. Fungi 2018, 4(3), 75; https://doi.org/10.3390/jof4030075
Received: 6 June 2018 / Revised: 22 June 2018 / Accepted: 22 June 2018 / Published: 23 June 2018
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Abstract
Mozambique is a sub-Saharan African country with limited information on the burden of fungal disease. We estimated the burden of serious fungal infections for the general healthy population and for those at risk, including those infected with HIV, patients with asthma, as well [...] Read more.
Mozambique is a sub-Saharan African country with limited information on the burden of fungal disease. We estimated the burden of serious fungal infections for the general healthy population and for those at risk, including those infected with HIV, patients with asthma, as well as those under intensive care. We consulted the Mozambican National Institute of Statistics Population and Housing Census report to obtain denominators for different age groups. We use modelling and HIV data to estimate the burdens of Pneumocystis jirovecii pneumonia (PCP), cryptococcal meningitis (CM) and candidiasis. Asthma, chronic obstructive pulmonary disease and tuberculosis data were used to estimate the burden of allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). In 2016, the Mozambique population was 26.4 million with 1.8 million people reported to be HIV-infected. Estimated annual incidence of fungal infections was: 33,380 PCP, 18,640 CM and 260,025 oral and oesophageal candidiasis cases. Following pulmonary tuberculosis, estimated numbers of people having chronic pulmonary aspergillosis (prevalence) and allergic bronchopulmonary aspergillosis complicating asthma are 18,475 and 15,626, respectively. Tinea capitis is common in children with over 1.1 million probably affected. We also highlight from studies in progress of high incidences of histoplasmosis, CM and Pneumocystis jirovecii in adult HIV-infected patients. Prospective epidemiology studies with sensitive diagnostics are required to validate these estimates. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
Estimated Burden of Serious Fungal Infections in Malawi
J. Fungi 2018, 4(2), 61; https://doi.org/10.3390/jof4020061
Received: 18 April 2018 / Revised: 16 May 2018 / Accepted: 17 May 2018 / Published: 21 May 2018
Cited by 4 | PDF Full-text (560 KB) | HTML Full-text | XML Full-text
Abstract
Despite efforts to address the burden of fungal infections in Malawi, the prevalence and incidence remain largely unknown. We assessed the annual burden in the general population and among populations at high risk and fungal infection frequencies in each particular population to estimate [...] Read more.
Despite efforts to address the burden of fungal infections in Malawi, the prevalence and incidence remain largely unknown. We assessed the annual burden in the general population and among populations at high risk and fungal infection frequencies in each particular population to estimate the national incidence or prevalence. The Malawi population is approximately 17.7 million (2017), with 48% under 15 years of age. Approximately 8% of the population is HIV positive. The most common infections are present in HIV/AIDS patients, with oral candidiasis being the commonest. Life threatening infections among those with AIDS patients include cryptococcal meningitis (8200 cases) and Pneumocystis pneumonia (3690 cases). Pulmonary TB is common, but extra pulmonary TB is rare; an estimated 2329 people have chronic pulmonary aspergillosis after TB. Asthma is a significant problem in Malawi, with an estimated 680,000 adults affected (4.67%) and 14,010 cases of allergic bronchopulmonary aspergillosis (ABPA). Tinea capitis is estimated to be present in over 670,000 young people (21% of school age children). The annual incidence of fungal keratitis is difficult to estimate, but as cases are frequently seen in the eye department, is likely to be a minimum of 1825 (10.3/100,000) cases. Among the most serious infections, cryptococcal meningitis and Pneumocystis pneumonia are top of the list. Overall, some 1,338,523 (7.54%) people are affected by a serious fungal infection in Malawi. These basic estimates are limited, due to poor record keeping, and require epidemiological studies to validate or modify the substantial burden estimates. National surveillance of fungal infections is urgently needed. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
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Open AccessArticle
Burden of Serious Fungal Infections in Argentina
J. Fungi 2018, 4(2), 51; https://doi.org/10.3390/jof4020051
Received: 14 February 2018 / Revised: 9 April 2018 / Accepted: 13 April 2018 / Published: 24 April 2018
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Abstract
The number of fungal infections at any given time in Argentina is not known. Here we estimate the burden of serious fungal infections in Argentina for the first time. Specific population statistics were searched from multiple sources, local literature was identified, and estimates [...] Read more.
The number of fungal infections at any given time in Argentina is not known. Here we estimate the burden of serious fungal infections in Argentina for the first time. Specific population statistics were searched from multiple sources, local literature was identified, and estimates made. Some additional data were sourced from the Ministry of Health, the Global Initiative for Asthma (GINA) program, and national haematology and transplant societies. Argentina has a population of 43.8 million, with 25% of this total being children under 15 years. The predicted candidemia annual incidence is 2193 cases, with 50% occurring in the ICU. At a 6% prevalence rate, an estimated 593,695 women suffer from recurrent vulvovaginal candidiasis. Invasive aspergillosis is relatively common because of high smoking and chronic obstructive pulmonary disease (COPD) rates, with 268 cases in immunocompromised patients and another 1938 in the 168,000 COPD patients admitted to hospital. Asthma is also common, affecting 14% of adults, and so allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS) are major problems. An estimated 432 cases of cryptococcal meningitis (CM)—90% of them in AIDS patients—and 1177 cases of Pneumocystis pneumonia (PCP) occur each year. The estimated annual case number of disseminated histoplasmosis is 404 in AIDS patients, almost as frequent as CM. Paracoccidioidomycosis annual incidence is estimated at 219, and coccidioidomycosis at 16 cases. At least 881,023 people (>2.01%) in Argentina are affected by a serious fungal disease annually, with considerable morbidity and mortality. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
The Burden of Serious Fungal Infections in Cameroon
J. Fungi 2018, 4(2), 44; https://doi.org/10.3390/jof4020044
Received: 22 February 2018 / Revised: 25 March 2018 / Accepted: 27 March 2018 / Published: 30 March 2018
Cited by 5 | PDF Full-text (264 KB) | HTML Full-text | XML Full-text
Abstract
Fungal infections are frequent in Cameroon, and invasive fungal infections are sometimes detected, usually in HIV-infected patients. For these reasons, we have estimated the burden of fungal infections. Using published literature and population estimates for the at-risk group, we used deterministic modelling to [...] Read more.
Fungal infections are frequent in Cameroon, and invasive fungal infections are sometimes detected, usually in HIV-infected patients. For these reasons, we have estimated the burden of fungal infections. Using published literature and population estimates for the at-risk group, we used deterministic modelling to derive national incidence and prevalence estimates for the most serious fungal diseases. HIV infection is common and an estimated 120,000 have CD4 counts <200 × 106/mL and commonly present with opportunistic infection. Oesophageal candidiasis in HIV is common, and in poorly controlled diabetics. We estimate 6720 cases of cryptococcal meningitis, 9000 of Pneumocystis pneumonia, 1800 of disseminated histoplasmosis annually complicating AIDS, and 1200 deaths from invasive aspergillosis in AIDS, but there are no data. We found that 2.4% of adults have chronic obstructive pulmonary disease (COPD) and 2.65% have asthma, with “fungal asthma” affecting 20,000. Chronic pulmonary aspergillosis probably affects about 5000 people, predominantly after tuberculosis but also with COPD and other lung diseases. Also, tinea capitis in schoolchildren is frequent. Overall, an estimated 1,236,332 people are affected by a serious fungal infection. There is an urgent need for government and clinician attention, improved laboratory facilities, fungal diagnostic tests, and competent laboratory technicians, as well as all World Health Organization (WHO)-endorsed essential antifungal drugs to be made available, as only fluconazole is registered and available in the country. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
Burden of Fungal Infections in Colombia
J. Fungi 2018, 4(2), 41; https://doi.org/10.3390/jof4020041
Received: 30 January 2018 / Revised: 14 March 2018 / Accepted: 19 March 2018 / Published: 21 March 2018
Cited by 4 | PDF Full-text (789 KB) | HTML Full-text | XML Full-text
Abstract
Data with respect to the epidemiological situation of fungal diseases in Colombia is scarce. Thus, the aim of this study is to estimate the burden of fungal infections. A population projection for 2017 from the Colombian Department for National Statistics was used, as [...] Read more.
Data with respect to the epidemiological situation of fungal diseases in Colombia is scarce. Thus, the aim of this study is to estimate the burden of fungal infections. A population projection for 2017 from the Colombian Department for National Statistics was used, as well as official information from the Ministry of Health and National Institute of Health. A bibliographical search for Colombian data on mycotic diseases and population at risk (chronic obstructive pulmonary disease, HIV infection/AIDS, cancer, and transplant patients) was done. The Colombian population for 2017 was estimated at 49,291,609 inhabitants, and the estimated number of fungal infections for Colombia in 2017 was between 753,523 and 757,928, with nearly 600,000 cases of candidiasis, 130,000 cases of aspergillosis, and 16,000 cases of opportunistic infection in HIV, affecting around 1.5% of the population. In conclusion, fungal infections represent an important burden of disease for the Colombian population. Different clinical, epidemiological, and developmental scenarios can be observed in which fungal infections occur in Colombia. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
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Open AccessArticle
Estimation of the Burden of Serious Human Fungal Infections in Malaysia
J. Fungi 2018, 4(1), 38; https://doi.org/10.3390/jof4010038
Received: 11 December 2017 / Revised: 7 February 2018 / Accepted: 14 February 2018 / Published: 19 March 2018
Cited by 2 | PDF Full-text (265 KB) | HTML Full-text | XML Full-text
Abstract
Fungal infections (mycoses) are likely to occur more frequently as ever-increasingly sophisticated healthcare systems create greater risk factors. There is a paucity of systematic data on the incidence and prevalence of human fungal infections in Malaysia. We conducted a comprehensive study to estimate [...] Read more.
Fungal infections (mycoses) are likely to occur more frequently as ever-increasingly sophisticated healthcare systems create greater risk factors. There is a paucity of systematic data on the incidence and prevalence of human fungal infections in Malaysia. We conducted a comprehensive study to estimate the burden of serious fungal infections in Malaysia. Our study showed that recurrent vaginal candidiasis (>4 episodes/year) was the most common of all cases with a diagnosis of candidiasis (n = 501,138). Oesophageal candidiasis (n = 5850) was most predominant among individuals with HIV infection. Candidemia incidence (n = 1533) was estimated in hospitalized individuals, some receiving treatment for cancer (n = 1073), and was detected also in individuals admitted to intensive care units (ICU) (n = 460). In adults with asthma, allergic bronchopulmonary aspergillosis (ABPA) was the second most common respiratory mycoses noticed (n = 30,062) along with severe asthma with fungal sensitization (n = 39,628). Invasive aspergillosis was estimated in 184 cases undergoing anti-cancer treatment and 834 ICU cases. Cryptococcal meningitis was diagnosed in 700 subjects with HIV/AIDS and Pneumocystis jirovecii pneumonitis (PCP) in 1286 subjects with underlying HIV disease. The present study indicates that at least 590,214 of the Malaysian population (1.93%) is affected by a serious fungal infection annually. This problem is serious enough to warrant the further epidemiological studies to estimate the burden of human fungal infections in Malaysia. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
Estimating the Burden of Serious Fungal Infections in Uruguay
J. Fungi 2018, 4(1), 37; https://doi.org/10.3390/jof4010037
Received: 2 February 2018 / Revised: 15 March 2018 / Accepted: 16 March 2018 / Published: 18 March 2018
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Abstract
We aimed to estimate for the first time the burden of fungal infections in Uruguay. Data on population characteristics and underlying conditions were extracted from the National Statistics Institute, the World Bank, national registries, and published articles. When no data existed, risk populations [...] Read more.
We aimed to estimate for the first time the burden of fungal infections in Uruguay. Data on population characteristics and underlying conditions were extracted from the National Statistics Institute, the World Bank, national registries, and published articles. When no data existed, risk populations were used to estimate frequencies extrapolating from the literature. Population structure (inhabitants): total 3,444,006; 73% adults; 35% women younger than 50 years. Size of populations at risk (total cases per year): HIV infected 12,000; acute myeloid leukemia 126; hematopoietic stem cell transplantation 30; solid organ transplants 134; COPD 272,006; asthma in adults 223,431; cystic fibrosis in adults 48; tuberculosis 613; lung cancer 1400. Annual incidence estimations per 100,000: invasive aspergillosis, 22.4; candidemia, 16.4; Candida peritonitis, 3.7; Pneumocystis jirovecii pneumonia, 1.62; cryptococcosis, 0.75; severe asthma with fungal sensitization, 217; allergic bronchopulmonary aspergillosis, 165; recurrent Candida vaginitis, 6323; oral candidiasis, 74.5; and esophageal candidiasis, 25.7. Although some under and overestimations could have been made, we expect that at least 127,525 people suffer from serious fungal infections each year. Sporothrichosis, histoplasmosis, paracoccidioidomycosis, and dermatophytosis are known to be frequent but no data are available to make accurate estimations. Given the magnitude of the burden of fungal infections in Uruguay, efforts should be made to improve surveillance, strengthen laboratory diagnosis, and warrant access to first line antifungals. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
Burden of Severe Fungal Infections in Burkina Faso
J. Fungi 2018, 4(1), 35; https://doi.org/10.3390/jof4010035
Received: 24 January 2018 / Revised: 6 March 2018 / Accepted: 9 March 2018 / Published: 11 March 2018
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Abstract
Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this [...] Read more.
Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the national demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
An Estimate of Severe and Chronic Fungal Diseases in the Republic of Kazakhstan
J. Fungi 2018, 4(1), 34; https://doi.org/10.3390/jof4010034
Received: 13 February 2018 / Revised: 2 March 2018 / Accepted: 3 March 2018 / Published: 8 March 2018
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Abstract
Our work aimed to generate a preliminary estimation of severe and chronic fungal diseases in the Republic of Kazakhstan with a model proposed by LIFE (Leading International Fungal Education). Calculations were carried out on data from 2015. Published results of studies of mycoses [...] Read more.
Our work aimed to generate a preliminary estimation of severe and chronic fungal diseases in the Republic of Kazakhstan with a model proposed by LIFE (Leading International Fungal Education). Calculations were carried out on data from 2015. Published results of studies of mycoses in Kazakhstan were identified; in the absence of national data from the scientific literature, the frequency of life-threatening and serious mycoses in defined groups of patients at risk from other countries were taken into account. We also used analogous estimations of mycoses in the Russian Federation. We estimate that 300,824 patients (1.7% of the population) were affected by severe and chronic mycotic diseases. There were an estimated 15,172 cases of acute mycoses, notably tinea capitis in children (11,847), Pneumocystis pneumonia and invasive candidiasis, and 285,652 of chronic fungal diseases. The most frequent were chronic recurrent vulvovaginal candidiasis (273,258 cases) and chronic pulmonary aspergillosis (6231). There is uncertainty about the prevalence of asthma in adults; the official number is 12,478 patients, but a prevalence estimate of 1.47% from a WHO consortium yields a prevalence of ~170,000 affected. We have used the official figures to generate the prevalence of fungal asthma, but it is likely to be a significant underestimate. Conclusion: Results of investigation indicate significant prevalence of severe and chronic mycoses in the Republic of Kazakhstan. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
The Burden of Fungal Diseases in Romania
J. Fungi 2018, 4(1), 31; https://doi.org/10.3390/jof4010031
Received: 29 January 2018 / Revised: 20 February 2018 / Accepted: 28 February 2018 / Published: 1 March 2018
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Abstract
Objective: To estimate for the first time the burden of fungal infections in Romania. Methods: Data derived from the World Health Organization (WHO), National Institute of Statistics, Romanian public health agencies and non-profit health organizations, and published annual reports on local epidemiology were [...] Read more.
Objective: To estimate for the first time the burden of fungal infections in Romania. Methods: Data derived from the World Health Organization (WHO), National Institute of Statistics, Romanian public health agencies and non-profit health organizations, and published annual reports on local epidemiology were used in the present study. When no data were available, specific at-risk populations were used to calculate frequencies of serious fungal diseases, using previously published epidemiological parameters. All data refer to the year 2016. Results: The estimated number of serious fungal infections in Romanian population was 436,230 in 2016. Recurrent vulvovaginal candidiasis accounted for up to 80% of total cases (more than 350,000 women annually). Concerning HIV-related infections, among 14,349 infected persons, Pneumocystis pneumonia occurred in about 10% of late presenters (30 cases in 2016), while cryptococcal meningitis was rarely diagnosed (less than 20 cases). Annually, the total number of oesophageal candidiasis and oral thrush cases in HIV-positive patients may have been as high as 1229 and 3066, respectively. In immunocompromised and cancer patient populations, the annual incidence of candidaemia was 295, and at least 458 invasive aspergillosis cases and 4 mucormycosis cases occurred yearly. With 4966 critical care beds and approximately 200,000 abdominal surgeries performed, the estimated annual incidence of candidaemia and Candida peritonitis was 689 and 344, respectively. The annual incidence of pulmonary tuberculosis is still high in Romania (12,747 cases). Thus, the prevalence of post-TB chronic pulmonary aspergillosis is estimated to be 8.98/100,000 (1768 cases). The prevalence of chronic obstructive pulmonary disease (COPD) and asthma in adults is 6% and 6.5%, respectively. Therefore, allergic bronchopulmonary aspergillosis prevalence is estimated at 29,387 and severe asthma with fungal sensitisation at 38,731 cases annually. Conclusions: Not being on the list of reportable diseases, the number of patients presenting with severe mycoses in Romania can only be roughly estimated. Based on local reports and prevalence estimation, we consider that at least 2.23% of Romanians suffer from a serious form of fungal disease. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
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Open AccessArticle
An Estimate of the Burden of Fungal Disease in Norway
J. Fungi 2018, 4(1), 29; https://doi.org/10.3390/jof4010029
Received: 22 January 2018 / Revised: 18 February 2018 / Accepted: 19 February 2018 / Published: 21 February 2018
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Abstract
The aim of this study was to examine the burden of fungal disease in Norway, contributing to a worldwide effort to improve awareness of the needs for better diagnosis and treatment of such infections. We used national registers and actual data from the [...] Read more.
The aim of this study was to examine the burden of fungal disease in Norway, contributing to a worldwide effort to improve awareness of the needs for better diagnosis and treatment of such infections. We used national registers and actual data from the Departments of Microbiology from 2015 and estimated the incidence and/or prevalence of superficial, allergic and invasive fungal disease using published reports on specific populations at risk. One in 6 Norwegians suffered from fungal disease: Superficial skin infections (14.3%: 745,600) and recurrent vulvovaginal candidiasis in fertile women (6%: 43,123) were estimated to be the most frequent infections. Allergic fungal lung disease was estimated in 17,755 patients (341/100,000). Pneumocystis jirovecii was diagnosed in 262 patients (5/100,000), invasive candidiasis in 400 patients (7.7/100,000), invasive aspergillosis in 278 patients (5.3/100,000) and mucormycosis in 7 patients (0.1/100,000). Particular fungal infections from certain geographic areas were not observed. Overall, 1.79% of the population was estimated to be affected by serious fungal infections in Norway in 2015. Even though estimates for invasive infections are small, the gravity of such infections combined with expected demographic changes in the future emphasizes the need for better epidemiological data. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
Open AccessArticle
Burden of Serious Fungal Infections in Jordan
J. Fungi 2018, 4(1), 15; https://doi.org/10.3390/jof4010015
Received: 30 November 2017 / Revised: 4 January 2018 / Accepted: 16 January 2018 / Published: 18 January 2018
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Abstract
Objective: To estimate the burden of fungal infections in Jordan for the first time. Material and Methods: Population data was from UN 2011 statistics and TB cases from WHO in 2012. Fewer than 100 patients with HIV were recorded in Jordan in 2013. [...] Read more.
Objective: To estimate the burden of fungal infections in Jordan for the first time. Material and Methods: Population data was from UN 2011 statistics and TB cases from WHO in 2012. Fewer than 100 patients with HIV were recorded in Jordan in 2013. Approximately 100 renal transplants and eight liver transplants are performed annually. There were 12,233 major surgical procedures in Jordan in 2013, of which 5.3% were major abdominal surgeries; candidemia was estimated in 5% of the population based on other countries, with 33% occurring in the ICU. Candida peritonitis/intra-abdominal candidiasis was estimated to affect 50% of the number of ICU candidemia cases. No adult asthma rates have been recorded for Jordan, so the rate from the Holy Land (8.54% clinical asthma) from To et al. has been used. There are an estimated 49,607 chronic obstructive pulmonary disease (COPD) patients in Jordan, with 64% symptomatic, 25% Gold stage 3% or 4%, and 7% (3472) are assumed to be admitted to hospital each year. No cystic fibrosis cases have been recorded. Literature searches on fungal infections revealed few data and no prevalence data on fungal keratitis or tinea capitis, even though tinea capitis comprised 34% of patients with dermatophytoses in Jordan. Results: Jordan has 6.3 million inhabitants (65% adults, 6% are >60 years old). The current burden of serious fungal infections in Jordan was estimated to affect ~119,000 patients (1.9%), not including any cutaneous fungal infections. Candidemia was estimated at 316 cases and invasive aspergillosis in leukemia, transplant, and COPD patients at 84 cases. Chronic pulmonary aspergillosis prevalence was estimated to affect 36 post-TB patients, and 175 in total. Allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS) prevalence in adults with asthma were estimated at 8900 and 11,748 patients. Recurrent vulvovaginal candidiasis was estimated to affect 97,804 patients, using a 6% rate among women 15–50 years of age. Conclusion: Based on local data and literature estimates of the frequency of mycoses in susceptible populations, at least 1.9% of Jordanians have some form of serious fungal disease. Full article
(This article belongs to the Special Issue Fungal Burden in Different Countries)
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