Gaps in basic data on disease prevalence hinders accurate burden estimates for most fungal diseases: there is a 15-fold difference between the official asthma prevalence in Kazakhstan and the likely true minimal estimate; almost no epidemiological data on fungal diseases in Jordan; no direct records of fungal keratitis from many countries; and no data on invasive candidiasis or aspergillosis from Africa.
LIFE Worldwide has made a significant step towards remedying this by publishing burden of fungal disease estimates for countries around the world in the Journal of Fungi. In a series of papers edited by Professor Donald Cole (University of Toronto) and Professor Malcolm Richardson (Director of the Mycology Reference Centre Manchester), a further 13 countries have recently been added to this list: Colombia, Uruguay, Argentina, Burkina Faso, Cameroon, Mozambique, Malawi, Jordan, Romania, Serbia, Norway, Kazakhstan and Malaysia.
The overall estimated population burden was as high as 7.5% in Malawi and Burkina Faso, 7.0% in Mozambique, 4.6% in Cameroon, down to 1.5-2.0% in most other countries. These countries include one of the wealthiest countries in the world – Norway (Annual GDP per capita $70,800) and the poorest – Mozambique ($382), Burkina Faso ($650), Cameroon ($1,033). Many of the problems affect rich and poor countries alike such as candidaemia, recurrent vulvovaginal candidiasis and fungal asthma (ABPA and SAFS); others are regionalized such as histoplasmosis and paracoccidioidomycosis in Latin America and Rhinosporidium infections in Serbia. A surprising number of cases of histoplasmosis were found in Cameroon and Mozambique, indicative of many missed diagnosis in routine care.
The AIDS epidemic continues to dominate the burden of several African countries, notably Mozambique and Cameroon. Surprising findings in both of these countries include many cases of histoplasmosis, which is barely described as an AIDS-related infection in Africa, whereas it is well recognized in Colombia and Argentina and probably Uruguay. The burden of cryptococcal meningitis and Pneumocystis pneumonia is also very high, and it is likely that invasive aspergillosis in under-diagnosed in AIDS, and generally in all countries.
Click here for a full list of disease burden estimates by country.