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Paracoccidioidomycosis in South America should be a Neglected Fungal Tropical Disease

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The Global Action Fund for Fungal Infections (GAFFI) has made the case for paracoccidioidomycosis (PCM) to be listed as a Neglected Tropical Disease (NTD) in a short paper published in Public Library of Science (PLoS) Neglected Tropical Diseases.

PCM is endemic to the tropical regions of Latin America. PCM is an important cause of mortality in Brazil. PCM causes significant morbidity and predominately affects poor rural workers or people living in urban slums at their most economically productive stage of life and requires very long treatment regimes. Lung, skin and adrenal sequelae are frequent, reducing work productivity and quality of life of a large number of patients. Complications are too often very disabling.
 
Professor Arnaldo Colombo, co-author of the paper, of the Universidade Federal de São Paulo, Brazil and Senior Advisor to GAFFI said:

“Paracoccidioidomycosis  is neglected by translational research, and the care of patients with the disease is underdeveloped when it comes to early  diagnostics, medicine, and other control tools. Providing serology to reference medical centers and the organization of a national registry of the cases of the disease across all states in Brazil are both required as a starting point.”
 
PCM fulfils World Health Organisation (WHO) NTD criteria and would benefit from such a classification. Diagnosis with antibody detection of PCM needs to be standardised and better serum markers are required, as well as simple, rapid tests. Research is required to optimise treatment and to minimize complications—particularly through randomised controlled trials— and to address latency. Though itraconazole is the first-line recommended drug, it is not provided free of charge in most medical centers in Brazil and Latin America.
 
Professor David Denning, Chief Executive of GAFFI and Professor of Infectious Diseases and Global Health at the University of Manchester explained that:

“Although a geographically localized disease primarily affecting working age men, the consequences of infection and delayed diagnosis are often catastrophic for patients and their families. GAFFI argues that PCM is perfect fit for NTD classification and should be adopted by the World Health Organisation and the Pan-Amercian Health Organization (PAHO) to accompany mycetoma, chromoblastomycosis, sporotrichosis and fungal keratitis.”
 
Published paper linked here: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007195

Link to article published by Universidade Federal de Sao Paulo (UNIFESP):https://www.unifesp.br/noticias-anteriores/item/3851-campanha-quer-tornar-doenca-tropical-fungica-em-negligenciada