Dangerous gaps in Diagnostics and Treatment
David Meya, Senior Lecturer, Department of Medicine, College of Health Sciences, Makerere University, Kampala. email: mailto
Felix Bongomin, Internal Medicine Resident, Department of Medicine, College of Health Sciences, Makerere University, Kampala. email: mailto
View the Fungal burden of disease in Uganda: Published: Parkes-Ratanshi et al 2015
How you have helped GAFFI so far? David Meya: Over the last eight years, I have worked with colleagues in Uganda to highlight the importance of fungal infections. We have focused on fungal meningitis caused by Cryptococcus and published data that has influenced WHO guidelines on Cryptococcal antigen screening and improving management of cryptococcal meningitis. Together with GAFFI, we have published the estimate of specific fungal infections in Uganda, which data will be shared with colleagues from CDC and the Ministry of Health. Felix Bongomin: With colleagues in GAFFI, we have recently updated the global estimates of the burden of fungal diseases and this has informed several stakeholders, including the WHO, that fungal diseases are a public health threat. View paper in Journal of Fungi 2017 In April 2018, I co-organised GAFFI’s 3rd Global Fungal Infection Forum on essential diagnostics for serious fungal infections and Advanced HIV Disease. Several of these diagnostic tests were included on the WHO’s first edition of the Model List of Essential In Vitro Diagnostics (EDL). View press release
Personal comment on the major needs in Colombia which GAFFI should be addressing: David Meya: - Uganda still has gaps in the areas of fungal disease diagnostics, clinical management and prevention. We would like to set up a regional center of excellence for mycology training with state-of-the-art diagnostics. - We would like to increase awareness on fungal infections in the region by developing short training courses that could be availed to health care personnel. We would also like to increase research capacity in mycology, especially among graduate students as a way to increase awareness of the problem and identify implementable solutions. - Understanding the burden of fungal disease and what can be done about it will require national documentation, an area where we are still struggling. Felix Bongomin: - Creating awareness among health-workers of the very wide spectrum of fungal diseases, to improve diagnosis, to appreciate the importance of screening in select populations and on the timely initiation of an appropriate treatment. - Dialogue with stakeholders, especially the Ministry of Health, on priority needs in fungal diagnostics, essential antifungal agents and national surveillance. - We would like to enhance teaching and learning of medical mycology both at undergraduate and post-graduate levels. - Developing a stand-alone post-graduate training curriculum in Medical Mycology in at least one university in Uganda. - Fostering empirical and epidemiological research in all aspects of fungal diseases to better understand the true burden of fungal disease in Uganda. - Establishment of an active medical mycology society in the country.
Links to key fungal/global health institutions in Colombia: Infectious Diseases Institute; CDC Global Health – Uganda;WHO – Uganda