Burden of serious fungal infections in Honduras

Abstract

Background The burden of serious fungal infections in Honduras is unknown. The diagnosis of fungal diseases relies on almost exclusively on microscopy and culture limiting an accurate estimate of the burden of disease. Objectives The primary objective of the study was to estimate the burden of serious fungal infections in Honduras using previously described methods. Methods National and international demographic data on population, HIV, tuberculosis, asthma, COPD and cancer were obtained. A thorough literature search was done for all epidemiological studies and case series of serious fungal diseases. Using these risk populations and whatever incidence and prevalence could be found that was most pertinent to Honduras, a burden estimate was derived. Results The estimated number of serious fungal infection was estimated to be between 178,772 and 179,624 with nearly 2300 cases of these representing opportunistic infections in people living with HIV. The incidence of histoplasmosis and cryptococcosis in people living with HIV is high and estimated to be 4.3 and 4.6 cases per 100,000 population respectively. Approximately 12,247–13,099 cases of aspergillosis and 164,227 of other serious fungal infections were estimated to occur each year. Conclusion An accurate estimate of the burden of serious fungal infections in Honduras is unknown but based on our results, likely significant. Serious fungal infections represent an important public health problem in Honduras affecting approximately 1.8% of the population. There is a clear need for better access to diagnostic tools and antifungals to conduct research to better understand the impact of fungal diseases in Honduras.

The Current and Future States of Diagnostic Tests for Histoplasmosis with a Focus on People with HIV and Disseminated Histoplasmosis

“…For the purposes of this review, we are particularly interested in how HIV infection might affect diagnostic test accuracy, keeping in mind that the degree of immune suppression (and so diagnostic test performance) may vary amongst people with HIV (PWH). HIV status is particularly important given the high incidence of histoplasmosis in PWH in many countries [ 3 , 34 ].…”