Epidemiology of fungal diseases in Africa: A review of diagnostic drivers

Abstract

Background and Purpose: There has been a significant increase in the burden of fungal diseases in the last few decades which has imposed a global threat to the health of humans, animals, and plants. Epidemiology of fungal diseases is not completely understood in Africa. Most of these diseases are under-reported or not reported at all mainly due to the challenges related to the availability of and access to fungal diagnostics and the lack of human resources in clinical and diagnostic mycology across the continent. Therefore, it is imperative to highlight the epidemiology of the endemic and epidemic of emerging and re-emerging fungal diseases as well as their diagnostic challenges in Africa based on the available data. Moreover, it is important to underline the existing gaps in this regard as well.
 Materials and Methods: For the purposes of the study, Medline and Google Scholar were searched to retrieve articles on these prominent fungal diseases, as well as their etiologies and available diagnostics.
 Results: It was found that histoplasmosis and other AIDS-associated mycoses have been reported in Africa, including blastomycosis, coccidioidomycosis, and paracoccidioidomycosis. Other reported infections were fungal neglected tropical diseases, especially sporotrichosis, dermatophytosis, mycetoma, and chromoblastomycosis as well as emerging fungal diseases, such as Emergomyces africanus, Candida auris, and Blastomyces emzantsi. In Africa, the major drivers of fungal diseases include human immunodeficiency infection, tuberculosis, and poverty.
 Conclusion: Serious fungal diseases are common in Africa; however, the true burden remains unknown.

Addressing Microbial Resistance Worldwide: Challenges over Controlling Life-Threatening Fungal Infections

“…HIV-associated fungal diseases represent one of the greatest challenges in Africa. Diseases such as cryptococcosis, candidiasis, histoplasmosis, and emergomycosis are among Africa’s most affected HIV-associated diseases despite the implementation of antiretroviral therapy [ 135 ]. Recent data published by UNAIDS showed that among the 37.7 million people living with HIV worldwide, more than 25 million live in Africa [ 136 ].…”

Fungal CNS Infections in Africa: The Neuroimmunology of Cryptococcal Meningitis

“…Human fungal infections of the CNS are an underrepresented group of invasive infections within the African population, occurring as opportunistic infections particularly in individuals living with HIV. The most common CNS infections reported in Africa are CM and histoplasmosis (12,13). It was estimated in 2017 that ~160,000 people were diagnosed with CM in Africa, with 98% of these cases localised to the sub-Saharan region (1).…”

Current situation of fungal diseases in Eritrea

“…Every year, over 2 million people die of fungal disease worldwide and many have significant morbidity from dermatophytosis, vulvovaginal candidiasis, allergic diseases, subcutaneous infections and life‐threatening invasive systemic diseases 6 . Fungal infections are common in Africa, mainly driven by HIV/AIDS, tuberculosis, poverty and the increasing number of patients with non‐communicable diseases notably, cancers, asthma and diabetes mellitus 7 . Definitive diagnosis of the fungal disease requires expertise as well as laboratory systems and equipment such as microscopy, culture, histopathology, antigen and antibody assays, and Pneumocystis PCR.…”

“…6 Fungal infections are common in Africa, mainly driven by HIV/AIDS, tuberculosis, poverty and the increasing number of patients with non-communicable diseases notably, cancers, asthma and diabetes mellitus. 7 Definitive diagnosis of the fungal disease requires expertise as well as laboratory systems and equipment such as microscopy, culture, histopathology, antigen and antibody assays, and Pneumocystis PCR. There is a scarcity of data related to fungal disease in Eritrea although reports of Eritrean migrants who have fungal infections have been published in Europe.…”