The Burden of Serious Fungal Infections in Cameroon

Abstract

Fungal infections are frequent in Cameroon, and invasive fungal infections are sometimes detected, usually in HIV-infected patients. For these reasons, we have estimated the burden of fungal infections. Using published literature and population estimates for the at-risk group, we used deterministic modelling to derive national incidence and prevalence estimates for the most serious fungal diseases. HIV infection is common and an estimated 120,000 have CD4 counts <200 × 106/mL and commonly present with opportunistic infection. Oesophageal candidiasis in HIV is common, and in poorly controlled diabetics. We estimate 6720 cases of cryptococcal meningitis, 9000 of Pneumocystis pneumonia, 1800 of disseminated histoplasmosis annually complicating AIDS, and 1200 deaths from invasive aspergillosis in AIDS, but there are no data. We found that 2.4% of adults have chronic obstructive pulmonary disease (COPD) and 2.65% have asthma, with “fungal asthma” affecting 20,000. Chronic pulmonary aspergillosis probably affects about 5000 people, predominantly after tuberculosis but also with COPD and other lung diseases. Also, tinea capitis in schoolchildren is frequent. Overall, an estimated 1,236,332 people are affected by a serious fungal infection. There is an urgent need for government and clinician attention, improved laboratory facilities, fungal diagnostic tests, and competent laboratory technicians, as well as all World Health Organization (WHO)-endorsed essential antifungal drugs to be made available, as only fluconazole is registered and available in the country.

Current burden of serious fungal infections in Republic of Congo

“…We have also added the following terms, “Africa” or “sub‐Saharan Africa” to expand research. When data were lacking, we used epidemiological data reported from nearby countries from the Central Africa region, notably Cameroon, and even from other African countries that have already estimated the burden of serious fungal infections in their respective country 8,9 …”

“…Access to data on the medical burden of diseases is critical for public health actions. Therefore, in the recent years, many countries have estimated the burden of fungal diseases 8,9 …”

Global Epidemiology of Mucormycosis

“…After the inclusion of Indian data, the estimate of mucormycosis rose to 910,000 cases globally [23,24]. The estimated burden of mucormycosis in different countries is summarised in Table 1 [25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63]. The estimated incidences per million populations in different continents were: Europe (from 0.2 cases in Denmark to 95 cases in Portugal), USA (3.0 cases), Canada (1.2 cases) and Australia (0.6 cases).…”

Strengthening the One Health Agenda: The Role of Molecular Epidemiology in Aspergillus Threat Management

“…Species in the ascomycete genus Aspergillus have emerged as key agents of the fungal infections around the world [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. For example, Aspergilli are the leading cause of chronic severe and allergic fungal infections, and the second leading cause of acute invasive fungal infections [ 1 ].…”