Major country differences in serious fungal diseases were found in the latest 5 countries to have their burden estimated – Japan (population 127M), Bangladesh (population 162M), Malaysia (population 30M) Peru (population 31M) and Congo (population 4.4M). These estimates were presented at the Advances Against Aspergillosis meeting in Manchester (March 3-5) and European Congress on Clinical Microbiology and Infectious Diseases in Amsterdam (April 9-12).
Japan had a remarkably high number of oesophageal candidiasis cases, 280/100,000 per year, primarily in non-HIV patients, many with no underlying disease. This contrasts with low rates of invasive aspergillosis as COPD is relatively uncommon, and low rates of fungal asthma (~60,000 patients). In contrast, Peru and Malaysia have predicted high numbers of fungal asthma at >80,000 and 70,000 patients respectively, with intermediate rates in Bangladesh and Congo (>200,000 and 7,000 respectively). Chronic pulmonary aspergillosis is probably quite common in Congo with >3,350 cases (81/100,000) and Bangladesh at 20,700 affected (48/100,000), but is not rare in Malaysia (25/100,000), Peru (15/100,000) or Japan (6/100,000).
Low rates of cryptococcal meningitis are likely in Bangladesh and Japan (0.01-0.02/100,000), in contrast to Congo and Malaysia with rates of 7 and 2.8/100,000. None of these countries had sufficient data to validate the rate of Candida bloodstream infections, so it was estimated as 5/100,000.
Histoplasmosis is uncommon in Peru, Malaysia and Bangladesh, but diagnosed, but there are very few cases in Japan each year and it is not known if cases are found in Congo. About 100 cases of sporotrichosis are seen in Peru every year, especially in the highlands, and some in Malaysia. Talaromyces marneffei infections are seen regularly in Malaysia, especially in HIV-infected people.
These estimates bring the number of countries with serious burden of disease estimates through the LIFE program to 62.
Posters from AAA and ECCMID