The Burden of Fungal Infections in Ethiopia
Abstract
:1. Introduction
2. Materials and Methods
Data Sources
3. Results
3.1. Country Profile
3.2. Cryptococcal Meningitis
3.3. Pneumocystis jirovecii Pneumonia
3.4. Oral Candidiasis
3.5. Oesophageal Candidiasis
3.6. Allergic Fungal Respiratory Diseases
3.7. Chronic Pulmonary Aspergillosis (CPA)
3.8. Invasive Aspergillosis (IA)
3.9. Candida Infections
3.10. Other Fungal Infections
3.11. Estimate of Fungal Infections-Associated Mortality in Ethiopia
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Demographic data | Total population = 105,000,000 of children (<15 years) = 41% Total number of adults = 60,180,000 Adult women = 31,293,600 % women over 60 = 5% % women 15–50 = 24,482,600 | Source: WHO Tuberculosis (TB) stats 2011 [21]; http://aidsinfo.unaids.org/ |
Children age 4–14 years = 21,832,000 | Source: Education for All 2015 national review report [16] | |
HIV/AIDS | Current total HIV/AIDS in 2017 = 610,000 Proportion of diagnosed cases on ARVs = 440,000 Annual new AIDS cases (at risk of OIs) = 169.5 | Source: https://www.unaids.org/en/resources/documents/2018/unaids-data-2018 |
Proportion of AIDS patients presenting with Pneumocystis jirovecii pneumonia (PCP) = 30% | Source: Aderaye, G. et al. (2008) | |
Proportion of AIDS patients presenting with cryptococcal meningitis = 12% = 44,400 | Source: Awoke D. et al. (2018) | |
AIDS-related deaths in 2017 = 15,000 | http://www.who.int/hiv/pub/progressreport2011 | |
Tuberculosis | Pulmonary tuberculosis annual incidence Total = 105,200 | Source: WHO Global Tuberculosis report 2016 [22] |
Adults with asthma | Prevalence of asthma in adults = 2.0% Asthma prevalence in adults = 1,239,000 | Source: To et al. [23] |
COPD | COPD prevalence (all GOLD stages) = 7.8% and 10% admitted to hospital annually | Source: Musafiri et al. [24] |
Patients with leukaemia | AML population = 3000 | Source: Globocan (2018) |
Lung cancer | Estimation of lung cancer = 2000 | Source: Globocan (2018) |
All cancer sites | otal cancer incidence = 67,600 | Source: Globocan (2018) |
Number of critical care patients | Estimated number of critical care beds = 1500 (5% of hospital beds in Ethiopian) Hospital beds (per 1000 people) in Ethiopia = 0.7 | Source: World Bank, country Indicator: Number of hospital beds |
Diseases | Population | Prevalence | Reference |
---|---|---|---|
Cryptococcal Infection | Cryptococcal antigen (CrAg)–positive HIV-infected persons <150 CD4 cells/µL | 6.2% | Beyene et al. [25] |
Cryptococcal antigenemia among HIV-infected patients receiving antiretroviral therapy in Ethiopia | 8.4% | Alemu et al. [26] | |
Cryptococcal disease among hospitalized HIV–infected adults in Ethiopia | 9.1% | Mamuye et al. [27] | |
Cryptococcal antigenemia ART-naïve and experienced HIV-infected persons | 10.2% | Beyene et al. [28] | |
Cryptococcal antigenemia among HIV-infected patients at a referral hospital | 11.7% | Derbie et al. [29] | |
PCP | Pulmonary infections in TB smear-negative HIV-positive patients with atypical chest X-ray in Ethiopia | 29.7% | Aderaye et al. [30] |
HIV-positive patients with suspected pulmonary tuberculosis in Ethiopia | 10.9% | Aderaye et al. [31] | |
Oral candidiasis | PLWHA ART-naive with CD4 <200 cells per µL | 90% | Fabian et al. [32] |
Oesophageal candidiasis | AIDS patients in Denmark. In total, 20% of patients with HIV not on ARVs and 5% of those on ARVs | 20% ART-naive and 5% of those on ART | Smith and Orholm [33] |
ABPA | Adult asthmatics | 2.5% | Denning et al. [34] |
CPA | Chronic pulmonary aspergillosis commonly complicates treated pulmonary tuberculosis with residual cavitation | 6.5% annually in those with tuberculosis cavity and 0.2% with no cavities, assumed to be 67% of all TB-related CPA | Page et al. [35] |
SAFS | Severe asthmatics (adults). In total, 10% of asthmatics have severe asthma | 33% | Denning et al. [34] |
rVVC | Adult women | 6% | Sobel et al. [36] Foxman et al. [37] |
Tinea capitis | School-age children | 32.3% | Hibstu et al. [38] |
Children | 29% | Figueroa et al. [39] | |
Children from grade 1 to grade 4 | 27.4% | Murgia et al. [40] | |
Primary school children in rural areas | 24.6% | Leiva-Salinas et al. [41] |
Fungal Infection | Predominant Groups at Risk | Rate Per 100,000 | Estimated Number of Cases |
---|---|---|---|
Cryptococcosis | AIDS | 9.4 | 9900 |
PCP | AIDS | 12.1 | 12,700 |
IA | Haematological Malignancy, lung cancer, 4% of AIDS deaths and 1.3% of COPD admissions to hospital | 10.9 | 11,500 |
CPA | Tuberculosis patients and other respiratory disorders | 14.5 | 15,200 |
ABPA | Adult asthma patients | 28.6 | 30,100 * |
SAFS | Adult asthma patients | 38.9 | 40,900 * |
Candidaemia | Hospitalised patients | 5.0 | 5300 |
Candida peritonitis | Post-surgical patients | 0.8 | 800 |
Oral candidiasis | HIV patients | 72.7 | 76,300 |
Oesophageal candidiasis | HIV infection | 53.2 | 55,900 |
Recurrent vaginal candidiasis | Adult women | 1399 | 1,469,100 |
Tinea capitis | 4–14-year-old children with poor hygiene | 6716.0 | 7,051,700 |
Total burden estimated | 8,738,300 |
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Tufa, T.B.; Denning, D.W. The Burden of Fungal Infections in Ethiopia. J. Fungi 2019, 5, 109. https://doi.org/10.3390/jof5040109
Tufa TB, Denning DW. The Burden of Fungal Infections in Ethiopia. Journal of Fungi. 2019; 5(4):109. https://doi.org/10.3390/jof5040109
Chicago/Turabian StyleTufa, Tafese B., and David W. Denning. 2019. "The Burden of Fungal Infections in Ethiopia" Journal of Fungi 5, no. 4: 109. https://doi.org/10.3390/jof5040109