Differences in the incidence of mycoses between indigenous people and general population of Colombia, 2009-2016

Abstract

Background: Vulnerable groups, including indigenous populations, are especially susceptible to certain infectious diseases and mycotic infections, especially those considered tropical, are not an exception. However, even if in clinical practice it is suspected to be a prevalent disease in this specific population, there are no studies that evaluate and compare the incidence of this group of infections in indigenous populations in Latin America and Colombia. Methods & Materials: This ecological study assessed incidence and its differences, on mycosis between general population and indigenous populations in Colombia and its departments (32) during 2009–2016. Epidemiological data was collected from the personal health record system of Colombia (RIPS), retrieving the codes for mycoses in both populations. We estimated mycoses incidence rates on both populations (cases/100,000 pop), using reference population of the indigenous population (RIPS affiliated population) and the general population (from the national statistics institute, DANE). Incidence rates ratios were calculated comparing both populations. Results: In general population, 2,911,028 cases of mycoses were reported (6,212.79 cases/100,000 pop, 95% CI 6,206.0–6,220.0) while 59,628 among indigenous population (16,486.19 cases/100,000 pop, 95%CI 16,365.0–16,607.0) occurred. Mycoses were 2.7 times higher among indigenous population than in general population (p < 0.05) (ranging from 1.66 times in 2009 to 5.41 in 2016). Higher differences were noticed for disseminated sporotrichosis (10.0 times), followed by endocarditis due to Candida (9.9 times), meningitis due to Candida (9.8 times), mucormycosis (8.3 times) and other forms of sporotrichosis (8.3 times). Conclusion: This study showed a significantly higher incidence of mycoses among indigenous people, compared to the general population in the same territories. Tropical mycoses such as sporotrichosis and mucormycosis were significantly higher among them, as expected. This has relevant implications for screening, diagnosis and management among indigenous population. Despite some limitations, this study is the first attempt in our country and in the region to provide national incidences of the disease in indigenous population of the country. Nevertheless, more studies are required to improve the understanding of mycoses among vulnerable populations, as well to provide better medical interventions and for the development of public policies in countries, such as Colombia.