Abstract

Fungal diseases kill more than 1.5 million and affect over a billion people. However, they are still a neglected topic by public health authorities even though most deaths from fungal diseases are avoidable. Serious fungal infections occur as a consequence of other health problems including asthma, AIDS, cancer, organ transplantation and corticosteroid therapies. Early accurate diagnosis allows prompt antifungal therapy; however this is often delayed or unavailable leading to death, serious chronic illness or blindness. Recent global estimates have found 3,000,000 cases of chronic pulmonary aspergillosis, ~223,100 cases of cryptococcal meningitis complicating HIV/AIDS, ~700,000 cases of invasive candidiasis, ~500,000 cases of Pneumocystis jirovecii pneumonia, ~250,000 cases of invasive aspergillosis, ~100,000 cases of disseminated histoplasmosis, over 10,000,000 cases of fungal asthma and ~1,000,000 cases of fungal keratitis occur annually. Since 2013, the Leading International Fungal Education (LIFE) portal has facilitated the estimation of the burden of serious fungal infections country by country for over 5.7 billion people (>80% of the world’s population). These studies have shown differences in the global burden between countries, within regions of the same country and between at risk populations. Here we interrogate the accuracy of these fungal infection burden estimates in the 43 published papers within the LIFE initiative.

Highlights

  • A billion people are estimated to have skin, nail and hair fungal infections, many 10’s of millions mucosal candidiasis and more than 150 million people have serious fungal diseases, which have a major impact on their lives or are fatal

  • Most of the studies have estimated the burden of Candida peritonitis as 50% of the total cases of invasive candidiasis occurred in the intensive care unit (ICU) unit

  • Pneumocystis jirovecii pneumonia is emerging as a leading cause of infection in HIV/AIDS

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Summary

Introduction

A billion people are estimated to have skin, nail and hair fungal infections, many 10’s of millions mucosal candidiasis and more than 150 million people have serious fungal diseases, which have a major impact on their lives or are fatal. Recent global estimates found 3,000,000 cases of chronic pulmonary aspergillosis, ~223,100 cases of cryptococcal meningitis complicating HIV/AIDs, ~700,000 cases of invasive candidiasis, ~500,000 cases of Pneumocystis jirovecii pneumonia, ~250,000 cases of invasive aspergillosis, ~100,000 cases of disseminated histoplasmosis, over 10,000,000 cases of fungal asthma and ~1,000,000 cases of fungal keratitis occur annually (Table 1) [1,7,8,9]. GAFFI has put together a list of priority fungal diseases that are of public health importance, clinical experience of excellent care in many settings and co-morbidities reducing the potential and amenable to improved diagnosis and better treatment outcomes These include cryptococcal for survival and cure [20]. >2000 million people (29% of the world population), with examples

Candidaemia
Discussion
Invasive Aspergillosis
Over 700 Cases of Pneumocystis jirovecii Pneumonia Per Year in Guatemala
Fungal Keratitis
Recurrent Vulvovaginal Candidiasis
Tinea Capitis
Findings
Conclusions
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