scholarly journals Determining the burden of fungal infections in Zimbabwe

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lorraine T. Pfavayi ◽  
David W. Denning ◽  
Stephen Baker ◽  
Elopy N. Sibanda ◽  
Francisca Mutapi
Keyword(s):  
Tinea Capitis ◽  
Fungal Infections ◽  
Fungal Diseases ◽  
Chronic Obstructive ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Pulmonary Tb ◽  
International Data ◽  
At Risk Populations ◽  
Hiv Aids

AbstractZimbabwe currently faces several healthcare challenges, most notably HIV and associated infections including tuberculosis (TB), malaria and recently outbreaks of cholera, typhoid fever and COVID-19. Fungal infections, which are also a major public health threat, receive considerably less attention. Consequently, there is dearth of data regarding the burden of fungal diseases in the country. We estimated the burden of fungal diseases in Zimbabwe based on published literature and ‘at-risk’ populations (HIV/AIDS patients, survivors of pulmonary TB, cancer, chronic obstructive pulmonary disease, asthma and patients receiving critical care) using previously described methods. Where there was no data for Zimbabwe, regional, or international data was used. Our study revealed that approximately 14.9% of Zimbabweans suffer from fungal infections annually, with 80% having tinea capitis. The annual incidence of cryptococcal meningitis and Pneumocystis jirovecii pneumonia in HIV/AIDS were estimated at 41/100,000 and 63/100,000, respectively. The estimated prevalence of recurrent vulvovaginal candidiasis (RVVC) was 2,739/100,000. The estimated burden of fungal diseases in Zimbabwe is high in comparison to other African countries, highlighting the urgent need for increased awareness and surveillance to improve diagnosis and management.

scholarly journals The Burden of Fungal Infections in Ethiopia

2019 ◽  
Vol 5 (4) ◽  
pp. 109 ◽  
Author(s):  
Tufa ◽  
Denning
Keyword(s):  
Tinea Capitis ◽  
Fungal Infections ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Chronic Obstructive ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Obstructive Pulmonary Disease ◽  
Incidence Data ◽  
Patients At Risk ◽  
Chronic Pulmonary Aspergillosis ◽  
Candida Peritonitis

The burden of severe fungal infections (FIs) is not well addressed in Ethiopia. We have estimated the burden of FIs from multiple demographic sources and by searching articles from PubMed. Opportunistic FIs were estimated using modelling and 2017 national HIV data. The burdens of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA) were estimated by using the prevalence of asthma, chronic obstructive pulmonary disease, and annual the incidence of tuberculosis. Of the 105,000,000 estimated Ethiopian population, 610,000 are thought to have HIV infection. Our estimation of HIV-related FIs were: 9900 cryptococcal meningitis (CM), 12,700 Pneumocystis jirovecii pneumonia (PCP), 76,300 oral and 56,000 oesophageal candidiasis cases. A remarkable 7,051,700 4–14-year-olds probably have tinea capitis and 1,469,000 women probably have recurrent Candida vaginitis. There were 15,200 estimated CPA cases (prevalence) and 11,500 invasive aspergillosis (IA) cases (incidence). Data are scant, but we estimated 5300 candidaemia and 800 Candida peritonitis cases. In conclusion, approximately 8% of Ethiopians suffer from FIs annually, mostly schoolchildren with tinea capitis. IA, CM and PCP are the major causes of fungal deaths. The absence of CD4 count is challenging the identification of HIV patients at risk of opportunistic FIs. There is a pressing need to improve FI diagnosis, probably including national surveillance.

scholarly journals Allergic Diseases Caused by Aspergillus Species in Patients with Cystic Fibrosis

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 357
Author(s):  
Aidan K. Curran ◽  
David L. Hava
Keyword(s):  
Cystic Fibrosis ◽  
Fungal Infections ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Hyphal Growth ◽  
Allergic Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Th2 Immune Response ◽  
Difficulty Breathing ◽  
Oral Corticosteroids

Aspergillus spp. are spore forming molds; a subset of which are clinically relevant to humans and can cause significant morbidity and mortality. A. fumigatus causes chronic infection in patients with chronic lung disease such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). In patients with CF, A. fumigatus infection can lead to allergic disease, such as allergic bronchopulmonary aspergillosis (ABPA) which is associated with high rates of hospitalizations for acute exacerbations and lower lung function. ABPA results from TH2 immune response to Aspergillus antigens produced during hyphal growth, marked by high levels of IgE and eosinophil activation. Clinically, patients with ABPA experience difficulty breathing; exacerbations of disease and are at high risk for bronchiectasis and lung fibrosis. Oral corticosteroids are used to manage aspects of the inflammatory response and antifungal agents are used to reduce fungal burden and lower the exposure to fungal antigens. As the appreciation for the severity of fungal infections has grown, new therapies have emerged that aim to improve treatment and outcomes for patients with CF.

scholarly journals An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa

2021 ◽  
Vol 18 (6) ◽  
pp. 3111
Author(s):  
Emmanuel Peprah ◽  
Mari Armstrong-Hough ◽  
Stephanie H. Cook ◽  
Barbara Mukasa ◽  
Jacquelyn Y. Taylor ◽  
...  
Keyword(s):  
Current Evidence ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Cardiopulmonary Disease ◽  
Current Trends ◽  
Significant Public Health ◽  
Artery Disease ◽  
Living With Hiv

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries.

Gender differences in causes of death among persons with HIV/AIDS in San Francisco, California, 1996–2013

2017 ◽  
Vol 29 (2) ◽  
pp. 135-146 ◽  
Author(s):  
Nancy A Hessol ◽  
Sandra K Schwarcz ◽  
Ling Chin Hsu ◽  
Martha Shumway ◽  
Edward L Machtinger
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Gender Differences ◽  
Substance Use ◽  
Heart Disease ◽  
San Francisco ◽  
Causes Of Death ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Standardized Mortality Ratios ◽  
Hiv Aids

The objective was to examine gender differences in causes of death using the San Francisco HIV/AIDS and death registries. Data from San Francisco residents diagnosed with HIV/AIDS who died from 1996 to 2013 were analyzed. Age, race/ethnicity, year, and gender-adjusted standardized mortality ratios and Poisson 95% confidence intervals were calculated for underlying causes of death. Among the 6268 deaths, deaths attributed to drug use, mental disorders due to substance use, cerebrovascular disease, chronic obstructive pulmonary disease, renal disease, and septicemia were more likely among women than among men. Compared to the California population, women had elevated standardized mortality ratios for drug overdose (25.37), mental disorders due to substance abuse (27.21), cerebrovascular disease (2.83), chronic obstructive pulmonary disease (7.37), heart disease (2.37), and liver disease (5.54), and these were higher than the standardized mortality ratios for the men in our study. Men, but not women, had elevated standardized mortality ratios for suicide (2.70), undetermined intent (3.88), renal disease (2.29), and non-AIDS cancer (1.68) compared to population rates. Continued efforts to reduce HIV-related illnesses and an increased emphasis on diagnosing and treating preventable causes of death, including substance use, heart disease, and mental health disorders, are needed as part of comprehensive HIV care.

scholarly journals Burden of fungal infections in Iran

2018 ◽  
Vol 12 (10) ◽  
pp. 910-918 ◽  
Author(s):  
Mohammad T Hedayati ◽  
Mojtaba Tagizadeh Armaki ◽  
Jamshid Yazdani Charati ◽  
Newsha Hedayati ◽  
Seyedmojtaba Seyedmousavi ◽  
...  
Keyword(s):  
Tinea Capitis ◽  
Fungal Infections ◽  
Hematologic Malignancy ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Epidemiological Data ◽  
Fungal Diseases ◽  
Relative Impact ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Populations At Risk

Introduction: The number of fungal infections occurring each year in Iran is not known. As the burden of fungal disease is a measure used to assess and compare the relative impact of different type of fungal diseases on populations, we have estimated the burden of fungal diseases in Iran. Methodology: We estimated the burden of human fungal diseases based on the specific populations at risk, existing epidemiological data in both local and international databases, and modelling previously described by the LIFE program (http://www.LIFE-worldwide.org). Results: Among the population of Iran (79,926,270 in 2016), 6,670,813 (8.3%) individuals are estimated to suffer from a fungal infection each year. A total of 2,791,568 women aged between 15 and 50 years are estimated to suffer from recurrent vulvovaginal candidiasis, annually. In addition, considering the 13.3% prevalence rate of tinea capitis in children, a total of 2,552,624 cases per year are estimated. The estimated burden of invasive aspergillosis in the 3 groups of patients with hematologic malignancy, lung cancer and chronic pulmonary obstructive disease was 6394 (8.0 per 100,000). The estimate for the burden of allergic disease related to fungi including allergic bronchopulmonary aspergillosis, severe asthma with fungal sensitization and allergic fungal rhinosinusitis was 272,095 (340 per 100,000). Based on the 28,663 cases of HIV infection reported, an estimated 900 and 113 cases with pneumocystosis and cryptococcal meningitis are annually anticipated, respectively. Conclusion: Our estimates indicate that the importance of fungal infections is high but overlooked in Iran, which warrants further actions by health care authorities.

scholarly journals Burden of Serious Fungal Diseases in Romania

2018 ◽  
Author(s):  
Mihai Mareș ◽  
Valentina Ruxandra Moroti-Constantinescu ◽  
David W. Denning
Keyword(s):  
Fungal Infections ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Pneumocystis Pneumonia ◽  
Annual Incidence ◽  
Fungal Diseases ◽  
World Health ◽  
Annual Reports ◽  
Chronic Obstructive ◽  
Number Of Patients ◽  
Candida Peritonitis

Objective: To estimate for the first time the burden of serious fungal infections in Romania; Methods: Data derived from the World Health Organization (WHO), National Institute of Statistics, Romanian public health agencies and non-profit health organizations and published annual reports on local epidemiology were used in the present study. When no data was available, specific at-risk populations were used to calculate frequencies of serious fungal diseases, using previously published epidemiological parameters. All data refer to the year 2016; 3) Results: The estimated number of serious fungal infections in Romanian population was 435,930 in 2016. Recurrent vulvovaginal candidiasis accounts for up to 80% of total cases (more than 350,000 women annually). Concerning the HIV related infections, among 14349 infected persons, Pneumocystis pneumonia occurred in about 10% of late presenters (30 cases in 2016), while cryptococcal meningitis is rarely diagnosed (less than 20 cases). Annually, the total number of oesophageal candidiasis and oral thrush cases in HIV-positive patients may be as high as 1229 and 3066, respectively. In immunocompromised and cancer patient population, the annual incidence of candidaemia is 295, and at least 158 invasive aspergillosis cases and 4 mucormycosis cases occur yearly. With 4,966 critical care beds and approximately 200,000 abdominal surgeries performed, the estimated annual incidence of candidaemia and Candida peritonitis is 689 and 344, respectively. The annual incidence of pulmonary tuberculosis is still high in Romania (12,747 cases). Thus, the prevalence of post-TB chronic pulmonary aspergillosis is estimated to be 8.98/100,000 (1768 cases). The prevalence of chronic obstructive pulmonary disease (COPD) and asthma in adults is 6% and 6.5%, respectively. Therefore, allergic bronchopulmonary aspergillosis prevalence is estimated at 29,387 and severe asthma with fungal sensitisation at 38,731 cases annually. 4) Conclusions: Not being on the list of reportable diseases, the number of patients presenting with severe mycoses in Romania can only be roughly estimated. Based on local reports and prevalence estimation, we consider that at least 2.2% of Romanians suffer a serious form of fungal disease.

Microbiology of removable dentures plaque in patients with chronic obstructive pulmonary disease

2017 ◽  
Vol 67 (2) ◽  
pp. 163-181
Author(s):  
Dorota Przybyłowska ◽  
Elżbieta Mierzwińska-Nastalska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Fungal Infections ◽  
Control Group ◽  
Chronic Obstructive ◽  
Pathogenic Microorganisms ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Removable Denture ◽  
The Impact

Introduction. The role of bacterial infection in the exacerbation of chronic obstructive pulmonary disease (COPD) has been the subject of numerous studies. The plaque of removable dentures in COPD patients is an example of bacterial-fungal biofilm that serves as a reservoir of potential pathogenic microorganisms of the respiratory system. Inadequate and improper cleaning of dentures may become a cause of COPD exacerbations. Aim of the study. To evaluate the impact of the respiratory pathogens in the denture plaque on the condition of the oral mucosa. Material and methods. The clinical status of the oral mucous membrane and the hygienic condition of dentures were assessed in 86 COPD patients and in 30 generally healthy removable denture-wearers. Microbiological and mycological examinations were conducted on the basis of material collected using direct swab from the surface of the denture. Results. Twenty-three species of potentially pathogenic microorganisms were isolated and analysed in the course of tests performed for the purpose of this study. The most frequently isolated strain, in all groups of COPD patients, was Candida albicans (from 47.6 to 60%), while in�the control group it accounted for 36.7% of the cases. In the group of COPD patients, the main isolated strains were: Candida tropicalis, Klebsiella pneumoniae, Enterobacter cloacae and Staphylococcus epidermidis. Stomatopathy complicated by fungal infections was observed both in patients with COPD (from 76% to 90%) and in the control group (53.3%). Conclusions. Denture plaque may be a potential source of bacterial and fungal infections in COPD patients. The elimination of the plaque from dentures can be an effective way of reducing the risk of exacerbations. A higher incidence of prosthetic stomatopathy complicated by fungal infection among COPD patients may be associated with the chronic use of inhaled glucocorticotherapy and home oxygen therapy.

Smart Inhaler

2021 ◽  
pp. 509-511
Author(s):  
N. Sakthi Bharathi
Keyword(s):  
Eastern Mediterranean ◽  
World Health ◽  
Chronic Obstructive ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Organization ◽  
Disease Study ◽  
Low And Middle Income

As per the World Health Organization released during May 2018, 9 out of 10 individuals are believed to breathe air containing high levels of pollutants. Studies reveal, above 90% of air pollution-related deaths worldwide occur in low- and middle-income countries, especially in Asian and African countries, followed by low- and middle-income countries of the Eastern Mediterranean, European and the American regions. As per the University of Washington’s Global Burden of Disease study, 2018, COPD was the second-highest cause of death in India, leading to the death of almost 958,000. Inhalers are essential for observing the strict regimen required for these conditions, as they avoid the need for and the adverse effects associated with the use of injectables and oral drugs.Inhalers are used to treat chronic obstructive pulmonary disease (COPD), such as asthma, by delivering bronchodilator medication to the airway directly, without passing through the blood. ‘Smart’ inhalers are inhalers with extra digital features – they link to an app on the phone or tablet to help the patient and the doctor to manage asthma better.

scholarly journals Availability of diagnostic services and essential medicines for non‐communicable respiratory diseases in African countries

2021 ◽  
Vol 25 (2) ◽  
pp. 120-125
Author(s):  
C. Plum ◽  
M. Stolbrink ◽  
L. Zurba ◽  
K. Bissell ◽  
B. O. Ozoh ◽  
...  
Keyword(s):  
Beta Agonist ◽  
Essential Medicines ◽  
Chronic Obstructive ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Effective Care ◽  
Long Acting ◽  
Lung Health

BACKGROUND: The global burden of disease due to asthma and chronic obstructive pulmonary disease (COPD) is substantial and particularly great in low‐ and middle‐income countries, including many African countries. Management is affected by availability of diagnostic tests and essential medicines. The study aimed to explore the availability of spirometry services and essential medicines for asthma and COPD in African countries.METHOD: Questionnaires were delivered to healthcare workers at the annual meeting of the Pan African Thoracic Society Methods in Epidemiology and Clinical Research (PATS MECOR) and International Multidisciplinary Programme to Address Lung Health and TB in Africa (IMPALA). Data were analysed using simple descriptive statistics.RESULTS: A total of 37 questionnaires representing 13 African countries were returned. Spirometry availability was 73.0%. The most common reasons for non‐availability were lack of knowledge of the utility of the test. Within the study sample, 33.3% faced sporadic availability due to maintenance issues. Essential medicines availability ranged from 37.8% for inhaled corticosteroid‐long‐acting beta‐agonist inhalers to 100% for prednisolone 5 mg tablets, mainly due to supply chain problems.CONCLUSION: There is varied availability of spirometry and WHO essential medicines for COPD and asthma in African countries. Strategies are needed to improve access to basic effective care for people with non‐communicable lung disease in Africa.

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