Invasive Fungal Diseases in Africa: A Critical Literature Review
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Fungi,
Abstract
Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly
in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive
diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent
illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies.
Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available
literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden
to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa,
accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though
somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported
with a similar predilection towards people living with HIV. More cases of histoplasmosis are also
being reported with recent epidemiological studies, particularly fromWestern Africa, showing high
prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden
of pneumocystis pneumonia has reduced significantly probably due to increased uptake of
anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis,
talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but
with very few studies from the literature. The emergence of resistance to most of the available
antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is
much more common than it appears and contributes significantly to morbidity and mortality. Huge
investment is needed to drive awareness and fungi related research especially in diagnostics and
antifungal therapy.
Description
Keywords
invasive fungal diseases, Histoplasmosis, Cryptococcosis, Histoplasmosis, Pneumocystosis, Emergomycosis, Mucormycoses
Citation
Bongomin, F.; Ekeng, B.E.; Kibone,W.; Nsenga, L.; Olum, R.; Itam-Eyo, A.; Kuate, M.P.N.; Pebolo, F.P.; Davies, A.A.; Manga, M.; et al. Invasive Fungal Diseases in Africa: A Critical Literature Review. J. Fungi 2022, 8, 1236. https:// doi.org/10.3390/jof8121236