The annual total of deaths due to fungal diseases worldwide has risen to 3.75 million, double the previous estimate, according to a new study. David Denning, Professor of Infectious Diseases at the University of Manchester, calculates an annual total of around 6.55 million acute cases using data from more than 80 countries.
The results of the study were published in The Lancet Infectious Diseases.
Fungal diseases: that's why they are expanding
Although fungal diseases have multiple causes, updated mortality figures still exceed deaths due to other single pathogens, killing six times more people than malaria and nearly three times more than tuberculosis.
The work is the result of a collaboration of over 300 professionals around the world who contributed to the publication of estimates for their country and for individual fungal diseases.
Previous estimates were imprecise, Professor Denning argues, because many fungal diseases aggravate an existing, often serious, disorder such as leukemia or AIDS.
However, according to the study, approximately 68% of fungal disease-related deaths, or 2.55 million, were directly caused by these diseases. Approximately 1.2 million deaths (32%) were due to other underlying diseases, to which these conditions contributed.
According to Professor Denning, around a third of the 3.23 million deaths due to chronic obstructive pulmonary disease (COPD) worldwide are linked to infection with the fungus Aspergillus. Although pulmonary tuberculosis was classified as a cause of death in 1.2 million people in 2019, he estimates, as many as 340,000 (28%) of these may actually be fungal disease deaths.
Of the 311,594 leukemia deaths estimated globally in 2020, 14,000 (4.5%) could be attributable to aspergillosis and some to other fungal infections encountered. Annual deaths from lung and bronchial cancer stand at 1.8 million, with the new estimate indicating that aspergillosis is implicated in 49,000 deaths (2.7%) of these.
Candida, another type of fungal infection, is a serious problem in intensive care patients, complex surgical patients, diabetes, cancer, and kidney failure, as well as premature babies.
Researchers estimate that approximately 1.57 million people suffer from Candida blood infection or invasive candidiasis with 995,000 deaths (63.6%) each year. Professor Denning said: “This work is the first comprehensive global estimate of the annual incidence of fungal diseases, but many gaps and uncertainties remain.
“Our previous estimates of annual mortality were between 1.5 and 2 million, but we now find that the likely number of people dying from a fungal infection is double that, at around 3.75 million.
“This estimate has been inspired by huge changes in awareness of fungal infections and diagnostic capabilities led by Global Action For Fungal Infections (GAFFI), working in partnership with the University of Manchester, the Fungal Infection Trust, the Fungal Kingdom programme: CIFAR Threats and Opportunities and the GAFFI global ambassador network program.
“This work would also not have been possible without the extraordinary collaboration of over 300 professionals around the world who contributed to the publication of estimates for their country and for individual fungal infections.”
An increase in hospital admissions linked to fungal infections has been identified during the COVID-19 pandemic, according to an additional study published in the July issue of Emerging Infectious Diseases.
Jeremy AW Gold, MD, of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed a database of health services to determine rates, patient demographics, and health care utilization for related hospitalizations to fungal infections during the COVID-19 pandemic. pandemic.
The researchers found that rates of fungal hospitalizations increased from 22.3 per 10,000 hospitalizations in 2019 to 25.0 and 26.8 in 2020 and 2021, respectively, representing an average annual percentage change of 8.5%. In the period from 2020 to 2021, 13.4% of 39,423 fungal hospitalizations were associated with COVID-19.
Hospitalizations caused by fungal diseases associated with COVID-19 more often resulted in longer hospital stays (21 vs. nine days), higher rates of intensive care unit admission (70.0 vs. 35.5%), ventilation interventions more invasive mechanics (64.4 versus 22.5%) and more. deaths (48.5 vs. 12.3%), compared to fungal infections not associated with COVID-19.
COVID-19-associated fungal hospitalizations with the highest percentage of deaths involved aspergillosis, invasive candidiasis, mucormycosis, and unspecified mycoses (57.6, 55.4, 44.7, and 59.0%, respectively).
“Our analysis highlights the substantial burden of hospitalizations of patients with fungal infections in the United States and indicates that an increase in hospitalizations for fungal diseases has occurred during the COVID-19 pandemic,” the authors write.
A team of researchers Indian and Manchester researchers have shown that over fifty million Indians are affected by serious fungal diseases, 10% of which result from potentially dangerous mold infections.
Experts from three Indian teaching hospitals – AIIMS, New Delhi, AIIMS Kalyani, West Bengal and PGIMER, Chandigarh, along with the University of Manchester, estimate that 57 million, or 4.4% of the 1.3 billion people living in India, they are likely to be affected.
The comprehensive review of data from more than 400 published academic articles is published in the journal Open Forum Infectious Diseases. Researchers found that vaginal thrush, or yeast infection,
affected approximately 24 million women of reproductive age, with repeated attacks.
The fungal hair infection, known as tinea capitis, has affected similar numbers in school-age children. It causes a painful infected scalp and leaves a lot of hair falling out.
The leading causes of death were mold infections that affected the lungs and sinuses, affecting more than 250,000 people. Another 1,738,400 people had chronic aspergillosis and 3.5 million had severe allergic lung disease.
More than 1 million people are thought to suffer from potentially blinding fungal eye diseases, and nearly 200,000 were affected by mucormycosis (so-called “black mold”).
Dr Animesh Ray of AIIMS Delhi, lead author of the paper, said, “The total burden due to fungal diseases is huge but underestimated. While tuberculosis affects less than 3 million people a year in India, the number of Indians affected by fungal diseases is many times higher.”
Professor David Denning from the University of Manchester and Global Action For Fungal Disease added: “There have been major diagnostic improvements in recent years, with public health services in India catching up with private hospitals in terms of capacity.
Fungal diseases, however, continue to be a threat to public health and a cause of significant morbidity and mortality, representing a significant socioeconomic burden for those infected. And there remain large parts of India with limited diagnostic capabilities, as evidenced by our inability to estimate some major diseases such as histoplasmosis. and fungal asthma in children.”
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