The estimated burden of fungal diseases in Mali |
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| Affiliation: | 1. Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali;2. Infectious disease and tropical medicine Unit, CHU Point G Bamako, Mali;3. Manchester Fungal Infection Group, Core Technology Facility Grafton Street, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK;4. Global Action for Fungal Infections, Geneva, Switzerland;1. Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France;2. Critical Care Unit, University Hospital of Purpan, Toulouse, France;3. Toulouse NeuroImaging Center, Unité Mixte de Recherche 1214, Institut National de la Santé et de la Recherche Médicale, Université Paul Sabatier, Toulouse, France;4. Department of Infectious and Tropical Diseases, CHU Toulouse, Toulouse, France;5. PHARMA-Dev, UMR 152 IRD-UPS, Université Toulouse, France;6. Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France;7. Neuroradiology Department, Pierre-Paul-Riquet/Purpan University Hospital, Toulouse, France;8. RESTORE Institute, UMR 1301-Inserm 5070-CNRS EFS Univ. P. Sabatier, Toulouse, France;1. Programa de Patologia Ambiental e Experimental, Universidade Paulista-Unip, Rua Dr. Bacelar 902, São Paulo, SP CEP 05622–001, Brazil;2. Laboratório de Fisiopatologia, Instituto Butantan, Av. Vital Brasil 1500, São Paulo, SP CEP 05503– 900, Brazil;1. Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India;1. Department of Medical Microbiology, Faculty of Medicine, KTO Karatay University, Konya, Turkey;2. Department of Medical Microbiology, Faculty of Medicine, Ni?de Ömer Halisdemir University, Ni?de, Turkey;3. Department of Medical Genetics, Faculty of Medicine, KTO Karatay University, Konya, Turkey;4. Department of Chemistry, Faculty of Science, Gazi University, Ankara, Turkey;5. Department of Medical Pharmacology, Faculty of Medicine, KTO Karatay University, Konya, Turkey;6. Department of Molecular Biology and Genetics, Faculty of Science, Necmettin Erbakan University, Konya, Turkey;1. Lauro Wanderley Universitary Hospital, Department of Health, state of Paraíba, Brazil;2. Department of Infectious, Parasitic and Inflammatory Diseases, Center for Medical Sciences, Federal University of Paraíba (UFPB), João Pessoa, Brazil;3. Medicine Graduated Course, Center for Medical Sciences, UFPB, João Pessoa, Brazil;4. Residence Program in Family and Community Medicine, Center for Medical Sciences, UFPB, João Pessoa, Brazil;5. Post-Graduate Program in Fungal Biology, Federal University of Pernambuco (UFPE), Recife, Brazil;6. Technical Health School, Federal University of Paraíba (UFPB), João Pessoa, Brazil;7. Post-Graduate Program in Bioactive Synthetic Natural Products, UFPB, João Pessoa, Brazil;8. Department of Tropical Medicine, Center for Medical Sciences, UFPE;9. Oswaldo Cruz Institute, FIOCRUZ, Av Brasil, 4365, Manguinhos, Rio de Janeiro – RJ, CEP 21045-360, Brazil;1. Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India;2. Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India |
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| Abstract: | Mali is a developing country facing several health challenges with a high rate of tuberculosis (TB) and a moderate HIV infection burden. Little is known or done about fungal diseases, yet they represent a significant public health problem in certain populations. The aim of this study was to estimate the national burden of fungal disease, and summarize data, diagnostic and treatment gaps. We used national demographics and PubMed searches to retrieve articles on published data on these infections and at-risk populations (pulmonary TB, HIV/AIDS patients, patients receiving critical care etc.) in Mali. The estimated Malian population was 21,251,000 in 2020 (UN), of which 45% were children <14 years. Among HIV patients, we estimate an annual incidence of 611 cryptococcosis, 1393 Pneumocystis pneumonia, 180 histoplasmosis and >5,700 esophageal candidiasis and some microsporidiosis cases. Our prevalence estimates for tinea capitis are 2.3 million, for recurrent vulvovaginal candidiasis 272,460, ～60,000 fungal asthma and 7,290 cases of chronic pulmonary aspergillosis (often mistaken for TB). Less common acute fungal infections are probably invasive aspergillosis (n=1230), fungal keratitis (n=2820), candidaemia (>1,060) and mucormycosis (n=43). Histoplasmin was found in 6% in general population. A few cases of mycetoma are described in Mali. Many WHO Essential medicines and Diagnostics are not available in Mali. This shows a marked disparity in documented and estimated cases of fungal diseases in Mali. These infections are underestimated due to the lack of accurate diagnosis tools and lack of support for fungal diseases diagnosis and management. |
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