Burden of serious fungal infections in Nigeria

Ref ID: 19200

Author:

R. Oladele*, O. Ozoh, D.W. Denning

Author address:

Lagos, NG; Manchester, GB

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Introduction: Nigeria is the most populous country in Africa with a high rate of tuberculosis and a moderate HIV infection burden. Reports of cutaneous fungal infections have emerged from Nigeria. We estimated the total number of serious fungal infections in Nigeria.
Method:Literature search was done to identify all epidemiology papers reporting fungal infection rates from Nigeria. We used specific populations at risk and fungal infection frequencies in the population to estimate national incidence/ prevalence. WHO population statistics of 2009; 2010 WHO HIV infection and ARV treatment rates; National Agency for the Control of AIDS child/adult HIV split 2011, WHO 2010 TB statistics, ISAAC estimate of asthma prevalence are some of the databases used for estimating population at risk.
Results:50% of the over 155M Nigerian population are children and 38M are women between the age of 15 to 50 yrs. 1.5M Nigerian women get recurrent vaginal thrush. Local estimates of tinea capitis exceed 20% of school age children, suggesting that over 15.5M children have tinea capitis. There were 78,032 cases of pulmonary TB in 2010, most in HIV negative people and based on cavity frequency and Aspergillus IgG serology, we expect 19,000 new cases of chronic pulmonary aspergillosis (CPA) with a 5 year period prevalence of 60,377 cases (Denning, 2011) probably 50% of the total CPA caseload. Asthma is also common in Nigeria and a population prevalence of 15.2% has been reported.Therefore we expect about 3.7M adult asthmatics of which 2.5% will have ABPA (94,000 with ABPA are likely and 124,000 with SAFS).Based on the 3,459,363 cases of HIV infection reported, (55% children), 1,449,166 on ARV therapy, and 281,180 new AIDS cases, an estimated 32,000 cases of cryptococcal meningitis is estimated. 75,000 of the AIDS cases are expected to develop Pneumocystis pneumonia (40% in children), 253,000 oral candidiasis and 144,000 oesophageal candidiasis based on the WHO prevalence rate. Rates of candidaemia, invasive aspergillosis, mucormycosis and histoplasmosis were estimated on a population basis, without supporting data and are probably uncommon.
Conclusion:Our estimates shows that over 11.8% of the Nigerian population is estimated to suffer from a serious fungal infection each year. If tinea capitis and recurrent vaginal thrush are excluded, over 800,000 are estimated to be affected, with substantial mortality. Epidemiological studies are required to validate or modify these estimates.

Abstract Number: P1035

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=159890&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

New link: NULL

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