Burden of serious fungal infections in Singapore

Ref ID: 19197

Author:

L.H.W. Lum*, L.Y.A. Chai, S. Archuleta, D.W. Denning

Author address:

Singapore, SG; Manchester, GB

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Objectives: Singapore is a cosmopolitan South East Asian country with a Gross Domestic Product of USD 240 billion and an estimated population of 5.35 million. We aim to estimate the burden of fungal infections in Singapore as part of a multi-national effort to quantify worldwide fungal infections.
Methods: Estimation of fungal disease burden was extrapolated from epidemiological documents. Population statistics and respective disease distributions pertaining to HIV, malignancies, tuberculosis, chronic obstructive pulmonary disease(COPD) and asthma were extracted from Singapore Demographics Profile 2012 and Ministry of Health releases. Transplant cases were estimated from Heart Lung Registry, and from the renal and liver transplant lists in Singapore hospitals. The number of critical care beds was obtained via a manual count of the hospitals countrywide. When local incidence of specific diseases was not known, figures were reasonably extrapolated from that of neighbouring Asian countries with similar population demographics.
Results: 13% of the population are younger than 15 years old, and 2.12 million are women older than 15 years of age, of which 94350 are estimated to have recurrent Candida vaginitis. The incidence of invasive aspergillosis in immunocompromised hosts is at least 37 cases annually, but many more in COPD admissions and ICU patients. The prevalence of chronic pulmonary aspergillosis(CPA) after tuberculosis(TB) figures at 182 cases, based on calculation of annual cavitary pulmonary TB cases and established CPA incidence, with further extrapolated data from Taiwan and China. This is possibly 33% of the total CPA caseload. While asthma is relatively common in adults(250,000 – 5%), allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation are rarely diagnosed. Based on 183 cases of AIDS in Singapore in 2011, 9.2%(17) present with cryptococcal meningitis, 47.7% (87) have Pneumocystis pneumonia. 460 patients per year have oral candidiasis, and 265 have esophageal candidiasis. The incidence of candidemia is 268 per annum, with two thirds of the patients being in critical care or surgical care, and one third being cancer or immunocompromised patients.
Conclusions: The prevalence of medically-significant fungal infections is under-recognised in Singapore. Increased awareness and surveillance will serve to enhance appropriate allocation of healthcare resources in this disease spectrum.

Abstract Number: P1038

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=163305&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

New link: NULL

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