The burden of serious fungal infections in Sri Lanka

Ref ID: 19402

Author:

P. I. Jayasekera,1 D. W. Denning,2 P. D. Perera,1 A. Fernando3
and S. Kudavidanage1

Author address:

1Medical Research Institute, Colombo, Sri Lanka; 2University of
Manchester, in association with theLIFE program, United
Kingdom and 3Central Chest Clinic, Colombo, Sri Lanka

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Objectives Estimates of fungal infection caseloads are required to
plan and implement healthcare policies. Most Sri Lankan health care
is free of charge with a few private hospitals. In each district a spe-
cialized medical facility is available. With the increase in elderly pop-
ulation and medical developments, increased numbers of those with
fungal diseases are expected. This necessitates a new vision for fungal
diseases in Sri Lanka, a tropical country with a population of 20 mil-
lion. We have estimated the national fungal infection caseloads from
epidemiological datasets.
Methods We searched national data available from the Sri Lankan
department of census & statistics, Ministry of Health, WHO & Faculty
of Medicine, Colombo, as well as surveillance studies published by us
and other authors for relevant disease terms. Locally collected inci-
dence data were available for candidaemia, fungal keratitis, crypto-
coccosis, ABPA& SAFS. Generally, disease estimates were
conservative as they assumed the lowest incidence rates reported in
the literature and focused only on well-defined risk populations.
Results Sri Lankan population in 2012 was 20.2 M (51.5% female,
25.5% children). The adult HIV prevalence is <0.1%. In 2009, 1,196 HIV/AIDS persons were detected and 40.6% were on anti-retroviral therapy. There were 16 deaths. Prevalence of all forms of TB was 21,000 (2010). According to TB and other respiratory death rates the prevalence of chronic pulmonary aspergillosis post TB (1,443) and all forms of chronic pulmonary aspergillosis (2,886) were esti- mated. Annual incidence of cryptococcal meningitis is 13, candida- emia 507 and mucormycosis 41. Based on an AML incidence of 3/ 100,000 and over 500 renal transplants, we estimated 229 cases of invasive aspergillosis. Based on candidaemia and immunocompro- mised patients, 76 candida peritonitis, 320 oral candidiasis and 97 oesophageal candidiasis and 25,750 recurrent vaginal candidiasis cases were estimated. Asthma affects 414,000 adults 2.75% of the adult population, and assuming ABPA prevalence is 2.5% 10,344 persons, and 33% of the worst 10% of asthmatics have SAFS 13,654 persons are estimated. Fungal keratitis is documented in 1,277 patients and tinea capitis in 50 children. Pneumocystis incidence could not be estimated. The total estimated annual serious fungal disease burden in Sri Lanka is 56,687. Conclusion Our estimates suggest that candidaemia and invasive aspergillosis are the leading causes of fungal-associated deaths. Fun- gal related morbidity is mainly attributed to SAFS, ABPA and CPA. More precise data from the whole country is needed for healthcare policymaking.

Abstract Number: p134

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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