The burden of severe human fungal infections in Brazil

Ref ID: 19205

Author:

L. Carneiro, L. Baethgen, M. Millington, D.W. Denning, A.L. Colombo, A. Pasqualotto

Author address:

in association with the LIFE program (www.LIFE-worldwide.org)

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Objectives: To determine the burden of fungal infections in Brazil.
Material and Methods: For inpatients, data was obtained from the Brazilian Ministry of Health Informatics Department System (DATASUS), based on patients’ CID-10 discharge. Data was considered consistent only for fungal diseases for which there was a surveillance program in place. Cases of cryptococcosis and PCP were obtained from the Information System of Notifiable Diseases (SINAN). To other invasive mycoses, assumptions were made based on incidence rates reported in the Brazilian literature or – in the absence of such data – in the world literature. The denominator included the overall Brazilian population, number of patients with HIV/AIDS, respiratory diseases, cancer/immunocompromised and critical care/surgery, as reported in governmental publications.
Results: Brazil has ~194 million inhabitants (75% adults, 51% women, and 33% are >40 years old). The current burden of serious fungal infections in Brazil was estimated in ~3.4 million (M) cases. Based on a TB incidence of 36/100,000 (2010), a prevalence of ~12 thousand (K) cases of chronic pulmonary aspergillosis (CPA) were estimated, not considering CPA cases due to other conditions. If 12.4% of Brazilian adults have asthma and assuming that at least 2.5% of asthmatics have ABPA, we estimated ~390K patients with ABPA. Only 392 cases of cryptococcal meningoencephalitis were documented per year (incidence 0.06% in the total HIV population) in official records. Cases of oral / oroesophageal candidosis in AIDS patients were estimated in ~164K and ~58K, respectively, whilst recurrent (>4 episodes/year) Candida vaginitis affected ~2.7M/year. The rate of candidaemia was 249/100,000 hospital admissions (~30K). Invasive aspergillosis in immunocompromised patients was estimated at ~9K patients including ~2K in critically ill/COPD patients. For mucormycosis, the general rate of 2/1,000,000 suggests 243 cases based on hospital admissions annually. For histoplasmosis, incidence was estimated in 2/100,000 hospital admissions per year. Other endemic mycosis added ~2K cases.
Conclusion: Based on local data and literature estimates of the frequency of mycoses in susceptible populations, 1.7% of Brazilians presents some form of severe fungal disease. Knowing that the mycoses are an internationally neglected health topic, we believe that if all fungal diseases could be officially notified the real number should be much higher than the estimated by this study.

Abstract Number: P1042

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=167497&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

New link: NULL

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