An updated analysis of the burden of fungal diseases in Uganda

Felix Bongomin 1, Bruce Kirenga 2, Richard Kwizera 2, David Meya 2, David W. Denning *3

Author address: 

1 Gulu University School of Medicine, Gulu, Uganda; 2 Makerere University, Kampala, Uganda; 3 The University of Manchester, Manchester, United Kingdom


Background: It is of utmost importance to monitor any change in the epidemiology of fungal diseases that may arise from a change in the number of the at-risk population or availability of local data. We sought to re-evaluate the incidence and prevalence of major fungal diseases in Uganda.

Materials/methods: Using the Leading International Fungal Education methodology, we reviewed published data on fungal diseases and drivers of fungal diseases in Uganda. Regional or global data were used where there is no Ugandan data

Results: With a population of ~45 million, overall we estimate annual burden of severe fungal diseases at 981,680 cases (2.2% of the population), excluding cases of tinea capitis. Estimates for the annual incidence of HIV-related life-threatening fungal disease include cryptococcal meningitis (17,859 cases), Pneumocystis pneumonia (4,962 cases in adults and 2,888 cases in children), oral candidiasis (29,772), oesophageal candidiasis (79,924 cases), and invasive pulmonary aspergillosis (920 cases). We estimate 656,340 cases of recurrent vulvovaginal candidiasis and 6,084 cases of fungal keratitis annually. The overall prevalence of post-tuberculosis chronic pulmonary aspergillosis is 8,905 cases (annual incidence of 1,291 cases) and the burden of fungal asthma at 171,863 cases (allergic bronchopulmonary aspergillosis, 74,079 cases and severe asthma with fungal sensitisation, 97, 784 cases). Candida peritonitis and candidaemia are estimated at the rate of 0.8/100,000 (343 annual incidence) and 5/100,000 (2,287 annual incidence), respectively. The neglected tropical fungal disease mycetoma is uncommon with an annual incidence rate of 0.3/100,000(79 cases annually).

Conclusions: Fungal diseases affect a significant proportion of Ugandans every year. Tuberculosis and HIV remains the most important predisposition to fungal disease in this population. The burden of fungal diseases in Uganda has remained stable for the past five years, calling for accelerated preventive, diagnostic and therapeutic interventions for the management of these diseases.

Presenter email address: [email protected]


abstract No: 


Full conference title: 

European Congress of Clinical Microbiology and Infectious Diseases 2020
    • ECCMID 30th (2020)