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Invasive aspergillosis in developing countries.

Arunaloke Chakrabarti1, Shiv Sekhar Chatterjee, Ashim Das

  • 1Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India. arunaloke@hotmail.com

Medical Mycology
|August 20, 2010
PubMed
Summary
This summary is machine-generated.

Invasive aspergillosis (IA) is a significant threat in developing nations, often underdiagnosed due to limited resources. Fungal infections like IA are prevalent, with treatment often restricted by cost, leading to high mortality rates.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Global Health

Background:

  • Invasive aspergillosis (IA) poses a significant challenge in developing countries, contributing to substantial morbidity and mortality.
  • Underreporting and diagnostic limitations hinder accurate assessment of IA prevalence.
  • Risk factors include suboptimal hospital practices, steroid/antibiotic misuse, and a rise in intravenous drug abuse.

Purpose of the Study:

  • To review the epidemiology and clinical aspects of invasive aspergillosis (IA) in developing countries.
  • To identify emerging patterns and challenges in IA diagnosis and treatment in these regions.

Main Methods:

  • Literature search of PubMed/Medline for IA studies from 1970 to March 2010.
  • Inclusion of countries listed in the IMF's Emerging and Developing Economies List, 2009.
  • Analysis of reported case series and risk factors.

Main Results:

  • IA is a major cause of death in hospitalized patients, though exact frequency is unknown.
  • Limited diagnostic facilities and reliance on conventional methods (microscopy, culture) are common.
  • Emerging sino-orbital, cerebral aspergillosis, and Aspergillus endophthalmitis are noted, predominantly caused by Aspergillus flavus.
  • Newly recognized associated conditions include liver failure, COPD, diabetes, and tuberculosis.
  • Mortality is high due to diagnostic and therapeutic delays; treatment is often limited to older antifungals like amphotericin B deoxycholate and itraconazole due to cost.

Conclusions:

  • IA is a critical issue in developing countries, demanding improved diagnostics and broader access to newer antifungals.
  • Aspergillus flavus is a predominant pathogen, particularly in sino-orbital and cerebral forms.
  • Economic constraints significantly impact treatment choices, necessitating strategies to improve patient outcomes.