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Published on: March 9, 2018
Burden of serious fungal infection in Nigeria
1National Aspergillosis Centre, University Hospital of South Manchester,UK.
Background:
Nigeria is the most populous country in Africa with a high rate of tuberculosis and a moderate HIV infection burden. Cutaneous and mucosal fungal infections are reported from Nigeria but there are few reports of serious fungal infections.
Methods:
A literature search was done to identify all epidemiology papers reporting fungal infection rates from Nigeria. We used specific populations at risk derived from the WHO and literature and the fungal infection frequencies were used to estimate national incidence or prevalence.
Results:
1.5M Nigerian women get recurrent vaginal thrush. Tinea capitis occurs in >20% of school age children, translating to over 15.5M children affected. Based on the 3,459,363 cases of HIV infection; an estimated 1,449,166 (55% children) of whom are on ARV therapy; there are 281,180 new AIDS cases, and an estimated 57,866 cases of cryptococcal meningitis. 75,000 patients with AIDS cases are expected to develop Pneumocystis pneumonia (40% rate in children), 253,000 oral candidiasis and 144,000 oesophageal candidiasis. There were 78,032 cases of pulmonary TB in 2010, and we anticipate 19,000 new cases of chronic pulmonary aspergillosis with a 5 year period prevalence of 60,377 cases. Prevalence of asthma in adults is 15.2%, estimated at 3.7M adult asthmatics of which 94,000 (2.5%) will have ABPA and 124,000 severe asthma with fungal sensitisation (SAFS). Rates of candidaemia, Candida peritonitis, invasive aspergillosis and mucormycosis were estimated on a population basis, without supporting data and are probably uncommon or rare.
Conclusion:
Our estimates indicate that over 11.8% of the Nigerian population is estimated to suffer from a serious fungal infection each year. If tinea capitis and recurrent vaginal thrush are excluded, over 960,000 are estimated to be affected, with substantial mortality. Epidemiological studies are urgently required to validate or modify these estimates.
Insights
Over 11.8% of Nigerians may suffer serious fungal infections annually, impacting over 960,000 individuals when common infections are excluded. Urgent epidemiological studies are needed to confirm these significant public health estimates.
Area of Science:
- Medical Mycology
- Infectious Diseases Epidemiology
- Public Health
Background:
- Nigeria faces a high burden of tuberculosis and moderate HIV, with limited data on serious fungal infections despite reported cutaneous and mucosal cases.
- The country's large population in Africa presents a significant demographic for studying infectious disease prevalence.
- Understanding the epidemiology of fungal infections is crucial for public health planning in Nigeria.
Purpose of the Study:
- To estimate the national incidence and prevalence of serious fungal infections in Nigeria.
- To identify specific fungal infections and at-risk populations within Nigeria.
- To highlight the need for further epidemiological research on fungal diseases in the region.
Main Methods:
- Conducted a comprehensive literature search for Nigerian epidemiology papers on fungal infection rates.
- Utilized World Health Organization (WHO) and literature-derived data on at-risk populations.
- Applied identified fungal infection frequencies to estimate national incidence and prevalence.
Main Results:
- An estimated 1.5 million Nigerian women experience recurrent vaginal thrush; over 15.5 million school-aged children are affected by Tinea capitis.
- Significant numbers of HIV/AIDS cases correlate with high risks for cryptococcal meningitis, Pneumocystis pneumonia, and candidiasis.
- Estimates suggest 19,000 new cases of chronic pulmonary aspergillosis and over 2.5 million cases of allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS) annually.
Conclusions:
- Over 11.8% of Nigeria's population may suffer from serious fungal infections yearly, totaling over 960,000 cases if common infections are excluded.
- These estimates indicate a substantial disease burden and potential mortality, underscoring the need for public health interventions.
- Urgent epidemiological studies are required to validate and refine these preliminary estimates for fungal infection prevalence in Nigeria.
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