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Published on: March 9, 2018
Burden of Serious Fungal Infections in India
Animesh Ray1, Adarsh Aayilliath K1, Sayantan Banerjee2
1Department of Medicine, AIIMS, New Delhi, India.
Background:
Fungal disease is frequent in India, but its incidence and prevalence are unclear. This review aims at defining the frequency or burden of various fungal infections in India.
Methods:
A systematic review of the literature on the PubMed, Embase, and Web of Science (WOS) databases was conducted using appropriate search strings. Deterministic modeling determined annual incidence and prevalence estimates for multiple life- and sight-threatening infections with significant morbidity.
Results:
Literature searches yielded >2900 papers; 434 papers with incidence/prevalence/proportion data were analyzed. An estimated 57 251 328 of the 1 393 400 000 people in India (4.1%) suffer from a serious fungal disease. The prevalence (in millions) of recurrent vulvovaginal candidiasis is 24.3, allergic bronchopulmonary aspergillosis is 2.0, tinea capitis in school-age children is 25, severe asthma with fungal sensitization is 1.36, chronic pulmonary aspergillosis is 1.74, and chronic fungal rhinosinusitis is 1.52. The annual incidence rates of Pneumocystis pneumonia (58 400), invasive aspergillosis (250 900), mucormycosis (195 000), esophageal candidiasis in HIV (266 600), candidemia (188 000), fungal keratitis (1 017 100), and cryptococcal meningitis (11 500) were also determined. Histoplasmosis, talaromycosis, mycetoma, and chromoblastomycosis were less frequent.
Conclusions:
India's fungal burden is high and underappreciated in clinical practice.
Insights
Fungal infections affect over 4% of India's population, with millions experiencing serious conditions like candidiasis and aspergillosis. This high burden of fungal disease in India is often overlooked in clinical settings.
Area of Science:
- Medical Mycology
- Infectious Diseases Epidemiology
- Public Health
Background:
- Fungal infections are common in India, yet their exact incidence and prevalence remain largely unknown.
- Understanding the burden of fungal diseases is crucial for public health planning and resource allocation.
Purpose of the Study:
- To determine the frequency and burden of various fungal infections across India.
- To provide updated epidemiological data on serious fungal diseases in the Indian population.
Main Methods:
- A systematic literature review was performed across PubMed, Embase, and Web of Science databases.
- Deterministic modeling was employed to estimate annual incidence and prevalence rates for key fungal infections.
- Data from over 434 relevant studies were analyzed to quantify the fungal disease burden.
Main Results:
- An estimated 4.1% of India's population (over 57 million people) suffer from serious fungal diseases.
- High prevalence rates were found for recurrent vulvovaginal candidiasis (24.3 million) and tinea capitis (25 million).
- Significant annual incidence was noted for fungal keratitis (1,017,100), mucormycosis (195,000), and invasive aspergillosis (250,900).
Conclusions:
- India faces a substantial and underestimated burden of fungal diseases.
- The findings highlight the need for increased clinical awareness and improved management strategies for fungal infections in India.
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