Diversity and Distribution of Fungal Infections in Rwanda: High Risk and Gaps in Knowledge, Policy, and Interventions

Area of Science:

• Medical Mycology
• Public Health
• Agricultural Science

Background:

• Fungal infections (FIs) are a growing global concern, yet data from Rwanda is scarce.
• A wide range of fungal pathogens, including *Candida*, *Histoplasma*, and *Blastomyces*, cause human infections in Rwanda.
• Soilborne fungi pose risks to agriculture, food security, and socioeconomic stability in Rwanda.

Purpose of the Study:

• To conduct a comprehensive review of fungal infections in Rwanda.
• To identify fungal pathogens and their associated human health impacts.
• To highlight gaps in diagnostics, surveillance, and research for FIs in Rwanda.

Main Methods:

• Systematic review of published reports from 1972 to 2022.
• Analysis of documented fungal pathogens and their clinical manifestations.
• Assessment of diagnostic techniques and surveillance systems for FIs.

Main Results:

• Identified diverse fungal pathogens causing human infections, including *Candida* (vaginal), *Histoplasma duboisi* (disseminated), *Blastomyces dermatitidis* (cerebellar), and *Rhinosporidium seeberi* (nasal).
• Observed widespread impact of soilborne fungi on bean crops, threatening agriculture and food security.
• Highlighted significant limitations in FIs detection, reporting, and healthcare services, with a reliance on traditional diagnostic methods.

Conclusions:

• Urgent need to develop diagnostic capacities and national surveillance systems for FIs in Rwanda.
• Addressing FIs is critical for improving human, animal, and crop health, as well as food security and socioeconomic stability.
• A multisectoral 'One Health' strategy is essential for research and intervention against fungal pathogens.