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Opportunistic Fungal Infections in Sub-Saharan Africa
Lucian Duvenage1,2,3, Emily Ruth Higgitt1,4,5, Rachael Dangarembizi1,4,5
1CMM AFRICA Medical Mycology Research Unit, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; email: lucian.duvenage@uct.ac.za, jennifer.hoving@uct.ac.za.
Annual Review of Microbiology
|June 26, 2025
Summary
Opportunistic fungal infections, particularly Cryptococcus neoformans and Pneumocystis jirovecii, cause significant deaths in sub-Saharan Africa. Addressing unique regional risks and research gaps is crucial to reduce this fungal disease burden.
Area of Science:
- Mycology
- Infectious Diseases
- Public Health
Background:
- Opportunistic fungal infections are a leading cause of death in sub-Saharan Africa.
- High rates of advanced HIV disease and limited healthcare access exacerbate fungal disease burden.
- Underreported endemic fungal pathogens pose significant threats.
Purpose of the Study:
- To review key fungal pathogens contributing to mortality in sub-Saharan Africa.
- To discuss advances in understanding fungal pathogenesis for novel therapies.
- To highlight regional risk factors, diagnostic/treatment challenges, and research priorities.
Main Methods:
- Literature review focusing on high-mortality fungal pathogens.
- Analysis of pathogenesis, risk factors, and treatment challenges in sub-Saharan Africa.
- Identification of research priorities for fungal disease control.
Main Results:
- Cryptococcus neoformans, Pneumocystis jirovecii, Histoplasma spp., and Emergomyces africanus are major contributors to mortality.
- Understanding pathogenesis offers potential for new antifungal drug development.
- Sub-Saharan Africa faces unique challenges in fungal disease diagnosis and treatment.
Conclusions:
- Urgent research is needed to address the significant burden of fungal infections in sub-Saharan Africa.
- Novel diagnostics and therapeutics are essential to reduce fungal-related morbidity and mortality.
- Targeted strategies are required to mitigate risks associated with HIV-related fungal diseases.
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