Spatial distribution of pathogenic fungal isolates from clinical samples in Uganda: Diagnostic gaps and trends, January 2020 - May 2024
Related Experiment Video
Updated: Sep 15, 2025
Isolation of Culturable Yeasts and Molds from Soils to Investigate Fungal Population Structure
Published on: May 27, 2022
Priscilla Atim1,2, Samuel Gidudu1, Bernard Ssentalo Bagaya2,3
1Uganda Public Health Fellowship Program, National Institute of Public Health, Kampala Uganda.
Background:
Pathogenic fungi cause approximately 13 million infections and 1.5 million deaths worldwide each year, yet surveillance and diagnosis remain inadequate in resource-limited settings. In Uganda, fungal infections affect approximately 4,099,357 per 45 million people annually, resulting in severe invasive diseases if untreated. This study describes laboratory-confirmed pathogenic fungal isolates from clinical samples in Uganda from January 2020 to May 2024, and highlights gaps in diagnostic capacity.
Methods:
We abstracted data from the National Microbiology Reference Laboratory database, disaggregated pathogenic fungal isolates by the sex and age group of the patients, sample type, and isolated species, district, and year of isolation. Pathogenic fungal isolates were confirmed by culture and biochemical tests. Using Epi Info 7 software, we analyzed frequencies.
Results:
Among 8,136 clinical samples tested, fungal pathogens were isolated from 744 (9%) samples. Of these, the majority were obtained from female (92%), persons aged 16-35 years (68%). Most fungal pathogens (93.7%) were isolated from superficial clinical samples, while 6.3% from deep samples. High-vaginal swabs accounted for 71% of the clinical samples, with most cases from Kampala (32%) and Mbarara (26%) districts. The pathogenic fungal species identified included C. albicans (65.4%), non-albicans Candida spp. (30.6%) and C. neoformans (3.9%). We observed a sharp decline of identified pathogenic fungi from 299 (40%) in 2020-39 (5%) in 2024, reflecting diagnostic disruptions during the COVID-19 pandemic.
Conclusion:
Candida spp. were the most commonly isolated pathogenic fungi, mainly among females and individuals aged 16-35 years from Kampala and Mbarara districts. There is need for targeted interventions against candidiasis in these groups and locations. This study also highlights the gaps in fungal diagnostic capacity in Uganda, as the national database was limited to Candida and Cryptococcus, emphasizing the need for improved diagnostic infrastructure, capacity-building and surveillance to enhance detection of pathogenic fungi.
Insights
Pathogenic fungi, primarily Candida species, were identified in 9% of clinical samples in Uganda, predominantly affecting young females. Diagnostic capacity in Uganda needs enhancement to improve fungal infection detection.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Public Health Surveillance
Background:
- Pathogenic fungi cause millions of deaths globally, with inadequate diagnostics in resource-limited settings like Uganda.
- Fungal infections impact approximately 4 million people annually in Uganda, leading to severe invasive diseases if untreated.
- This study examines laboratory-confirmed fungal isolates from Uganda (2020-2024) to identify diagnostic capacity gaps.
Purpose of the Study:
- To describe laboratory-confirmed pathogenic fungal isolates from clinical samples in Uganda.
- To identify demographic and clinical characteristics of patients with fungal infections.
- To highlight limitations in current fungal diagnostic capacity in Uganda.
Main Methods:
- Data abstraction from the National Microbiology Reference Laboratory database (January 2020 - May 2024).
- Analysis of fungal isolates by patient sex, age, sample type, species, district, and year.
- Confirmation of isolates via culture and biochemical tests; frequency analysis using Epi Info 7 software.
Main Results:
- Fungal pathogens were isolated from 744 (9%) of 8,136 clinical samples.
- The majority of isolates were from females (92%), aged 16-35 years (68%), and from high-vaginal swabs (71%).
- Candida albicans (65.4%), non-albicans Candida spp. (30.6%), and Cryptococcus neoformans (3.9%) were identified; a significant decline in detection was noted during the COVID-19 pandemic.
Conclusions:
- Candida species are the most common fungal pathogens in Uganda, particularly among young females in Kampala and Mbarara.
- Targeted interventions for candidiasis are recommended for high-risk groups and locations.
- Significant gaps in Uganda's fungal diagnostic capacity necessitate improved infrastructure, training, and surveillance.
More Related Videos
06:58Author Spotlight: Evaluation of Entomopathogenic Fungi in Wild Monochamus alternatus Populations for Biocontrol Applications in Forest Wood Borers
Published on: September 29, 2023
07:58Use of Image Cytometry for Quantification of Pathogenic Fungi in Association with Host Cells
Published on: June 19, 2013
