Cryptococcosis in Colombia: Analysis of Data from Laboratory-Based Surveillance 2017-2024

Area of Science:

• Infectious Diseases
• Epidemiology
• Mycology

Background:

• Cryptococcosis is a serious fungal infection, particularly affecting immunocompromised individuals.
• Colombia has conducted a long-term laboratory-based survey on cryptococcosis since 1997.
• Understanding current epidemiological trends is crucial for public health interventions.

Purpose of the Study:

• To analyze the epidemiological characteristics of cryptococcosis in Colombia from 2017 to 2024.
• To identify changes in risk factors, patient demographics, and fungal species.
• To inform diagnostic and treatment strategies.

Main Methods:

• Analysis of 891 laboratory-confirmed cryptococcosis surveys from 2017-2024.
• Calculation of incidence rates stratified by HIV status.
• Identification of fungal species and molecular patterns.

Main Results:

• Overall incidence was 0.22/100,000; incidence in people living with HIV was 38/100,000.
• Higher prevalence in men (3.2:1). Younger adults (26-40) with HIV vs. older adults (≥60) without HIV.
• HIV was the main risk factor (63%), followed by other immunosuppression (21.2%). Neurocryptococcosis (62.2%) and disseminated disease (31.1%) were common.
• Cryptococcus neoformans (93.1%) predominated over Cryptococcus gatti (6.9%). VNI (92.4%) and VGII (45.3%) were dominant molecular types.

Conclusions:

• Colombian cryptococcosis epidemiology is shifting towards non-HIV-related immunosuppression in older adults.
• The findings underscore the need for continued surveillance and improved diagnostics.
• Public health strategies must adapt to evolving risk factors and patient populations.