Epidemiologic Aspects of Fungal Infections (Tom M. Chiller, Section Editor)

Current Fungal Infection Reports

, Volume 5, Issue 4, pp 224-232

Neglected Fungal Diseases in Sub-Saharan Africa: A Call to Action

  • Nelesh P. GovenderAffiliated withCentre for Opportunistic, Tropical and Hospital Infections, National Institute for Communicable Diseases, a division of the National Health Laboratory Service Email author 
  • , Tom M. ChillerAffiliated withMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infections, Centers for Disease Control and Prevention
  • , Bhavani PoonsamyAffiliated withCentre for Opportunistic, Tropical and Hospital Infections, National Institute for Communicable Diseases, a division of the National Health Laboratory Service
  • , John A. FreanAffiliated withCentre for Opportunistic, Tropical and Hospital Infections, National Institute for Communicable Diseases, a division of the National Health Laboratory Service

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Abstract

Despite the considerable morbidity and mortality associated with fungal diseases in sub-Saharan Africa, it is notable that these diseases have been omitted from an expanded list of neglected tropical diseases. Inextricably tied together with HIV/AIDS and tuberculosis in sub-Saharan Africa, important fungal diseases such as cryptococcal meningitis and Pneumocystis jirovecii pneumonia (PCP) manifest as relatively common and deadly AIDS-defining opportunistic infections, often masked by and comorbid with tuberculosis. Others, such as mycetoma, which manifest as a debilitating and deforming illness primarily affecting rural adults, directly affect the socioeconomic productivity of rural communities. Lack of adequate diagnostic tests makes identifying the true disease burden due to fungal diseases difficult. To highlight the devastating impact of fungal diseases on the health and socioeconomic circumstances of sub-Saharan Africa’s poorest people and to increase the profile of efforts to control and prevent these diseases, we propose that the following fungal diseases be added to the list of neglected tropical diseases: cryptococcal meningitis, PCP, mycetoma, histoplasmosis, sporotrichosis, and blastomycosis. By outlining the prevalence, distribution, and disease burden of these fungal diseases in sub-Saharan Africa in this review, we hope to provide information to prioritize strategies for detection, control, and prevention of the neglected fungal diseases.

Keywords

Neglected fungal diseases Fungal infection Africa Sub-Saharan Resource-limited settings Cryptococcus neoformans Cryptococcal meningitis Histoplasma capsulatum Histoplasmosis Blastomyces dermatitidis Blastomycosis Sporothrix schenckii Sporotrichosis Madurella mycetomatis Mycetoma Eumycetoma Pneumocystis jirovecii, PCP Opportunistic infections Prevalence Distribution