Study reveals huge extent of fungaldisease in India AdmissionsUoM
We estimated a total of 57 250 826 patients to be affected by serious fungal diseases in India. Around 4.1% of the Indian population is probably affected, which is similar to reports from other countries like China, Brazil, Korea, Senegal, and Germany . This total burden of serious fungal infections is >10 times the annual incidence of tuberculosis in India, indicating an enormous population of patients affected by fungal diseases.
Overall, our estimates are probably conservative. Candidemia represents only 40% of invasive candidiasis, as blood cultures are not very sensitive, and even less so in patients already on antifungal therapy. A possible reason for the high proportion of candidemia in non-ICU patients may be a shortage of ICU beds that leads to care of critically ill patients in general wards.
However, it could be argued that we may have overestimated the burden of some groups of patients. Although IA burden was estimated in hematological malignancies, COPD, HIV, and transplant patients, the largest proportion was COPD patients , which is barely documented in India. Our new methodology for estimating CPA needs epidemiological validation in India. We have taken a 5% proportion of adult asthmatics as having ABPA, but on the other hand, the overall asthma prevalence was estimated at 2.
Our estimate for CPA includes consideration of those misdiagnosed as tuberculosis, who had a dual infection with tuberculosis, CPA arising during anti-tuberculous treatment, as well as those left with cavitation following successful therapy to treat tuberculosis. The current estimate of incidence and 5-year prevalence is ∼5 times the previous estimate [].
Besides India having a very high baseline incidence of mucormycosis, the recent COVID-19 pandemic led to a massive surge of CAM cases, leading to substantial morbidity and mortality. The possible reasons suggested include excessive systemic steroids given for COVID-19 and prolonged use of masks and “repeated” nasopharyngeal swabbing, complicating newly occurring and/or uncontrolled diabetes [
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