title: Burden of serious fungal infections in Tanzania.
abstract: The incidence and prevalence of fungal infections in Tanzania remains unknown. We assessed the annual burden in the general population and among populations at risk. Data were extracted from 2012 reports of the Tanzanian AIDS program, WHO, reports, Tanzanian census, and from a comprehensive PubMed search. We used modelling and HIV data to estimate the burdens of Pneumocystis jirovecii pneumonia (PCP), cryptococcal meningitis (CM) and candidiasis. Asthma, chronic obstructive pulmonary disease and tuberculosis data were used to estimate the burden of allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). Burdens of candidaemia and Candida peritonitis were derived from critical care and/or cancer patients' data. In 2012, Tanzania's population was 43.6 million (mainland) with 1,500,000 people reported to be HIV-infected. Estimated burden of fungal infections was: 4412 CM, 9600 PCP, 81,051 and 88,509 oral and oesophageal candidiasis cases respectively. There were 10,437 estimated post-tuberculosis CPA cases, whereas candidaemia and Candida peritonitis cases were 2181 and 327 respectively. No reliable data exist on blastomycosis, mucormycosis or fungal keratitis. Over 3% of Tanzanians suffer from serious fungal infections annually, mostly related to HIV. Cryptococcosis and PCP are major causes of mycoses-related deaths. National surveillance of fungal infections is urgently needed.
authors.affiliation: Ifakara Health Institute, Dar es Salaam, Tanzania.
authors.forename: Diana
authors.initials: D
authors.lastname: Faini
authors.affiliation: National AIDS Control Program, Dar es Salaam, Tanzania.
authors.forename: Werner
authors.initials: W
authors.lastname: Maokola
authors.affiliation: Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Hansjakob
authors.initials: H
authors.lastname: Furrer
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Hatz
authors.affiliation: University of Basel, Basel, Switzerland.|Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Battegay
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.affiliation: The National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Denning
authors.affiliation: Ifakara Health Institute, Dar es Salaam, Tanzania.|Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.|ISGLOBAL, Barcelona Ctr. Int. Health Res (CRESIB), Hospital Clinic - Universitat de Barcelona, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Letang
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
keywords: Fungal infections; HIV/AIDS; Tanzania; cryptococcal meningitis; epidemiology