Serious fungal infections in Ecuador.
There is a dearth of data from Ecuador on the burden of life-threatening fungal disease entities; therefore, we estimated the burden of serious fungal infections in Ecuador based on the populations at risk and available epidemiological databases and publications. A full literature search was done to identify all epidemiology papers reporting fungal infection rates. WHO, ONU-AIDS, Index Mundi, Global Asthma Report, Globocan, and national data [Instituto Nacional de Estadística y Censos (INEC), Ministerio de Salud Pública (MSP), Sociedad de Lucha Contra el Cáncer (SOLCA), Instituto Nacional de Donación y Trasplante de Órganos, Tejidos y Células (INDOT)] were reviewed. When no data existed, risk populations were used to estimate frequencies of fungal infections, using previously described methodology by LIFE. Ecuador has a variety of climates from the cold of the Andes through temperate to humid hot weather at the coast and in the Amazon basin. Ecuador has a population of 15,223,680 people and an average life expectancy of 76 years. The median estimate of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) population at risk for fungal disease (<200 CD4 cell counts) is ∼10,000, with a rate of 11.1% (1100) of histoplasma, 7% (700) of cryptococcal meningitis, and 11% (1070) of Pneumocystis pneumonia. The burden of candidemia is 1037. Recurrent Candida vaginitis (≥4 episodes per year) affects 307,593 women aged 15-50 years. Chronic pulmonary aspergillosis probably affects ∼476 patients following tuberculosis (TB). Invasive aspergillosis is estimated to affect 748 patients (∼5.5/100,000). In addition, allergic bronchopulmonary aspergillosis (ABPA) in asthma and severe asthma with fungal sensitization (SAFS) were estimated to affect 26,642 and 45,013 people, respectively. Our estimates indicate that 433,856 (3%) of the population in Ecuador is affected by serious fungal infection.
Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador. jzurita@zuritalaboratorios.com.|Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador. jzurita@zuritalaboratorios.com.
J
J
Zurita
National Aspergillosis Centre, University Hospital of South Manchester and University of Manchester, Manchester, UK.
D W
DW
Denning
Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador.
A
A
Paz-Y-Miño
Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador.
M B
MB
Solís
Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.
L M
LM
Arias
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D055815:Young Adult