Khwakhali Ushana Shrestha, Denning David W
Department of Microbiology, Amrit Campus, Tribhuvan University, Kathmandu, Nepal.
National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester, Manchester, UK.
Mycoses. 2015 Oct;58 Suppl 5:45-50. doi: 10.1111/myc.12393.
There are few reports of serious fungal infections in Nepal though the pathogenic and allergenic fungi including Aspergillus species are common in the atmosphere. Herein, we estimate the burden of serious fungal infections in Nepal. All published papers reporting fungal infection rates from Nepal were identified. When few data existed, we used specific populations at risk and fungal infection frequencies in those populations to estimate national incidence or prevalence. Of the 27.3 M population, about 1.87% was estimated to suffer from serious fungal infections annually. We estimated the incidence of fungal keratitis at 73 per 100,000 annually. Chronic obstructive pulmonary disease is common with 215,765 cases, contributing to 1119 cases of invasive aspergillosis annually. Of 381,822 adult asthma cases, we estimated 9546 patients (range 2673-13,364) develop allergic bronchopulmonary aspergillosis and 12,600 have severe asthma with fungal sensitisation. Based on 26,219 cases of pulmonary tuberculosis, the annual incidence of new chronic pulmonary aspergillosis (CPA) cases was estimated at 1678 with a 5 year period prevalence of 5289, 80% of CPA cases. Of 22,994 HIV patients with CD4 counts <350 not on antiretrovirals, Pneumocystis pneumonia was estimated at 990 cases annually. Cases of oral and oesophageal candidiasis in HIV/AIDS patients were estimated at 10,347 and 2950, respectively. There is a significant burden of serious fungal infections in Nepal. Epidemiological studies are necessary to validate these estimates.
尽管包括曲霉菌属在内的致病性和致敏性真菌在尼泊尔的大气中很常见，但关于尼泊尔严重真菌感染的报道却很少。在此，我们估算了尼泊尔严重真菌感染的负担。我们检索了所有已发表的报道尼泊尔真菌感染率的论文。当数据较少时，我们使用特定的高危人群及其真菌感染频率来估算全国的发病率或患病率。在尼泊尔2730万人口中，估计每年约有1.87%的人患有严重真菌感染。我们估计真菌性角膜炎的年发病率为每10万人中有73例。慢性阻塞性肺疾病很常见，有215765例病例，每年导致1119例侵袭性曲霉病。在381822例成人哮喘病例中，我们估计有9546例患者（范围为2673 - 13364例）发生变应性支气管肺曲霉病，12600例患有严重哮喘并伴有真菌致敏。基于26219例肺结核病例，新发性慢性肺曲霉病（CPA）的年发病率估计为1678例，5年期间患病率为5289例，占CPA病例的80%。在22994例CD4细胞计数<350且未接受抗逆转录病毒治疗的HIV患者中，估计每年有990例肺孢子菌肺炎病例。HIV/AIDS患者的口腔念珠菌病和食管念珠菌病病例估计分别为10347例和2950例。尼泊尔严重真菌感染的负担很重。需要进行流行病学研究来验证这些估算结果。
