Gugnani H C, Denning D W, Rahim R, Sadat A, Belal M, Mahbub M S
Department of Microbiology & Epidemiology, Saint James School of Medicine, British West Indies, Anguilla.
The University of Manchester and The National Aspergillosis Centre, University Hospital of South Manchester in association with the LIFE program at www.LIFE-Worldwide.org, Manchester, UK.
Eur J Clin Microbiol Infect Dis. 2017 Jun;36(6):993-997. doi: 10.1007/s10096-017-2921-z. Epub 2017 Feb 4.
In Bangladesh there are several published papers on superficial mycoses. Deep mycoses are also recognized as an important emerging problem. Here, we estimate the annual incidence and prevalence of serious fungal infections in Bangladesh. Demographic data were obtained from world population reports and the data on TB and HIV extracted from the online publications on tuberculosis in Bangladesh and Asia Pacific research statistical data information resources AIDS Data HUB. All the published papers on fungal infections in Bangladesh were identified through extensive search of literature. We estimated the number of affected people from populations at risk and local epidemiological data. Bangladesh has a population of ∼162.6 million, 31% children and only 6% over the age of 60 years. The pulmonary TB caseload reported in 2014 was 119,520, and we estimate a prevalence of 30,178 people with chronic pulmonary aspergillosis, 80% attributable to TB. An anticipated 90,262 and 119,146 patients have allergic bronchopulmonary aspergillosis or severe asthma with fungal sensitization. Only 8,000 people are estimated to be HIV-infected, of whom 2900 are not on ART with a CD4 count <350 μL, Pneumocystis pneumonia and cryptococcal meningitis being rare. Superficial mycoses are very common with Trichophyton rubrum as the predominant etiological agent (80.6%). Numerous cases of mycotic keratitis have been reported from several parts of Bangladesh. Candida bloodstream infection was estimated based on a 5 per 100,000 rate (8100 cases) and invasive aspergillosis based primarily on leukemia and COPD rates, at 5166 cases. Histoplasmosis was documented in 16 cases mostly with disseminated disease and presumed in 21 with HIV infection. This study constitutes the first attempt to estimate the burden of several types of serious fungal infections in Bangladesh.
在孟加拉国,有几篇关于浅表真菌病的已发表论文。深部真菌病也被认为是一个重要的新出现问题。在此,我们估计孟加拉国严重真菌感染的年发病率和患病率。人口数据来自世界人口报告,结核病和艾滋病毒数据从孟加拉国和亚太地区研究统计数据信息资源艾滋病数据中心关于结核病的在线出版物中提取。通过广泛检索文献,确定了孟加拉国所有已发表的关于真菌感染的论文。我们根据高危人群和当地流行病学数据估计了受影响人数。孟加拉国人口约1.626亿,31%为儿童,60岁以上人口仅占6%。2014年报告的肺结核病例数为119,520例,我们估计慢性肺曲霉病患病率为30,178人,其中80%归因于结核病。预计有90,262例和119,146例患者患有变应性支气管肺曲霉病或伴有真菌致敏的重度哮喘。估计只有8000人感染艾滋病毒,其中2900人未接受抗逆转录病毒治疗且CD4细胞计数<350 μL,肺孢子菌肺炎和隐球菌性脑膜炎较为罕见。浅表真菌病非常常见,红色毛癣菌是主要病原体(80.6%)。孟加拉国多个地区报告了大量真菌性角膜炎病例。念珠菌血流感染根据每10万人5例的发病率估计(8100例),侵袭性曲霉病主要根据白血病和慢性阻塞性肺疾病发病率估计,为5166例。记录到16例组织胞浆菌病,大多为播散性疾病,21例伴有艾滋病毒感染的患者疑似患有该病。本研究首次尝试估计孟加拉国几种严重真菌感染的负担。