Medina N, Samayoa B, Lau-Bonilla D, Denning D W, Herrera R, Mercado D, Guzmán B, Pérez J C, Arathoon E
Asociación de Salud Integral, Guatemala City, Guatemala.
Universidad de San Carlos de Guatemala, Guatemala City, Guatemala.
Eur J Clin Microbiol Infect Dis. 2017 Jun;36(6):965-969. doi: 10.1007/s10096-017-2920-0. Epub 2017 Feb 27.
Guatemala is a developing country in Central America with a high burden of HIV and endemic fungal infections; we attempted to estimate the burden of serious fungal infections for the country. A full literature search was done to identify epidemiology papers reporting fungal infections from Guatemala. We used specific populations at risk and fungal infection frequencies in the population to estimate national rates. The population of Guatemala in 2013 was 15.4 million; 40% were younger than 15 and 6.2% older than 60. There are an estimated 53,000 adults with HIV infection, in 2015, most presenting late. The estimated cases of opportunistic fungal infections were: 705 cases of disseminated histoplasmosis, 408 cases of cryptococcal meningitis, 816 cases of Pneumocystis pneumonia, 16,695 cases of oral candidiasis, and 4,505 cases of esophageal candidiasis. In the general population, an estimated 5,568 adult asthmatics have allergic bronchopulmonary aspergillosis (ABPA) based on a 2.42% prevalence of asthma and a 2.5% ABPA proportion. Amongst 2,452 pulmonary tuberculosis patients, we estimated a prevalence of 495 for chronic pulmonary aspergillosis in this group, and 1,484 for all conditions. An estimated 232,357 cases of recurrent vulvovaginal candidiasis is likely. Overall, 1.7% of the population are affected by these conditions. The true fungal infection burden in Guatemala is unknown. Tools and training for improved diagnosis are needed. Additional research on prevalence is needed to employ public health measures towards treatment and improving the reported data of fungal diseases.
危地马拉是中美洲的一个发展中国家，艾滋病病毒负担沉重，真菌传染病呈地方性流行；我们试图估算该国严重真菌感染的负担。通过全面的文献检索来查找报告危地马拉真菌感染情况的流行病学论文。我们利用特定的高危人群以及人群中的真菌感染频率来估算全国发病率。2013年危地马拉人口为1540万；40%年龄在15岁以下，6.2%年龄在60岁以上。据估计，2015年有53000名成人感染艾滋病病毒，大多数就诊时已处于疾病晚期。机会性真菌感染的估计病例数为：播散性组织胞浆菌病705例、隐球菌性脑膜炎408例、肺孢子菌肺炎816例、口腔念珠菌病16695例以及食管念珠菌病4505例。在普通人群中，基于哮喘患病率2.42%以及变应性支气管肺曲霉病（ABPA）比例2.5%，估计有5568名成年哮喘患者患有ABPA。在2452例肺结核患者中，我们估计该组慢性肺曲霉病患病率为495例，所有病症患病率为1484例。复发性外阴阴道念珠菌病估计可能有232357例。总体而言，1.7%的人口受这些病症影响。危地马拉真正的真菌感染负担尚不清楚。需要用于改善诊断的工具和培训。需要对患病率进行更多研究，以便采取公共卫生措施进行治疗并改善真菌疾病的报告数据。
