Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, NC, USA.
Department of Medicine, Hanoi Medical University, Hanoi, Vietnam; Oxford University Clinical Research Unit, Hanoi, Vietnam.
Lancet Glob Health. 2021 Nov;9(11):e1618-e1622. doi: 10.1016/S2214-109X(21)00350-8.
Talaromycosis (penicilliosis) is an invasive mycosis that is endemic in tropical and subtropical Asia. Talaromycosis primarily affects individuals with advanced HIV disease and other immunosuppressive conditions, and the disease disproportionally affects people in low-income and middle-income countries, particularly agricultural workers in rural areas during their most economically productive years. Approximately 17 300 talaromycosis cases and 4900 associated deaths occur annually. Talaromycosis is highly associated with the tropical monsoon season, when flooding and cyclones can exacerbate the poverty-inducing potential of the disease. Talaromycosis can present as localised or disseminated disease, the latter causing cutaneous lesions that are disfiguring and stigmatising. Despite up to a third of diagnosed cases resulting in death, talaromycosis has received little attention and investment from regional and global funders, policy makers, researchers, and industry. Diagnostic and treatment modalities remain extremely insufficient, however control of talaromycosis is feasible with known public health strategies. This Viewpoint is a global call for talaromycosis to be recognised as a neglected tropical disease to alleviate its impact on susceptible populations.
足放线菌病(青霉病)是一种地方性热带和亚热带真菌感染。足放线菌病主要影响晚期 HIV 感染者和其他免疫抑制人群,在中低收入国家,特别是在农村地区,足放线菌病在经济生产力最高的年龄段人群中发病率过高。每年约有 17300 例足放线菌病病例和 4900 例相关死亡。足放线菌病与热带季风季节高度相关,洪水和旋风会加剧疾病的致贫潜力。足放线菌病可表现为局部或播散性疾病,后者会导致皮肤损伤,造成毁容和污名化。尽管多达三分之一的确诊病例导致死亡,但足放线菌病几乎没有受到区域和全球供资者、决策者、研究人员和行业的关注和投资。诊断和治疗方式仍然非常不足,但是可以通过已知的公共卫生策略来控制足放线菌病。本观点呼吁将足放线菌病确认为被忽视的热带病,以减轻其对易感人群的影响。