Post-graduation Programme in Pathology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Molecular Biology Laboratory, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil.
Infectious Diseases Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Lancet Microbe. 2022 Jun;3(6):e464-e470. doi: 10.1016/S2666-5247(21)00190-7. Epub 2022 Jan 18.
Africa, although not unique in this context, is a favourable environment for fungal infections, given the high burden of risk factors. An online survey was developed asking about laboratory infrastructure and antifungal drug availability. We received 40 responses (24·4% response rate) of 164 researchers contacted from 21 African countries. Only five institutions (12·5%) of 40 located in Cameroon, Kenya, Nigeria, Sudan, and Uganda potentially fulfilled the minimum laboratory requirements for European Confederation of Medical Mycology Excellence Centre blue status. Difficulties included low access to susceptibility testing for both yeasts and moulds (available in only 30% of institutions) and Aspergillus spp antigen detection (available in only 47·5% of institutions as an in-house or outsourced test), as well as access to mould-active antifungal drugs such as amphotericin B deoxycholate (available for 52·5% of institutions), itraconazole (52·5%), voriconazole (35·0%), and posaconazole (5·0%). United and targeted efforts are crucial to face the growing challenges in clinical mycology.
非洲，尽管在这方面并非独一无二，但由于危险因素负担沉重，却是真菌感染的有利环境。我们开展了一项在线调查，询问有关实验室基础设施和抗真菌药物供应的情况。我们从联系的 164 位研究人员中收到了来自 21 个非洲国家的 40 份回复（回复率 24.4%）。在位于喀麦隆、肯尼亚、尼日利亚、苏丹和乌干达的 40 家机构中，仅有 5 家（12.5%）可能符合欧洲医学真菌联合会卓越中心蓝色标准的最低实验室要求。困难包括对酵母和霉菌的药敏试验（仅 30%的机构可进行）和曲霉菌属抗原检测（仅 47.5%的机构可作为内部或外包测试进行）的获取机会有限，以及获取多烯类抗真菌药物，如两性霉素 B 脱氧胆酸盐（52.5%的机构可获得）、伊曲康唑（52.5%）、伏立康唑（35.0%）和泊沙康唑（5.0%）的机会有限。需要采取联合和有针对性的措施来应对临床真菌学方面日益增长的挑战。
