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. 2011 Sep;85(3):546-50.
doi: 10.4269/ajtmh.2011.11-0084.

Paracoccidioidomycosis epidemiological features of a 1,000-cases series from a hyperendemic area on the southeast of Brazil

Fernando Bellissimo-Rodrigues  1 , Alcyone Artioli Machado, Roberto Martinez
Affiliations

Paracoccidioidomycosis epidemiological features of a 1,000-cases series from a hyperendemic area on the southeast of Brazil

Fernando Bellissimo-Rodrigues et al. Am J Trop Med Hyg. 2011 Sep.

Abstract

Paracoccidioidomycosis has been known for over 100 years, and until now, there were only few estimates of the disease's incidence. We aim to analyze 1,000 cases treated between 1960 and 1999 at Ribeirão Preto city, São Paulo, Brazil, where the disease's incidence range detected was 1.6 to 3.7 cases per 100,000 habitants per year (mean = 2.7 cases/year). We observed a male to female ratio of 6:1 and an age distribution from 3 to 85 years. The acute/subacute form of the disease accounted for 25.4% of cases. Most of the patients (93.5%) had lived or worked in rural areas before the disease development. Smoking and alcoholism were reported by 64.7% and 37.2% of patients, respectively. Comorbidities identified included tuberculosis (8.3%), Chagas' disease (8.6%), and human immunodeficiency virus/acquired immunodeficiency syndrome (4.2%). The present study revealed an area in Brazil where paracoccidioidomycosis is hyperendemic (has the highest reported incidence of this disease); this endemic area is probably caused by geological and climatic conditions as well as intensive agriculture.

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Figures

Figure 1.
Figure 1.
Geographic area where most of the 1,000 patients with paracoccidioidomycosis lived (Brazil 1960–1999). The grey mark delimits Ribeirão Preto State district. MG = Minas Gerais State; SP = São Paulo State.
Figure 2.
Figure 2.
Paracoccidioidomycosis incidence per 100,000 habitants on Ribeirão Preto State district from 1980 to 1999.
Figure 3.
Figure 3.
Age distribution of 1,000 patients with paracoccidioidomycosis according to the clinical form presented (Brazil 1960–1999). • = acute/subacute form; ▪ = chronic form; ▴ = all patients.
See this image and copyright information in PMC

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