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. 2022 Dec 26;9(12):ofac603.
doi: 10.1093/ofid/ofac603. eCollection 2022 Dec.

Burden of Serious Fungal Infections in India

Animesh Ray  1 , Adarsh Aayilliath K  1 , Sayantan Banerjee  2 , Arunaloke Chakrabarti  3 , David W Denning  4   5
Affiliations

Burden of Serious Fungal Infections in India

Animesh Ray et al. Open Forum Infect Dis. .

Abstract

Background: Fungal disease is frequent in India, but its incidence and prevalence are unclear. This review aims at defining the frequency or burden of various fungal infections in India.

Methods: A systematic review of the literature on the PubMed, Embase, and Web of Science (WOS) databases was conducted using appropriate search strings. Deterministic modeling determined annual incidence and prevalence estimates for multiple life- and sight-threatening infections with significant morbidity.

Results: Literature searches yielded >2900 papers; 434 papers with incidence/prevalence/proportion data were analyzed. An estimated 57 251 328 of the 1 393 400 000 people in India (4.1%) suffer from a serious fungal disease. The prevalence (in millions) of recurrent vulvovaginal candidiasis is 24.3, allergic bronchopulmonary aspergillosis is 2.0, tinea capitis in school-age children is 25, severe asthma with fungal sensitization is 1.36, chronic pulmonary aspergillosis is 1.74, and chronic fungal rhinosinusitis is 1.52. The annual incidence rates of Pneumocystis pneumonia (58 400), invasive aspergillosis (250 900), mucormycosis (195 000), esophageal candidiasis in HIV (266 600), candidemia (188 000), fungal keratitis (1 017 100), and cryptococcal meningitis (11 500) were also determined. Histoplasmosis, talaromycosis, mycetoma, and chromoblastomycosis were less frequent.

Conclusions: India's fungal burden is high and underappreciated in clinical practice.

Keywords: Aspergillus; Candida; Cryptococcus; Pneumocystis; histoplasmosis; mycetoma; sporotrichosis; tinea capitis.

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Figures

Figure 1.
Figure 1.
Flowchart showing the methodology adopted for estimating the fungal incidence and prevalence in the Indian population. Abbreviations: CPA, chronic pulmonary aspergillosis; PTB, pulmonary tuberculosis; TB, tuberculosis.
Figure 2.
Figure 2.
A, Published reports of histoplasmosis by state of residence of patients. B, Published reports of histoplasmosis according the authors’ institution, by state.
Figure 3.
Figure 3.
Figure showing the calculations involved in deriving new CPA cases (arising 12 months after TB therapy) in HIV+ & HIV- population.
See this image and copyright information in PMC

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