The Current State of Clinical Mycology in Africa: A ECMM and ISHAM survey

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Cândida Driemeyer
  • Diego R. Falci
  • Rita Oladele
  • Felix Bongomin
  • Nelesh P. Govender
  • Martin Hoenigl
  • Jean-pierre Gangneux
  • Cornelia Lass-Flörl
  • Oliver A Cornely
  • Alexandre Alanio
  • Jesus Guinea
  • C Orla Morrissey
  • Arunaloke Chakrabarti
  • Jacques F Meis
  • Caroline Bruns
  • Jannik Stemler
  • Alessandro C Pasqualotto

Abstract

Africa is a favourable environment for fungal infections, given the high burden of risk factors. An online survey was developed asking about antifungal drug availability and laboratory infrastructure. We received 40 responses (24.4% response rate) from 21 African countries. Only five institutions (12·5%) located in Cameroon, Kenya, Nigeria, Sudan, and Uganda potentially fulfil the minimum laboratory requirements for ECMM Excellent Centres Blue status. Difficulties included lack of access to susceptibility testing for both yeasts and moulds (available in 30% of institutions), and Aspergillus antigen detection (available in 47.5% of institutions as in- house or outsourced test), as well as access to mould-active antifungal drugs such as amphotericin B deoxycholate, itraconazole, voriconazole and posaconazole (available for 52·5%, 52·5%, 35·0% and 5.0% of institutions, respectively). United and targeted efforts are mandatory to face the growing challenges in medical mycology.

Keywords
Africa; fungal infection; mycology; diagnosis; laboratory; access; low and middle-income countries (LMIC); treatment; antifungals; serology; susceptibility testing.

Bibliographical metadata

Original languageEnglish
JournalThe Lancet. Microbe
Publication statusAccepted/In press - 24 Dec 2021

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