Using published data, we were able to estimate the incidence or prevalence of the above referred fungal infections and ~194 293 (1.8%) people in Portugal suffer from those fungal infections each year

Denning, D.

Pais, C.

Sabino, Raquel

Veríssimo, Cristina

Mycoses

Repositório Científico do Instituto Nacional de Saúde

here are the most frequent mycoses – superficial. Invasive mycosesare dominated by aspergillosis and candidosis.P211The burden of serious fungal infections in PortugalR. F. P. Sabino,1 C. Verıssimo,1 C. S. Pais2 and D. Denning31National Institute of Health Dr. Ricardo Jorge, Lisboa, Portugal;2University of Minho, Braga, Portugal and 3The University ofManchester and National Aspergillosis Centre, Manchester,United KingdomObjectives We here attempt the first estimate of the burden of seri-ous fungal disease in Portugal using deterministic scenario modellingand published incidence and prevalence data.Methods Published epidemiology papers reporting fungal infectionrates from Portugal were identified. Where no data existed, we usedspecific populations at risk and fungal infection frequencies in thosepopulations to estimate national incidence or prevalence, dependingon the condition. Population statistics were derived from the Statis-tics Portugal and the population census (2011). The incidence andprevalence of fungal infections affecting HIV patients were obtainedfrom the report on HIV/AIDS 2013 published by the National HealthInstitute Doutor Ricardo Jorge, I.P. The total number of transplantswas obtained from the Authority for Blood Services and Transplanta-tion (data from 2011). Data on respiratory infections were recoveredand inferred from the WHO data on TB.Results The population of Portugal in 2011 was 10.56M, with 75%>15 years of age. An estimated 150 000 women (15–50) suffer fromrecurrent vulvovaginal candidiasis each year. We have not estimatedoral or oesohphageal candidiasis rates. Candidaemia affects 0.88/1000 hospital admissions or approximately 8.1/100 000 patients, atotal of 856 cases nationally. An estimated 150 patient developintra-abdominal candidiasis, post-operatively. Invasive aspergillosis isless common than other countries as COPD is uncommon in Portu-gal, a total of 180 cases annually. An estimated 69 patients developchronic pulmonary aspergillosis after TB each yearSo, assuming a15% annual mortality and surgical resection rate, the prevalence is218 cases following TB, whereas the prevalence of chronic pul-monary aspergillosis for all underlying pulmonary conditions was654 patients. In contrast, asthma rates are high and so an estimated23 198 SAFS episodes (220 cases/100 000), 17 586 ABPA episodes(167/100 000). 81 patients developed pneumocystis pneumonia inAIDS and 16 cryptococcosis. Data on dermatophytosis and fungalkeratitis were not included in this study.Conclusion Using published data, we were able to estimate the inci-dence or prevalence of the above referred fungal infections and~194 293 (1.8%) people in Portugal suffer from those fungal infec-tions each year. Vaginal candidiasis was the most frequent fungalinfection detected in this study. Further inclusion of dermatomycosisdata will largely increase the incidence and prevalence of fungalinfections. This is a preliminary study but constitutes the first reporton the global burden of fungal infections in Portugal. Further studiesbased on local surveys are required to obtain more precise and com-plete data.P212The burden of serious fungal infections in VenezuelaM. Dolande,1 M. Panizo,1 A. Alastruey-Izquierdo2 andD. Denning31Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela;2Spanish National Centre for Microbiology, Instituto de SaludCarlos III, Majadahonda, Spain and 3The University ofManchester and National Aspergillosis Centre, Manchester,United KingdomIntroduction Venezuela is just north of the equator and has highrates of endemic fungal infections, HIV and hospital infections. Theburden of fungal infection in Venezuela is not known, despite someepidemiological studies. This is the first estimate of the burden of seri-ous fungal disease in Venezuela.Methods We have used deterministic scenario modelling and pub-lished incidence and prevalence data on both underlying diseasesand fungal infection rates from Venezuela to estimate burden. Whereno data existed, we used specific populations at risk and fungal infec-tion frequencies in those populations to estimate burden. Populationstatistics were derived from the Instituto Nacional de Estadıstica(http://www.ine.gov.ve). Data on respiratory infections were obtainedand inferred from the WHO data on TB.Results In 2011, the population of Venezuela was 29.44M, with71% >15 years of age, and about 9% >60 years of age. An estimated474 720 women (15-50) suffer from recurrent vulvovaginal candidi-asis each year. Of the 110 000 HIV positive patients, an estimated59 000 have CD4 counts <350, and 14 700 are at high risk ofinfection. We estimate that 2699 develop PCP Pneumocystis pneumo-nia in AIDS, 693 cryptococcosis and 1746 disseminated histoplasmo-sis, in AIDS. There are an estimated 3800 deaths from AIDSannually. Candidaemia is relatively common with affects 1.72/1000hospital admissions or approximately 16/100 000 patients, a total of4798 cases nationally. An estimated 824 patient develop intra-ab-dominal candidiasis post-operatively. Invasive aspergillosis is thoughtto affect 1143 people each year. An estimated 226 patients developchronic pulmonary aspergillosis after TB each year, a prevalence of711 cases and overall 1422 patients. Assuming ABPA affects 2.5%of adult asthmatics, 33 440 cases are likely and 44 141 SAFS cases.Data on dermatophytosis were not included in this study and thereare few data on fungal keratitis, mucormycosis, coccidioidomycosisand paracoccidioidomycosis.Conclusion Over 565 685 Venezuleans are affected by serious fun-gal disease annually, with many deaths. Further studies based onlocal surveys are required to obtain more precise and complete data.Table 1Table 1ª 2015 The AuthorsMycoses ª 2015 Blackwell Verlag GmbH, 58 (Suppl. 4), 51–226 127Poster Presentations

The burden of serious fungal infections in Portugal

Abstract

Similar works

Full text

Available Versions

Repositório Científico do Instituto Nacional de Saúde

Scientific Repository of the National Health Institute Doutor Ricardo Jorge